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  • John Kuhn DPT

Got elbow pain? It might be Medial or Lateral Epicondylitis!

Medial Epicondylitis is commonly known as golfer’s or climber’s elbow; Lateral Epicondylitis is commonly known as tennis elbow. At the end of your humerus (arm bone), there are two bony prominences called epicondyles, the one on the inside being the medial epicondyle, and the one on the outside being the lateral epicondyle. The muscles responsible for wrist flexion (reaching down into a jar) and forearm pronation (going from palm up to palm down) attach to the medial epicondyle. The muscles responsible for wrist extension (position of waving) and forearm supination (going from palm down to palm up) attach to the lateral epicondyle.

Causes of Injury:

Both the muscles attaching to the medial and the lateral epicondyle are involved in grip, and this pathology typically develops from a repetitive activity involving grip like tennis, golf, rock climbing, or jobs involving manual labor. Sometimes it can even come from something as simple as working a desk job and spending lots of time typing on a computer or laptop. Underlying factors of this pathology can be a mismatch of strength in one muscle group compared to the other, which can put undue stress on one of the muscle groups. The end result is a strain or irritation of the tendon that attaches to the bone, which causes further irritation when performing activities involving grip or pronation/supination (like using a screwdriver).

Signs of Medial or Lateral Epicondylitis:

With this pathology, the inside or outside of the elbow will be painful to touch. It will be painful to grip things or move the wrist up or down. Your wrist range of motion may be decreased on the affected side compared to the unaffected side due to muscular tightness and pain as well. Grip strength will typically be reduced on the affected side compared to the unaffected side.

How Can Physical Therapy Help?

A Physical Therapist can help you improve your wrist and forearm strength, as well as teach you how to stretch out the affected muscles and tendons that are sore, as well as strengthen them. Stretching and strengthening the involved muscles and tendons is important for healing, as well as to prevent future recurrence of the injury. A PT will help you identify aggravating activities that may need to be modified for proper healing. Your Physical Therapist may use manual techniques such as cross friction massage or dry needling to help decrease pain, improve healing, and improve muscle and tendon flexibility.

Do I Need Surgery?

Most commonly, medial or lateral epicondylitis will either resolve on its own or with physical therapy. Few cases that last longer and become chronic may require surgical intervention, but the vast majority do not.

What Can I Do at Home While Waiting to Be Seen in PT?

Some, but not all benefit from using a tennis elbow strap or counterforce brace, which can decrease the load felt on the affected muscles and tendons. These can easily be found online or in the store. Another vital part of helping epicondylitis heal is activity modification, which involves identifying activities that aggravate pain and either avoiding them to let things heal or modifying the activity to help decrease the stress on the aggravated area.

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