The Elbow

Golfers elbow - Prevalence

The term "golfers elbow" is commonly used to indicate a lesion of the common flexor tendon at the medial condyle.
Also the term 'medial epicondylitis' is used, in analogy with the 'lateral epicondylitis' or 'tennis ellbow'.
The lesion is not as common as a tennis elbow. It is an overuse disorder that mainly occurs in patients aged between 40 and 60.
Golfers elbow is characterised by pain at the inner side of the elbow during elbow and wrist movements.

Clinical Examination

The clinical examination shows a normal and painless passive range of elbow movement.

Resisted flexion of the wrist is painful as is the resisted pronation of the arm because the tendon of the pronator teres partly originates from the common flexor tendon.

Exceptionally, only the resisted pronations is painful, which makes the dd with a pronator teres lesion difficult.

Rarely the standard clinical examination of the elbow is entirely negative. In this situation a complementary test should be performed, the resisted flexion of the fingers.
A very localised lesion on the deeper part of the common flexor tendon may only be provoked by a resisted flexion of one or two fingers.

Palpation of the common flexor tendon will determine the exact spot.

There are two possibilities:

A tenoperiosteal variety: the tender spot is found at the anterior aspect of the epicondyle - junction between bone and tendon
A musculotendinous variety: The tender spot is 5-10 mm farther down. The common tendon is diverging in the separate muscle bellies.

Treatment

Type I (tenoperiosteal variety): We have the choice between deep transverse frictions or on-two infiltrations with triamcinolone.
Type II (musculo-tendinous lesion): Deep transverse friction is the treatment of choice/