Narendra pal (physio)

1. Golfer elbow
BY :-NARENDRA PAL
( PHYSIO)

3. Golfer elbow
Medial epicondylitis:
Medial golfer elbow involves primarily the flexor origin at the medial
epicondyle.
The pain of golfer elbow occurs primarily where the tendon of the
forearms muscles attach to the bony bump on the inside of the elbow
(medial epicondyle)
.

4. Etiology
 It is an overuse syndrome in the throwing sports where it may be related to repetitive valgus stress along
with pronation and wrist flexion .golfing with excessive driving , or by mishitting the ground racket
sports due to the wrist action also in baseball pitching , and in pull-through phase of swimming strokes
.occupations that require a strong hand grip and an adduction movement of the elbow it occurs in
middle aged subjects involved in these activities .

5. Evalution
 Tenderness palpation felt under the medial epicondyle .
 Pain on resisted pronation of forearm.
 Pain on stretching the flexor muscles group by fully extending the forearm from supine position
,and then passively hyper extending the wrist..
 pain on resisted wrist flexion and ulnar deviation .

6. Clinical presentation
 Age above 30 year ,both gender are effected.
 Pain on medial area of elbow joint
 Tenderness
 Spasm
 Stiffness
 Pain on movement of the wrist, elbow joint . pain when shaking hands
 Numbness tingling from your elbow up and ring finger.
 Pain when flexing your wrist .

7. causes
 Degenerative changes.
 Over &repeated uses wrist & elbow .repetitive flexing , gripping or swinging can cause pull or tiny
tears in the tendons.
 Any repetitive hand, wrist or forearm motions can lead to golfer elbow
 Carpenter ,plumber , mechanics, house wife cooking . Infact its some time called pitchers elbow.
People may also get it by using tools like screw-drivers & Hammers , raking or painting.
 Racket sports
 Throwing sports
 Weight training
 Forceful ,repetitive occupational movements –these occur in field such as construction, plumbing &
carpentry.

8. Risk factor
 Age 30 years or older.
 Performing repetitive activity at least two hours a day
 Obese
 A smoker.

9. investigation
 X-ray elbow joint- nothing is seen in x-ray.
 MRI can scan of elbow can detect the inflammation and tear of common flexor of
the fore arm.
 Soft tissue edema around the common flexor tendon.
 Thickening and increased signal intensity on both T1 and T2 weighted sequences
of the common flexor tendon.

10. Treatment
 conservative:-1st line of treatment
 Medicine
 Analgesic
 Antacid
 Multivitamin
 Analgesic ointment
 Physiotherapy
 Rest ,bracing , splint