Elbow exercises for pain (Golfer’s elbow)

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SOURCE: Golfer’s elbow. From Wikipedia, the free encyclopedia

Golfer’s elbow, or medial epicondylitis, is an inflammatory condition of the elbow which in some ways is similar to tennis elbow.

The anterior forearm contains several muscles that are involved with flexing the fingers and thumb, and flexing and pronating the wrist. The tendons of these muscle come together in a common tendinous sheath which is inserted into the medial epicondyle of the humerus at the elbow joint. In response to minor injury, or sometimes for no obvious reason at all, this point of insertion becomes inflamed.

Treatment

Non-specific palliative treatments include:

1. Non-steroidal anti-inflammatory drugs (NSAIDs): ibuprofen, naproxen or aspirin
2. Heat or ice
3. A counter-force brace or “elbow strap” to reduce strain at the elbow epicondyle, to limit pain provocation and to protect against further damage.

Before anesthetics and steriods are used, conservative treatment with an occupational therapist is attempted. Before therapy can commence, treatment such as the common rest, ice, compression and elevation (R.I.C.E.) will typically be used. This will help to decrease the pain and inflammation. The rest will help with the discomfort seeing as how Golfer’s Elbow is an overuse injury. The patient can use a tennis elbow splint for compression. A pad can be placed anteromedially on the proximal forearm. ^[2] The splint is made in 30-45 degrees of elbow flexion. A daytime elbow pad also may be useful, by limiting additional trauma to the nerve.

Therapy will include a variety of exercises for muscle/tendon reconditioning, starting with stretching and gradual strengthening of the flexor-pronator muscles. Strengthening will slowly begin with isometrics and pregresses to eccentric exercises helping to extend the range of motion back to where it once was. After the strengthening exercises, it is common for the patient to ice the area.^[3]

Simple analgesic medication has a place, as does more specific treatment with oral anti-inflammatory medications (NSAIDs). These will help control pain and any inflammation.^[4] A more invasive treatment is the injection into and around the inflamed and tender area of a long-acting glucocorticoid (steroid) agent. After causing an initial exacerbation of symptoms lasting 24 to 48 hours, this may produce a resolution of the condition in some five to seven days.^[citaThe ulnar nerve runs in the groove between the medial humeral epicondyle and the olecranon process of the ulna. It is most important that this nerve should not be damaged accidentally in the process of injecting a Golfer’s Elbow.

If all else fails, epicondylar debridement (a surgery) may be effective.^{[citation needed]} The ulnar nerve may also be decompressed surgically. ^[5]

The overall prognosis is good. Few patients will need to progres to steroid injection and even fewer, less than 10%, will need surgical intervention

Tags: Bursitis, Elbow, Inflammation, Olecranon bursitis, Tennis elbow