Ep 32: Golfer's Elbow - Understanding and treating Medial Epicondylitis and elbow pain

Ever felt a nagging pain on the inside of your elbow when gripping a coffee mug or lifting a grocery bag? That's likely golfer's elbow—and no, you don't need to be teeing off regularly to experience it. This misunderstood condition affects countless people who've never set foot on a golf course.

Board-certified hand therapist Carl Petito breaks down what's actually happening when that tender spot on your inner elbow flares up. The pain stems from inflammation where your forearm muscles anchor to the medial epicondyle—that bony knob on the inside of your elbow. Every time you grip something tightly or turn your palm downward, you're engaging these muscles and potentially aggravating the condition.

Surprisingly, many common treatments like thick compression sleeves can actually make golfer's elbow worse by putting pressure on sensitive nerves and bony prominences. Instead, Petito reveals why simple approaches often work best: cold water therapy for just 10-20 seconds to reduce inflammation, proper stretching techniques to lengthen tight muscles, and a specialized counterforce strap that redirects pulling forces away from the tender area. You'll learn exactly how to modify your activities and grip positions to allow healing while maintaining functionality in your daily life.

If you're tired of that persistent elbow pain limiting your activities, this episode provides a clear roadmap to relief with practical, evidence-based recommendations from a specialist who treats these conditions daily. Most importantly, you'll know exactly when to try self-care and when it's time to seek professional help. The solution to your elbow pain might be simpler than you think—and it starts with understanding what's really happening beneath the surface.

Chapters

• 0:00 What is Golfer's Elbow?
• 1:41 Treatment Approaches and Stretches
• 4:34 Heat, Protection, and Grip Modifications
• 6:36 When to Seek Professional Help

Transcript

Speaker 1: 0:00

Welcome back to the Hand-to-Shoulder Solution, giving Pain the Middle Finger. I'm Carl Petito, occupational Therapist and Board-Certified Hand Therapist. Let's talk about golfer's elbow. There's a nickname for everything in orthopedics. What is golfer's elbow? Why do I have it? I don't play golf.

Speaker 1: 0:15

If you are having pain on the inside part of your elbow, there's a couple of things that can be going on. But but let's talk about golfer's elbow. So it's the opposite of tennis elbow because it's on the opposite side. So tennis elbow is on the thumb side or the outside part of your elbow, and golfer's elbow is on the inside part of your elbow. So if you start on the on the top with your palm up, if you start on the top of your elbow area and come down to the side on the inside part of your elbow, it touched right here where there's a round bony knob right there. That's actually the end of the humerus. So this humerus or upper arm bone comes down and flares out. The inside flare right there is what you're touching right there and that's the anchor point for all of the muscles that do this grip and turn it palm down. So if you squeeze something real hard and that hurts on the inside part of your elbow or if you lift something with your palm up and that hurts on the inside part of your elbow, or if you touch that part and it's tender, most likely you have golfer's elbow or medial medial for inside part. The other side is lateral. So medial epicondyleitis it's that epicondyle or bony knob area. Itis means inflammation. So if that's inflamed you might be leaning on the inside part of your elbow and if you are, chances are you're also having numbness and tingling on the small finger side of your hand, which is cubital tunnel syndrome, which we talked about. The ulnar nerve is being compressed. We talked about that in another show.

Speaker 1: 1:59

So, focusing on medial epicondylitis or golfer's elbow, what you don't want to do is wear a thick compressive sleeve, neoprene sleeve. I've seen people come into the office wearing these. Sometimes they're. I've seen them prescribed before. But you know they put pressure on the cubital tunnel, they put pressure on the nerve, they put pressure on the bony prominences and aggravate those because when you're moving it slides a little bit. I've seen the skin get really chafed.

Speaker 1: 2:29

But here's the mechanics real quick. So all the muscles in the, in the palmer surface, or the, the, the, yeah, the palm surface of the forearm, are the muscles that they connect right here. So this is the anchor point. So when you bend your wrist and you grab something, you pick something up heavy. That's the anchor point. So when you bend your wrist and you grab something, you pick something up heavy. That's the anchor point right there.

Speaker 1: 2:48

So there's one thing that we do use in the clinic for certain cases is a counterforce strap, so a strap that goes around the meaty muscle part to hold it. So now when you do use those muscles, it pulls more from here and not so much the original anchor point on the epicondyle and that allows the area to rest. Now, sticking the inside part of the elbow under cold running water only until it's deeply cold 10 to 20 seconds, that reduces the inflammation very, very nicely. Now the muscles in here tend to get very, very tight. The tighter they get, that means they're getting shorter right. So if they're getting shorter, that means it's pulling harder on the tendon that connects the muscles to the bone and it's aggravating the bone. If you lengthen the muscle now you have less pulling right here. So proper stretches if a person goes like this palm, a good, firm but not painful stretch in the forearm, that is really, really good for that and will be a great step in the right direction to get this to fully go away. So, in combination of wearing that counterforce strap when working, when doing heavy things, to help support this area, and then when relaxing, not doing much, take the strap off, do some nice stretches three or four times a day, hold the stretch for 20 seconds, a couple of repetitions. You know nothing crazy, you don't want to be. You want to be, you don't want to be really, really intense with this stuff. Nice, gentle, sustained stretch, 20 seconds two times and then repeat that three or four times a day. After heavy use, let's say you know the. A person's been been working all day. You know. At every break I usually tell people to just stick under cold rain water, just the inside part of the elbow and then the muscles around the forearm.

Speaker 1: 4:44

A low electric heating pad on the lowest setting for 10 to 15 minutes. Now people ask me I have the beanbag thing that I can just microwave. Um, I don't like those. The reason I don't like those is number one. Every microwave is different. Sometimes they start too hot. Uh causes an inflammatory response, makes inflammation go way up. No matter what the temperature it is, they start to cool down immediately. So you want an electric heating pad with a thermostat so it stays on a nice low to medium, steady temperature for a period of 10 to 15 minutes. Two to three times a day, not more than three times a day.

Speaker 1: 5:20

You can overdose on heat. It always feels great when it's on, but if more than three times a day, you're going to start causing inflammation. You're going to start really getting addicted to the heat and you're going to say, oh, would have felt great when it was on, I'm going to go back to it and just stay in the heat. They come out and now it's inflamed and now it hurts worse. I'll just go back to the heat. It's. It's a loop you don't want to get into. So two to three times a day you know when people underestimate it oh, it's just a heating pad. No, you can overdose on this stuff and really make things worse. So that's the basic mechanics.

Speaker 1: 5:48

We want to stay protected during the day. You want to try to avoid a really hard, tight grip. Avoid lifting really heavy things. Palm up. If you can't lift palm up, my goodness well, how can I lift Hammer position? So if you can lift something this way, you're using some different muscles. You're still using some of the same muscles but you're offloading those significantly. So that's a better way to do it In the clinic.

Speaker 1: 6:14

You know, know, if you do these things, if you touch the inside part of your elbow and that hurts a lot and the muscles are in a touch of muscles and they're a little sore and you do a stretch and you're yeah, you know what I feel a stretch. Just start doing some stretches right now. Stretches aren't going to hurt you unless you're having. You're responding adversely then to obviously stop. But if it doesn't go away in a few weeks, get into the clinic. You got to be seen. We have to do a thorough exam and nip it in the bud.

Speaker 1: 6:41

It's not a lot of therapy. I have people come in oh, after the first visit, show them exactly what to do at home. I'll do some co-laser treatment or some other manual therapy techniques that the person can't do for themselves at home. Have them come back in a week. Change up what they do at home a little bit. Upgrade the home program. Set them on their way. Have them come back in two weeks. I usually follow up with them once every couple of weeks week and a half to two weeks with the instruction that if they have any questions to call anytime, and with the instruction that if goodness forbid, anything gets worse, they have to call. Tell them I said I would squeeze them in and get them right back in immediately if something adversely is going on.

Speaker 1: 7:20

So, anyway, the bottom line is it's not a lot of going into the clinic, but try that at home. Most likely it's going to make you feel better. But don't wear a tight compressive sleeve or anything that's putting pressure on the inside part of the elbow right or anywhere on any bony prominence or any nerve. If any of your fingers are going to sleep, just stop using the device. It's just making things worse. Okay, thanks a lot for watching and thank you for subscribing to the channel. Thank you for sharing it with people who are having problems in this. This is meant to be a good, good resource to empower people just to simply feel better. Thank you.