Golfer's elbow

Golfer's elbow is caused by inflammation of the flexor origin at the medial humeral epicondyle, where there is pain and tenderness. It is far less common than its counterpart tennis elbow.

It is characterised by pain radiating across the flexor aspect of the arm and there is pain on resisted pronation.

Medial epicondylitis is an overuse injury affecting the flexor-pronator muscles (i.e. pronator teres, flexor carpi radialis, palmaris longus) at their origin on the anterior medial epicondyle of the humerus

• onset can be related to occupation (e.g. consistent use of a tool such as a hammer, or in baseball when throwing a pitch)
• examination should reveal point tenderness of the medial aspect of the elbow over the common flexor origin
  • this point can be found by palpating the elbow with the wrist held in resisted palmar flexion
  • discomfort with this manoeuvre is confirmatory
  • neurological examination of the upper limb should be normal
  • joint is not involved so ROM should not be affected

Investigation

• diagnosis is made clinically
• ultrasound is the investigation of choice if there is any doubt over the diagnosis
• a nerve conduction study can be useful in excluding cubital tunnel syndrome

Reference:

1. Arthritis Research UK (2011). Hands On (11) - upper limb in primary care.