Golfer’s Elbow Test (or Medial Elbow test) is used for Medial Epicondylitis of the elbow joint or Golfer’s Elbow.
Medial epicondylitis is only one-third as common as lateral epicondylitis. It primarily involves a tendinopathy of the common flexor origin, specifically the flexor carpi radialis (FCR) and the humeral head of the pronator teres. To a lesser extent, the palmaris longus, flexor carpi ulnaris (FCU), and flexor digitorum superficialis (FDS) may also be involved.
The mechanism for medial epicondylitis is not usually related to direct trauma, but rather to overuse. This commonly occurs for three reasons:
Medial epicondylitis usually begins as a microtear at the interface between the pronator teres and FCR origins with subsequent development of fibrotic and inflammatory granulation tissue. An inflammation develops in an attempt to speed up tissue production to compensate for the increased rate of microdamage caused by increased use and decreased recovery time.
Chronic symptoms result from a loss of extensibility of the tissues, leaving the tendon unable to cope effectively against tensile loads.
The typical clinical presentation for medial epicondylitis is pain and tenderness over the flexor pronator origin, slightly distal and anterior to the medial epicondyle. The symptoms are typically reported to be exacerbated with either resisted wrist flexion and pronation or passive wrist extension and supination.
Differential diagnosis for medial elbow symptoms includes:
Conservative intervention for medial epicondylitis has been shown to have success rates as high as 90%.
The conservative intervention for this condition initially involves rest, activity modification, and local modalities.
Complete immobilization is usually not recommended as it eliminates the stresses necessary for maturation of new collagen tissue.
Once the acute phase has passed, the focus switches to restoring range of motion and correcting any imbalances of flexibility and strength. The strengthening program initially includes multi-angle isometrics, and then concentric and eccentric exercises of the flexor–pronator muscles. Splinting or the use of a counterforce brace may be a useful adjunct.