Medial Epicondylitis Part 1

Medial epicondylitis is a common condition which affects the inside of the elbow around the ‘funny bone’ area.…
Tom Eather

Tom Eather

Senior Physiotherapist and Clinical Educator

Physio Bio

Medial epicondylitis is a common condition which affects the inside of the elbow around the ‘funny bone’ area. You may have heard of it referred to as ‘Golfer’s elbow’, but although it does present in lots of golfers, it doesn’t mean non-golfers aren’t affected. Golfer’s elbow is at its most basic, as most non-acute tendon issues are, an overload and capacity problem.

Tendons, which are the link between muscles and bones, are vital in allowing us to move, and they are generally pretty robust structures. The shape and size of a given tendon will vary depending on the role that tendon plays and the movements it helps to produce. For instance, an achilles tendon acts very much like a spring or bungee cord so it is round and thick. The common forearm flexor tendon, which is made up from the tendons of a number of forearm muscles (pictured), acts more as a stabiliser to the medial elbow so it is more flat and wide.

As we touched on earlier, Golfer’s elbow is an overload issue. It usually stems from a sharp increase in the amount of activity that the forearm flexor muscles do on a day-to-day, or week-to-week basis. This usually takes the form of lots of gripping activities – e.g. golf or swing based sports, baseball or throwing sports, gym based activities or even doing too much gardening or chopping in the kitchen!

The issue is not participating in these activities, it is doing too much in a short period of time. Overload and adaptation is how we build muscle, bone and tendons to become stronger and more resilient; However, consistently overloading a tendon and not giving it adequate time to adapt, will result in an ‘angry’ and sore tendon. 

As with most tendinopathies, Golfer’s elbow will tend to be more irritable in the morning when first activating or gripping things, such as the kettle. It will usually improve with more activity, then return in the evening once you’ve ‘cooled down’. Similarly, sufferers will also feel it at the start of a golf round or gym session – it will improve when playing/working out – and then may return after the round/session. It often feels quite sharp and specific to the inside of the elbow when gripping or carrying things, and is more of a broad ache when not using your forearm muscles. 

So that’s a quick overview of ‘Golfer’s Elbow’ in part one of this series, look out for part two where we will go through some common treatments for this pathology.

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