Golfer’s elbow

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What are the signs of golfer’s elbow?

Medial epicondylitis, more commonly known as golfer’s elbow, causes pain where the flexor muscles of the wrist and fingers attach to the bone on the inner side of the elbow. This pain tends to increase when bending the wrist or during pronation (internal wrist rotation). An ultrasound or MRI is needed to diagnose this condition. It is important to make sure that the patient does not have ulnar nerve entrapment or a ligament issue (which are common in athletes).

Possible repercussions

The most common result of this condition is that it limits the patient’s activities (for example, difficulty holding a tool or a golf club). Pain can also worsen at night, causing trouble sleeping. Patients may also lose elbow mobility.

Non-surgical treatments

There are several non-surgical treatment options for people with golfer’s elbow.

  • Treatments like physical and occupational therapy, osteopathy, and acupuncture cure more than 90% of cases.
  • If pain persists after three months of treatment and rest, ultrasound-guided PRP (plasma-rich platelet) injections may be considered.
  • If pain persists after six months of treatment and rest, patients need to have an ultrasound or MRI and be seen by an orthopaedist to evaluate surgical options.

About PRP treatment (platelet-rich plasma injections)

  • Blood is drawn after arriving at the clinic and centrifuged to separate the platelets.
  • Ultrasound is used to inject the plasma
  • Length of procedure: 30 minutes
  • Do not take anti-inflammatory drugs for two weeks before or four weeks after the injection
  • Resume normal activities gradually
  • Recovery rate: 75% (4–5 months of treatment)

Surgical treatment

Tenotomy with debridement and tendon repair is the surgical method used. This involves cleaning the damaged tendon, releasing excess tension, and letting the tendon reattach to the surrounding muscles.

About the procedure

  • Outpatient procedure
  • Short two- to three-centimetre incision
  • Length of procedure: 30 to 45 minutes
  • Local anesthesia – the patient remains conscious during the procedure

Post-surgical recovery

Patients may be escorted home immediately after their procedure. The elbow may be mobilized immediately after surgery. Patients must take pain relievers during the first two to three days after surgery.

About recovery

  • Physical therapy will be recommended if needed.
  • Non-physical activities may be resumed the next day if pain levels permit.
  • Patients can resume non-strenuous activities during the first week (cooking, driving, writing, typing).
  • Physical activity may be resumed gradually six to eight weeks post surgery. Non-strenuous sports (like golf) can be resumed two months after surgery and strenuous sports (like tennis) can be resumed approximately four months after surgery.
  • Full recovery normally takes between four and six months.
  • Success rate: 90% to 95%
  • Complications are relatively rare (<1%).

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