Medial epicondylitis, commonly referred to as golfer’s elbow refers to the tendonitis/tendinopathy of the common flexor tendon which is located at the medial aspect of the elbow. This is usually brought about by activities which put repetitive strain on the common flexor tendon. The usual culprits are sports involving an overhead throwing activity with Golfers contributing to a significant chunk of the sports related cases. The medial epicondyle is the bony point of origin for the muscles constituting the common flexor tendon. These include the pronators and flexors of the forearm namely pronator teres, flexor carpi radialis, palmaris longus, and flexor digitorum superficialis and flexor carpi ulnaris. While the flexor carpi ulnaris is innervated by the ulnar nerve , the rest of the muscles are innervated by the median nerve. Measuring roughly 3 cms long, extending beyond the medial ulnohumeral joint, the common flexor tendon traverses in a parallel orientation to the ulnar collateral ligament behaving as a secondary stabilizer

Patients can present with swelling, redness and warmth in acute cases but chronic cases are unlikely to present with this symptom complex. Tenderness can elicited by palpation just anterior and distal to the medial epicondyle.Clinical testing for golfer’s elbow/medial epicondylitis comprises of an active and a passive component. For active component of the test, the patient is asked to resist wrist flexion with the arm in extension and supination. For the passive component wrist extension with the elbow in extension is included.[5,6] If pain is produced by these provocative manoeuvres, one should have a high clinical suspicion of golfer’s elbow. Ulnar neuropathy must be ruled out to complete the clinical examination. Tinel’s test should be performed to check for ulnar neuropathy.On exam, there may be swelling, erythema, or warmth in acute cases; chronic cases are less likely to present with abnormalities on inspection. The patient will have tenderness over the five to ten millimeters distal and anterior to the medial epicondyle, especially near the conjoined tendon or muscles including pronator teres and flexor carpi radialis. Resisted pronation or flexion of the wrist elicits pain. The patient may be weak in the affected arm. The range of motion is typically normal.

The golfer’s elbow test or medial epicondylitis test involves an active and a passive component. In the active component, the patient resists wrist flexion with the arm in extension and supination. The passive component includes wrist extension with the elbow in extension. A test is positive when the patient endorses pain with this maneuver. [1,2]Tinel’s test should be used to evaluate for ulnar neuropathy, and the ulnar collateral ligament should be stressed especially in throwing athletes.