Q. I am a golfer who has had pain on the inside part of my right elbow for a couple of months. I usually take a couple of ibuprofen before I play and it helps somewhat. It has started to bother me more, and I rested it for a month and it felt better. When I went back to golfing, the same pain came back. Is it safe to play and just ignore the pain or should I do something else?
A. Pain on the inside part of the elbow is very common in golfers, weight trainers and baseball players. All the muscles that allow you to point your wrists and fingers downward and rotate your palm downward start as a tendon on the inside part of the elbow known as the medial epicondyle. The area where the tendon attaches to the bone has a poor micro-circulation and when injured can be very slow to heal.
Golfer’s elbow is painful on the inside part of the elbow; tennis elbow is painful on the outside part of the elbow. Golfer’s elbow tends to occur with overuse, a change in your golf clubs, or a change in your swing. The initial line of treatment is usually an anti-inflammatory medication, coupled with a physical therapy and rehabilitation program aimed at decreasing the pain and improving forearm muscle strength without exacerbating the condition.
If this fails, a cortisone injection may be helpful in relieving the symptoms, but they are likely to return if proper care of the elbow and strengthening techniques are not incorporated into your daily routine. If the cortisone injections fail, an MRI scan is usually obtained to determine if there is any actual tearing of the tendon at its attachment point to the medial epicondyle. The MRI will also reveal any other conditions, such as arthritis, spurs or ligamentous disruption. Plasma-rich protein injections can be effective in about half the patients who have failed the other conservative treatment modalities. Rarely is surgery necessary for this condition, but it is effective most of the time when necessary. I recommend you see an orthopedic surgeon for evaluation to confirm the diagnosis as well as begin treatment so you can go back to enjoying painless rounds of golf.
Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send your questions to HarlanS@baptisthealth.net