Diagnosis: Medial Epicondylalgia
What is Medial Epicondylalgia?
Medial Epicondylalgia, more commonly known as medial epicondylitis or golfer’s elbow is a relatively common overuse injury of the tendons in the forearm causing pain in the inner aspect of the elbow1.
Medial Epicondylalgia, more commonly known as medial epicondylitis or golfer’s elbow. #performbetter @pogophysio Click To TweetSymptoms of Medial Epicondylalgia
Symptoms of medial epicondylalgia usually develop gradually overtime. At first people usually develop a localised ache over the inner portion of the elbow, over 1-‐2cm below the bony lump (medial epicondyle) following unaccustomed or over activity1. Overtime, many experience one or more of the following symptoms:
- Pain reproduced with everyday activities such as: pick up a cup or turning a door knob1
- Elbow stiffness, especially first thing in the morning1
- Weakness in the hand and wrist2
- Numbness or tingling in the ring finger2
- Pain and weakness with gripping activities3
- Neck stiffness and tenderness3
How is Medial Epicondylalgia Diagnosed?
The physiotherapist is able to help diagnose medial epicondylalgia by taking an in depth history of the symptoms and clinical examination. The most prominent symptom to diagnose medial epicondylagia is pain 1-‐2cm below the medial epicondyle. There are many other conditions that can present similarly to medial epicondylalgia including: compression of the nerves running through the elbow and injury to the ligament in the inner elbow (medial collateral ligament) 2. The physiotherapist through the physical examination can rule these out. Some of the tests the physiotherapist may perform include: Grip strength test3, movements of the wrists and elbow such as; straightening the elbow and bending the wrist backwards and muscle strength tests such as; bending the wrist with resistance3.
What Causes Medial Epicondylalgia?
Many muscles attach to the medial epicondyle; these muscles are responsible for bending the wrist and fingers as well as turning the palm down2. Activities that constantly require the use of these muscles are a major factor causing medial epicondylalgia. Here, the tendons of these muscles are constantly being pulled and stretched and overtime some damage can occur to the tendon, which is causes pain3. Even through this condition is referred to as golfer’s elbow; golf contributes a small percentage of people with the condition. Some other causes include: badminton, squash, tennis, carpentry, painting, hammering, bricklaying, knitting, computer work and gymnastics1. In some cases this condition can occur suddenly with a large, sudden forceful movements including heavy lifting or gripping force through the arm1.
http://physioworks.com.au/injuries-conditions-1/golfers-elbow
How is Medial Epicondylalgia treated?
Physiotherapy is an effective way to manage and treat medial epicondylalgia. Treatment is split up in three individual stages to help reduce pain and gain strength back in the muscles impacted2.
Stage 1: The first step is to reduce inflammation and swelling around the elbow. The best way for this is through: rest, ice, compression and elevation. It is not advised to stop all activity as it can lead to muscle wasting, but reducing activities that aggravate pain is advised2.
Stage 2: In this stage the aim is to regain full, painless wrist and elbow range of motion. Followed by stretching and strength training. Some exercise that the physiotherapist can use to achieve this is to glide the elbow or move the wrist up with the palm facing down2.
Stage 3: In this stage the physiotherapist may look at the equipment or techniques that may have induced medial epicondylagia and advise on ways to minimise the risk or reoccurrence2.
Shanam Nisha
Student Physiotherapist
Resources
- http://www.physioadvisor.com.au/injuries/elbow-‐forearm/golfers-‐elbow-‐medial-‐ epicondylitis/
- http://www.physio-‐com/Medial_Epicondylitis#Clinically_Relevant_Anatomy
- http://physioworks.com.au/injuries-‐conditions-‐1/golfers-‐elbow
