What Causes Medial Epicondylitis?

The 3 Main Events That Cause Golfer's Elbow

Golfer's elbow is most common in men between 20 - 49 years of age, however it can affect anyone who uses their hands, wrists and fingers to wrap around instruments, type on keyboards, or grip objects (golfers, pitchers, racquet players, small parts manufacturers, office workers, lab technicians, hygienists, carpenters, wood choppers). It is most often a result of forceful contractions and overuse.

Tennis elbow and golfer's elbow are a result of vigorous use and movements or overstraining of the forearm muscles that move your fingers, hand, wrist and forearm. Overuse of your muscles really depends on how long you do something and how much effort you exert doing it. The constant tugging at the point of attachment on the outside of your elbow (lateral epicondyle) or the inside of your elbow (medial epicondyle) can cause these tendons to become inflamed and strained. Your muscles and tendons can then become irritated which can result in weaker tendons, tiny tendon tears and development of scar tissue and/or calcium deposits. The development of scar tissue will put pressure on your soft tissue and nerves, and interrupt the blood flow to this area; this can be very painful.

If golfer's elbow pain is due to a deterioration of the tendon (tendinopathy), it can take from two to six months to fully recover. Many cases of medial epicondylitis become chronic problems (just like lateral epicondylitis) that progressively get worse if the sufferer continues performing the causal activity that started the condition in the first place. When you do this, your body definitely indicates there is a problem as the area will continue to generate a lot of pain.

• Acute Trauma: this can occur from an accident or high intensity movement. An example of this would be straightening your arm while hitting a golf iron into the ground.
• Repetitive Stress: this happens through overuse of the elbow joint without proper treatment or recovery. An example of this would be spending hours per day typing at a computer without taking a break.
• Re-Injury (Chronic Trauma): this injury is from continually injuring your medial epicondyle tendon. Small tears in the tendon form and worsen over time, allowing the growth of scar tissue. An example of this would be painting high walls or ceilings with an already damaged elbow day in and day out.

Over time with overuse, your muscles and tendons can become irritated which will result in weaker tendons, tiny tendon tears and development of scar tissue and/or calcium deposits. The development of scar tissue will put pressure on your soft tissue and nerves, and interrupt the blood flow to this area. Scar tissue is tough to get rid of and can cause significant pain over a long period of time. Fortunately, Circulation Boost treatments aid in the reduction of scar tissue and when combined with PT and a conservative treatment plan, most patients can rid themselves of epicondylitis and get back to a normal pain free lifestyle faster than would ever expect.

Golfer's Elbow Re-injury

There can be different factors leading to a re-injury of your medial epicondyle, but in most cases, the strongest reasons are:

• Strenuous Activity
• Age (a person with a greater age has a greater chance of contracting golfers elbow)
• Technique of Movement and Tools Used (ie. proper versus improper form on the court, use of an ergonomic keyboard when typing may help prevent tendonitis, etc.
• General Health and Wellness (armchair & weekend athletes are at greater risk of a tendon injury compared to an athlete that does such activities on a daily basis.

Activities - If your household, workplace, or recreational activities involve significant repetitive movement of your wrist, forearm, upper arm, and/or shoulder you are at risk for developing Golfer's Elbow. Some common activities that can cause Golfer's Elbow include but are not limited to: painting, house cleaning, playing an instrument, playing sports, heavy lifting, frequent use of a computer (or typing), shaking hands frequently, and/or frequent holding of a phone to the ear

As you can see, its not just professional athletes or people with physically demanding jobs who suffer from Golfer's Elbow.

Actively moving your arm for long periods of time can cause a lot of stress to be exerted on your elbow. Repeated movements gradually increases the stress placed on muscles.If you don't give your body a chance to rest and regain strength, stronger muscles ( like the ones in your shoulder )have no choice but to transfer energy to less capable structures (such as the muscles in your hand or wrist ). Weaker muscles cannot handle the impact stronger muscles can. As a result, they begin to strain and even tear.

It is important that you allow your body to rest between periods of exertion or repetitive movement. Fatigue in your muscles can lead to bad form, or overuse. You body is an amazing thing! It is constantly trying to heal itself and perform at its fullest capabilities. When you don't allow your body to rest and push yourself beyond your physical limitations, chances of becoming injured are quite high.

Your tendons attach your forearm muscles to the bone of your elbow. When high levels of stress are exerted on your forearm, tendon fibres stretch beyond their limits. If this action is repeated over and over again, tendon fibers lose their strength and elasticity. They can become disorganized and tangled. If repeated long enough or with too much stress exerted, your tendon fibres may even begin to tear.

These small tears cause inflammation in the area of your elbow called the epicondyle ( the bony bumps just below your elbow where the tendon attaches the forearm muscles to your elbow bone ). You elbow may become swollen, bruised, or disfigured. Your elbow joint is a very small complex structure and doesn't handle swelling well. Swelling will limit blood flow. Micro tears and swelling can cause mild discomfort to intense pain. The limited blood flow can restrict your body's ability to heal. If not treated, your tendon will begin to deteriorate. It can take months for you to fully recover.

If you repeatedly injure your tendon without proper treatment and recovery, scar tissue will form. Scar tissue is weak and inflexible tissue that hardens around the tendon without giving it any support or strength. Scar tissue will never heal into healthy, mature, strong tissue. Scar tissue will put pressure on your soft tissues and nerves. It interrupts the blood flow to the areas of your elbow causing pain and delaying recovery. It is important to prevent the growth of scar tissue with conservative treatments.

This is why it is very important to seek medical advice when you've had an accident or injury. Your doctor will be able to recommend the best course of action for treating your injury using conservative treatment options such as rest, cold/heat treatments and stretches. We recommend incorporating Circulation Boost (via use of an Elbow T•Shellz Wrap^®) once swelling is down; enhanced blood flow in most cases, will help maximize your own body's healing capability. A quick recovery is more important than most people think, as slow recoveries mean a higher likelihood of re-injury and a worsening injury; this basically means more and more scar tissue will grow in the area, creating more severe problems of atrophy and overcompensation issues.

How Your Age Affects Your Golfer's Elbow

Age is always a factor when it comes to injury. As we become older, our tendons begin to weaken and eventually break down. By not training our bodies or allowing repetitive injuries, we speed up this process.

Degeneration, or the breakdown of tissues, is especially noticeable in individuals who have a repeated history of overuse. Over time, repeated damage to your tendon can cause you to develop a condition called 'Tendinosis'. This means that your tendon becomes unable to heal fully. Age and repeated injury without proper treatment can cause tendinosis - a serious breakdown of your tendon.

Taking Steps to Initiate Long Term Recovery

Your body is an amazing organism and has all of the tools to heal itself. However, healing your tendon can take a very long time. It is unrealistic to expect anyone to put their life on hold for weeks or months. Without the proper treatments, your tendons will thicken with weak, inflexible scar tissue.

If you are experiencing a deterioration of the tendon (tendinopathy), it can take from two to six months to fully recover. Many cases of medial epicondylitis become chronic problems that progressively get worse if sufferer continues performing the causal activity that started the condition in the first place. When you do this, your body definitely indicates there is a problem as the area will continue to generate a lot of pain.

Only you can prevent injury. Take steps before you injure your body to avoid spending valuable time in recovery instead of at work, with your family, or your favorite activities.

It is important that you speak to your doctor about the recovery and prevention options available to you.

• Have you recently re-injured your elbow by returning to your normal daily activities too quickly?
• How many times in the past have you aggravated your elbow just trying to perform basic tasks around your house?
• Is your golfer's elbow preventing you from work or activities you love to do?

To take a deep dive into conservative treatment options for soft tissue injuries in the elbow and forearm, please go to our golfers elbow treatments page.

Techniques and Tools To Help Prevent Golfers Elbow

Your environment plays a huge part in the health of your body. Using tools that are properly fitted and weighted to your body and abilities will help you perform with success and avoid injury.

Young athletes with improper training are among those suffering from Golfers Elbow symptoms. When starting a new job, activity, or exercise routine, it is important to learn and understand the best techniques for you to achieve your tasks and goals.

It is important for athletes to have their techniques and equipment checked by professionals for the best fit and performance. Why use movements or tools that don't give you the best opportunities for success?

Just like athletes, workers with physical jobs or people performing repetitive tasks should refer to occupational therapists. These specialists understand how the body works and which movements should be avoided as they can lead to injury.

Over extending your arm while painting can cause an injury just as easily as an improper back hand swing. It is important to understand that your body is a complex network of connected structures. When using the wrong muscles or positioning, you put yourself at risk for injury.

General Health and Fitness Help Prevent Injury

Maintaining your general health and fitness can help you prevent injury.

Training your body to perform the ways you need it to will decrease risk of injury. An untrained body may make movements with the least amount of effort... BUT ...this can lead to awkward motions with badly distributed, stress causing, long term injury.

It is important to remain physically active. The health of your whole body contributes to the health of the individual parts. Maintaining a healthy weight and overall level of fitness through regular activity and healthy eating will increase your ability to avoid injury.

Lack of activity can cause muscles to become weak and unsupported. Without strong muscles your body places the stress on weaker structures like joints. Strong muscles help maintain a strong body, evenly distributing weight and forces to the areas that can handle it properly.

Remember to drink fluids and rest. Resting your body will help reduce fatigue in your muscles. Energized muscles are strong and will help you complete tasks efficiently and effectively.

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During your recovery, you will probably have to modify and/or eliminate any activities that cause pain or discomfort at the location of your soft tissue injury until the pain and inflammation settle. Always consult your doctor and/or Physical Therapist before using any of our outstanding products, to make sure they are right for you and your condition. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results!

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