Medial Epicondylalgia (Golfers Elbow) | Plenty Physiotherapy, Bundoora

Medial Epicondylalgia (Golfers Elbow) Document

Medial epicondylalgia is a tendinopathy of the common flexor tendon at the medial epicondyle of the humerus. It  most often involves: • Flexor carpi radialis (FCR) • Pronator teres • Sometimes includes palmaris longus, flexor carpi  ulnaris (FCU), and flexor digitorum superficialis  (FDS) It results from overuse or repetitive stress, particularly involving wrist flexion, pronation, and gripping movements. his region of the forearm is the common flexor origin (where  all the wrist flexors meet at this point on the humerus). This  condition often causes pain and tenderness at the inside region of the elbow.  Despite the term ‘-itis’ (in some diagnosis), it is not primarily  inflammatory. Rather, it is a tendinopathy characterised by: - Collagen disorganisation - Angiofibroblastic hyperplasia - Increased tendon load sensitivity Contributing Factors:A) Repetitive movements: Activities which involve repetitive wrist flexion and high  amounts of hand gripping, such as using tools, racquet sports, and golf, can  lead to the overload and strain of the wrist flexor tendons and therefore lead to  medial epicondylalgia.  Poor ergonomics: Poor work environment, poor equipment, ergonomic design  and poor technique during daily tasks and sports can increase stress on the  tendons and initiate or worsen these conditions.  C) Age-related: Over time as people age, tendons become less flexible and more  rigid, therefore increasing the risk of tendon micro-traumas and injuries such as  medial epicondylalgia. Males tend to be affected more than females for this  condition.  D) Decreased Strength: Decreased muscle deficits in the forearm muscles, more  specifically the wrist flexors, can increase loads into the tendon potentially  increasing the risk of developing medial epicondylalgia.Treatment/management:  1) Activity modifications: Identifying aggravating factors and avoiding or reducing  these will reduce irritation and minimise the cycle of potential inflammation  which can help with pain reduction and healing.  2) Exercise-based rehab: Strengthening the wrist flexor muscles and surrounding  upper limb muscles will help support the injured tendon but also increase the  capacity and load in which the tendon can withstand for future physical  demands. This will help with recovery and minimising future injuries.3) Bracing/Taping: Using golfer elbow specific braces can help support the injured  tendon and distribute/shift some of the forces away from the tendon's  attachment point in the elbow. This helps support the area to de-load, heal and  reduce pain.  4) Manual therapy: Soft tissue work to release the forearm muscle and other  surrounding soft tissue as well as joint mobilisations of the radioulnar joint can  help with pain, facilitating normal movement and healing. Dry needling can be  an option for trigger point release in the muscle of the target tissue. Shockwave therapy is also another great intervention