Medial Epicondylalgia (Golfer's Elbow) Treated by Eccentric Exercise

Abstract

Background Eccentric exercises have been successfully used in the treatment of Achilles and patellar tendinopathies, as well as lateral epicondylalgia. No studies have explored the same treatment for medial epicondylalgia (golfer's elbow). Methods Twenty consecutive adults with a clinical diagnosis of medial epicondylalgia were treated with eccentric exercise over 3 months in this prospective case series. The programme was based on home training. There were 11 women and nine men, with a mean age of 47 years, and a mean duration of symptoms of 19 months. At baseline, at 3 months and after a mean of 11 years, pain was assessed by three independent visual analogue scales (VAS) and grip strength using a Jamar dynamometer (Sammons Preston Inc., Jackson, MI, USA). At the 11-year follow-up, patients also reported their satisfaction on a 100-mm VAS and completed the Disabilities of Arm, Shoulder and Hand questionnaire. Results Pain decreased significantly in all measured variables at both assessment occasions (all p < 0.0001). Grip strength in the affected arm/hand increased significantly after 3 months ( p = 0.009). Discussion Twelve weeks of eccentric training reduced pain and increased grip strength in patients with medial epicondylalgia. It is a safe, uncomplicated and cost-effective method, with only a minimum contribution from a physiotherapist.