Medial Elbow Musculotendinous Injury & Tendinopathy

Medial Elbow Epicondylalgia is Far less common than lateral Epicondylalgia, has = distribution between males & females, may be concomitant w/

UCL injury → repetitive valgus stress

Other work related UE disorders: Lateral elbow pain, shoulder tendinopathy, Ulnar Tunnel or Ulnar nerve entrapment

Less likely to persist as a chronic condition

Medial Elbow Pain Differential Diagnosis**

Medial Epicondylitis

Cervical Radiculopathy C7-T1

Thoracic Outlet Syndrome

Shoulder conditions

Ulnar nerve entrapment (cubital tunnel)

UCL injury/instability

Medial Elbow Pain/Epicondylalgia signs & sxs

Medial Elbow pain that can radiate into ventral forearm

Most commonly dominant arm: 1 cm distal to medial epicondyle

painful gripping

pain w/ passive stretching (wrist ext): Elbow ext > Flexion

Pain w/ active wrist flexion: Elbow ext > Flexion

dull or sharp pains: rest should be pain free or reduce sxs

Medial Elbow Pain/Epicondylalgia Management includes Load management/activity modification, progressive exercise to focus on

improving load tolerance (Eccentric vs isotonic)

MT for pain modulation (medial elbow glides)

Wrist/Hand Orthosis

Counter force bracing (focusing on flexor group)

Injections

Biceps/Triceps Tendinopathy Biceps -> pain in

cubital fossa

Resisted elbow flexion and supination

Triceps Tendinopathy presents w/ Pain Along

olecranon at triceps insertion

Pain w/ resisted elbow extension, usually worse w/ elbow flexed

Interventions for Biceps/Triceps tendinopathy include

Activity modification

Resisted exercise (isometrics, eccentrics)

Distal Biceps Rupture is less common 1.2/100,000 pts, typical population include

40-70 y/o males

Weightlifters

Physically active

Rapid eccentric contraction

signs of Distal Biceps Rupture

May hear a pop

Cubital Fossa Pain & ecchymosis

Tender over biceps tendon

Hook Test

Weakness in elbow flexion & supination

Surgical Repair is usually warranted

Medial epicondylitis/Epicondylalgia is Tendinosis/itis/opathy of the common Flexor tendon; aka

Golfer’s Elbow