Golfer’s elbow is also called medial epicondylitis. It is not as frequent as lateral epicondylitis or tennis elbow . Both of these condition arise from overuse.
Besides golf, medial epicondylitis can be seen in any throwing sports in addition to archers, bowlers and weight lifters.
WHERE IS THE PROBLEM?
It affects mainly the dominant elbow of the patient. The site of the pathology is at the interface or attachment to the medial epicondyle of the pronator teres and the flexor carpi radialis muscles. Immunohistologic studies have shown that long-standing epicondylitis is associated with a degenerative state instead of a traditional inflammatory process and probably should more accurately be called "epicondylosis." This is problably why Prolotherapy and PRP work so well for this condition.
WHAT ARE THE SYMPTOMS AND EXAM FINDINGS?
Patients will c/o pain in medial aspect of the elbow and when it is chronic they may c/o grip weakness. On exam there is palpable tenderness over the medial elbow and pain with resisted wrist flexion and pronation.
It is important to examine the Ulnar Collateral Ligament (UCL), especially in baseball players. Chronic UCL deficiency is more common than medial epicondylitis in throwing athletes. However, because the origins of the flexor mass and the UCL are relatively close together, both chronic UCL deficiency and medial epicondylitis may present with medial elbow pain. A magnetic resonance imaging (MRI) study may be useful in differentiating these injuries, if they are not clinically apparent. A pronation weakness at 90 degree of flexion of the elbow is a reliable sign of medial epicondylitis.
WHAT CAN BE DONE ABOUT IT?
Physical therapy, cortisone injection have been tried without much long-term success. Injections with cortisone is basically a no no since they may the problem worse. Surgery is much more successful but why summit yourself to surgery and all its risks plus those of anesthesia when you can treat it as successfully or even with more success with Prolotherapy and/or PRP?
All patients stated that the pain and stiff- ness in their elbows was better after prolotherapy. Over 78% per- cent said the improvements in their pain and stiffness since their last prolotherapy session have continued 100%. Sixty-three per- cent received greater than 75% pain relief. In regard to quality of life issues prior to receiving prolotherapy: 77% were totally independent in activities of daily living, but this increased to 94% after prolotherapy. In regard to exer- cise ability before prolotherapy, only 33% could exercise greater than 30 minutes but, after prolotherapy, this increased to 87% These numbers are pretty hard to ignore when choosing your treatment specially when you consider there is basically no risk!