Medial Epicondylitis

Medial epicondylitis (forehand tennis elbow, baseball elbow, suitcase elbow) is damage to the tendons that bend the wrist toward the palm, causing pain on the palm side of the forearm from the elbow toward the wrist.

This injury is caused by bending the wrist toward the palm with excessive force. Factors that produce such force include having weak shoulder or hand muscles; serving with great force in tennis; using an overhand and a top spin serve; hitting heavy, wet balls; using a racket that is too heavy, has a grip that is too small, or has strings that are too tight; pitching a baseball; throwing a javelin; certain golf swings, and carrying a heavy suitcase. Continuing to exercise with pain can pull the tendons from the bone, causing bleeding.

Pain is felt in the palm side of the elbow and forearm on the same side as the smallest finger when bending the wrist toward the palm against resistance or when squeezing a hard rubber ball. To confirm the diagnosis, a doctor asks the person to sit in a chair with the injured arm resting on a table, palm up. The doctor holds the wrist down and asks the person to raise the hand by bending the wrist. A person who has medial epicondylitis feels pain at the elbow.

Any activity that causes pain when the wrist is bent toward the palm or turned so that the little finger is next to the body should be avoided. After the injury has healed, the person should strengthen the wrist and shoulder muscles, as well as the injured muscles. Surgery is rarely needed. Surgery is more common on the lateral side; the Nirschl procedure removes scar tissue from the muscle to promote healing.

See the sidebar Strengthening the Wrist Muscles.