Epicondylitis: Golfer’s Elbow and Tennis Elbow
Tennis elbow (lateral epicondylitis) and golfer’s elbow (medial epicondylitis), are painful elbow conditions that can significantly affect your day-to-day life. If you’re living with elbow pain, you don’t have to wait for answers or treatment. With locations throughout the Minneapolis / Saint Paul area, Summit Orthopedics experts are available to provide specialized diagnosis and treatment so you can focus on living life at your summit.
Parts of the Elbow Joint
Golfer’s and tennis elbow are similar conditions affecting opposite sides of the elbow. The elbow joint contains three bones: the upper arm bone, or humerus, and the radius and ulna, the bones in the forearm. There are also bands of fibrous tissue called ligaments connecting bone to bone, and tissue bands called tendons attach muscles to bone. Many of these bands connect to bony bumps called epicondyles on the bottom of the humerus. The bony bump on the outside of the elbow is called the lateral epicondyle, and the bump on the inside is called the medial epicondyle.
One of the tendons attached to the lateral epicondyle connects to a forearm muscle called the extensor carpi radialis brevis (ECRB). This muscle allows you to extend your fingers and wrist and stabilizes your wrists when your arm is straight. Tendons on the opposite side of the elbow joint attach the medial epicondyle to a group of forearm muscles called flexor-pronator muscles. These muscles let you flex your fingers and wrists and rotate your forearm.
Causes of Lateral and Medial Epicondylitis
Overusing tendons connecting the ligaments to forearm muscles leads to inflammation and tiny tears in the muscles and tendons. When this happens, you develop epicondylitis.
- Golfer’s elbow, or medial epicondylitis affects the medial epicondyles inside of the elbow.
- Tennis elbow, or lateral epicondylitis, affects the lateral epicondyle and ECRB muscle on the outside of the elbow. Tennis elbow is much more common than golfer’s elbow.
Lateral and medial epicondylitis earned their nicknames because they’re both common sports injuries. Typically, epicondylitis isn’t caused by an acute injury. Instead, it develops over time.
Tennis elbow often occurs due to repetitive movements or frequently using improper equipment during racket sports, such as badminton, pickleball or tennis. Similarly, golfer’s elbow can be caused by too many golf swings or using improperly fitted equipment. Golfer’s elbow can also develop due to repetitive motions during racket sports, weight training or sports involving throwing, such as baseball.
Not all people who get tennis elbow play tennis. Likewise, golfer’s elbow can develop in people who’ve never touched a golf club. You have a higher risk of developing tennis elbow or golfer’s elbow if your job involves repetitive forearms and wrist movements. People at higher risk of epicondylitis include:
- Assembly line workers
- Auto mechanics
- Butchers
- Chefs
- Construction workers
- Painters
- People who frequently work on computers
- Plumbers
Sometimes, the cause of lateral or medial epicondylitis is never known.
Golfer’s and Tennis Elbow Symptoms
Symptoms of golfer’s and tennis elbow are similar, but not identical. In both, symptoms generally begin gradually and slowly worsen over several weeks or months.
Golfer’s elbow causes pain on the inside of the elbow that sometimes radiates to the forearm on the pinky finger side. Generally, pain is highest when bending your wrist toward your forearm, making a sudden wrist movement or shaking hands with someone. The pain can be severe enough to interrupt your sleep. Golfer’s elbow may also lead to numbness or tingling, running from your elbow to your pinky and ring fingers, or weak grip strength.
People with tennis elbow feel pain on the outside of the elbow that may radiate to the forearm and back of the hand. Other symptoms of tennis elbow include a burning sensation or a weak grasp. Typically, symptoms are worse when holding something tightly, rotating your forearm or shaking hands. Tennis elbow pain may also make sleeping difficult.
It’s possible to develop golfer’s or tennis elbow in either arm. However, it’s more common for it to affect your dominant arm.
Diagnosing Epicondylitis
To diagnose epicondylitis, your orthopedic specialist will ask you about your medical history, symptoms and what makes your symptoms better or worse. They will also do a physical exam that may include moving your elbow and wrist into different positions, measuring your grip or trying to straighten your fingers or wrists against resistance.
Your provider may confirm an epicondylitis diagnosis or rule out other conditions with imaging and other tests, such as:
- Electromyography (EMG)
- MRI scans
- X-rays
Treatment for Lateral and Medial Epicondylitis
More than 8 out of 10 people with epicondylitis recover with only nonsurgical care. Initial treatment for epicondylitis is two to three weeks of rest, including avoiding heavy work and sports.
Your provider may also recommend:
- Corticosteroid injections
- Ice packs two to three times a day
- Nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen
- Physical therapy
- Platelet-rich plasma injection therapy
If you have tennis elbow, a specialized forearm brace called a counterforce brace can also help relieve pressure around the muscle.
If you still have symptoms six to 12 months after beginning treatment, your orthopedic physician may recommend surgery. There are multiple surgical techniques available to treat golfer’s or tennis elbow.
If you developed golfer’s or tennis elbow playing sports, our ASCEND program can also help you return to competition and prevent future injuries.
To learn more about lateral and medial epicondylitis treatments, schedule an appointment with a Summit Orthopedics elbow expert.
