Huw David

Tennis Elbow & Golfer's Elbow

Tennis elbow (lateral epicondylitis) is much more common than Golfers elbow (medial epicondylitis) though neither is the preserve of sportsmen or women. It tends to occur in the 20-30 age group and may follow an injury. As the name implies, it involves inflammation of the muscles attached to the lateral or outer aspect of the elbow (epicondyle). These muscles pass down the outer side of the forearm and attach by tendons to the wrist. These muscles extend the wrist. The neighbouring muscles attach to the fingers and thumb and enable extension of the digits. The muscles attached to the medial epicondyle pass along the anterior aspect of the forearm and are responsible for flexion of the wrist and fingers. Epicondylitis involves those muscles working on the wrist and it is not surprising that lateral epicondylitis is the more common of the two conditions given that strength is enhanced by extending not flexing the wrist (watch how a weightlifter extends rather than flexes his wrists when lifting). Occasionally, both conditions are experienced in the same arm at the same time.

Inflammation at the interface between the muscles and bone leads to pain with movement of the wrist and rotation of the forearm. As with other soft tissue conditions; rest, ice and use of anti-inflammatories may be recommended. Deep friction physiotherapy and use of a clasp can be effective. A tennis elbow or golfers elbow clasp differ from an elbow or sports support and Huw or your therapist will be able to advise as to which is best for you. If still symptomatic, an injection of an anti-inflammatory will resolve the problem for many, but surgery is indicated if symptoms recur. This is a small procedure that involves removal of a very small segment of the inflamed tissue. It is performed on a day case basis and is usually curative.

Relatively few individuals suffering with golfers elbow will require surgery and when symptoms are felt over both sides of the joint, successful treatment of the lateral epicondylitis may result in the medial symptoms settling without recourse to surgery.