All through Little League and middle school, Grace played second base on her softball teams. But when she got to high school, the coach moved her to third. Grace was having trouble making the longer throw across the infield, so every day after practice she stayed late and made dozens of long throws, thinking she was strengthening her arm.
After a few weeks, Grace noticed a slight pain in her elbow, but she kept playing softball. Soon, though, the pain got so bad that sometimes she could barely throw at all. That's when she went to see a doctor. The doctor examined her elbow and asked Grace about her recent activities. After the exam, he told her she probably had medial epicondylitis and should stop playing softball for a month or more to let her arm rest.
What Is Medial Epicondylitis?
Medial epicondylitis (pronounced: mee-dee-uhl ep-ih-kon-di-lite-uss) is a kind of tendonitis. Tendonitis is when a tendon is swollen, irritated, or injured.
Tendons are the tough connective tissues that attach our muscles to our bones. The tendons that attach the muscles in the forearm to the bone connect to two small knobs on the upper arm bone called epicondyles. The medial epicondyle is the bony knob you can feel on the inside of your elbow, closest to your body.
When the tendon that attaches the medial epicondyle to the muscles gets tendonitis, it's called medial epicondylitis. You may hear this called "golfer's elbow," but in reality it happens mostly to pitchers.
Medial epicondylitis can make moving the elbow or wrist painful. The good news is, most cases heal on their own with rest and at-home treatment.
How Do People Know They Have It?
Medial epicondylitis usually happens in person's dominant arm. So if you're right-handed, you'd be more likely to feel pain in your right arm. If you're a lefty, it would probably be your left arm. The pain can start right away or come on gradually over time.
Other common signs that arm pain might be caused by medial epicondylitis include:
- pain on the inside of the elbow
- pain that spreads from the elbow toward the wrist
- swelling and tenderness in the inner part of the elbow
- tightness or weakness in the forearm
- trouble moving the elbow or hand
People with medial epicondylitis also can feel increased pain when they do things that involve the hands and wrists, such as picking things up, turning doorknobs, shaking hands, and playing sports like golf and tennis.
How Do Doctors Diagnose it?
If you feel pain in your elbow that doesn't go away after a couple of days or gets worse, call a doctor. The doctor will examine your elbow and forearm and ask questions about any activities that might have caused repeated stress on your wrist or hands.
The doctor will check the strength and range of motion in your elbow, wrist, and forearm. For a more serious case (or to rule out other problems), the doctor might want you to have an X-ray.
What Causes Medial Epicondylitis?
Most of the time, athletes get medial epicondylitis because they are repeating the same motion over and over — like throwing a ball or swinging a golf club. These kinds of overuse situations can eventually cause damage and swelling in the tendon that connects to the epicondyle.
Pitchers aren't the only athletes who develop medial epicondylitis. Sports that involve the hands and arms — such as tennis, golf, softball, rowing, weight lifting, and even biking — can increase someone's risk.
You don't have to play sports to get medial epicondylitis. People who lift objects, play the violin, paint, or type on a computer for long periods of time also are at risk. Basically, if you're using your hands and wrists repeatedly, especially in awkward positions, you're more likely to get a case of medial epicondylitis.
How Can I Prevent It?
The best way to prevent medial epicondylitis is to avoid activities that require you to use your hands and wrists a lot, especially if the movements are repeated. Of course, that's not always possible.
If your sport or job requires repetitive arm movement, take these steps to protect yourself:
- Build arm strength. Strengthening your wrist and arm muscles will keep the entire elbow area more stable and less likely to get injured. A simple exercise is just squeezing a tennis ball, but your coach or a physical therapist can show you other ways to build arm muscles.
- Warm up and stretch your arm muscles before playing.
- Develop good technique. Playing sports in a way that moves your arm into weird positions can put stress on your elbow and wrist. A coach or sports trainer can help you develop good technique. Or visit a sports medicine clinic where experts can analyze your movements and offer advice on improving.
- If you feel any pain in your elbow or forearm, stop doing the activity that might be causing it right away. Don't start that sport or task again until the pain is gone or a doctor has told you it's OK to play. Never try to ignore pain or play through it. This will most likely make the condition worse.
How Should I Treat Medial Epicondylitis?
Most cases of medial epicondylitis can be treated at home easily. Doctors will do surgery as a last resort if nothing else is working, but it's rare that someone will need surgery for this injury.
Here are some things your doctor might suggest:
- Rest your arm. Stop doing activities that require a lot of arm movement and don't start doing them again until the pain is gone. When you begin activities again, start off slowly and gradually increase your arm's workload.
- Ice the affected area. Apply an ice pack wrapped in a towel or a cold compress to your elbow for up to 20 minutes several times a day to help keep the swelling down. Never apply ice directly to the skin.
- Take anti-inflammatory medications. Painkillers such as ibuprofen can help relieve pain and reduce swelling in the elbow and forearm. In some cases, doctors may give people steroid injections to ease pain and help reduce swelling.
- Do stretching and strengthening exercises. These will help strengthen your forearm and restore the range of motion in your elbow and wrist as you recover. A doctor or a physical therapist can help you come up with a good exercise program.
Medial epicondylitis is rarely a serious or long-term injury. But it can keep you off the pitch (or course or court) for a few months if you don't give your arm some rest and take steps to treat it.
Avoid the temptation to start playing again too soon — you may re-injure yourself and have an even longer healing period. When you start swinging a club or racquet again, you want to be sure you're ready.
Reviewed by: Alfred Atanda Jr., MD
Date reviewed: October 2012
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