II. Epidemiology
- Much less common than Lateral Epicondylitis
III. Pathophysiology
-
Tendinopathy (not a Tendonitis)
- The term Tendonitis is a misnomer, as this is a degenerative tendon change, not an inflammatory change
- Flexor forearm Tendinopathy
- Flexor carpi radialis
- Pronator teres
- Repetitive motion injury in sports and manual labor
- Repetitive flexion with valgus stress at the elbow
- Repetitive wrist flexion and pronation
- More common in baseball pitchers and golfers
- Also more common with the forehand in tennis
- Contrast with the tennis backhand affecting Lateral Epicondylitis)
IV. Symptoms
- Dull ache at medial epicondyle
- Gradual onset of pain
- Pain radiates into Forearm
- Grip strength weakness
V. Signs
- Maximum tenderness localized within 1 cm distal and anterior to the medial epicondyle
- Provocative maneuvers eliciting pain
- Wrist flexion against resistance
- Forearm pronation against resistance (best Test Sensitivity for Medial Epicondylitis)
VI. Management: Initial
- See RICE-M
- Relative rest of Forearm pronators and wrist flexors
- Avoid repetitive motion activities
- Counterforce bracing
- Pad positioned over the proximal and medial Forearm (over the flexor-pronator complex)
- Variable evidence (see Lateral Epicondylitis)
-
Wrist Splint
- Indicated for severe medial epicondyliytis symptoms
-
Elbow extension splint
- Indicated for comorbid Ulnar Neuropathy
- Splint at 30-45 degrees elbow flexion
- Worn only overnight
VII. Management: Rehabilitation
- Start after 1-6 weeks of initial therapy, and when free of pain on wrist flexion and Forearm pronation
- Step 1
- Start with gentle flexor and pronator stretches
- Step 2
- Advance to Isometric Exercises and then to Eccentric Exercises
VIII. Resources
- EMedicine Physical Medicine and Rehabilitation for Epicondylitis
Images: Related links to external sites (from Bing)
Related Studies
Concepts | Acquired Abnormality (T020) |
ICD9 | 726.31 |
ICD10 | M77.0 , M77.00 |
SnomedCT | 53286005, 156659008, 268088003, 24133009 |
Dutch | golfer's elbow, mediale epicondylitis, epicondylitis; medialis, medialis; epicondylitis, Epicondylitis medialis |
French | Coude du golfeur, Epicondylite interne |
German | Golfellbogen, mediale Epikondylitis, Epicondylitis ulnaris humeri |
Italian | Gomito del golfista, Epitrocleite |
Portuguese | Cotovelo de jogador de golfe, Epicondilite interna |
Spanish | Codo del golfista, Epicondilitis medial, codo de golfista, epicondilitis interna, epitrocleítis (trastorno), epitrocleítis, inflamación de la epitróclea |
Japanese | ゴルフ肘, 内側上顆炎, ゴルフチュウ, ナイソクジョウカエン, ゴルフヒジ |
English | Medial epicondylitis of elbow joint, medial epicondylitis (diagnosis), medial epicondylitis, Medial epicondylitis, unspecified elbow, elbow epicondylitis medial, golfer elbow, elbow golfers, epicondylitis medial, Medial epicondylitis, Golfer's elbow, Medial epicondylitis of elbow, Medial epicondylitis of elbow joint (disorder), epicondylitis; medial, golfer's elbow, medial; epicondylitis, Golfers' elbow |
Czech | Golfový loket, Mediální epikondylitida |
Korean | 내측 상과염 |
Hungarian | Epicondylitis medialis, Teniszkönyök |