The golfer's elbow is classified according to cause and course:

1. **Acute golfer's elbow:**

- Sudden onset of pain, usually after intense exertion.

2. **Chronic golfer's elbow:**

- Prolonged discomfort due to repeated or sustained overuse.

3. **Secondary golfer's elbow:**

- Pain as a result of other conditions, such as misalignments or rheumatic diseases.

The main causes of golfer's elbow lie in the overuse of the forearm flexor muscles:

• Sporting activities:
  • Repeated movements, such as those in golfing, throwing, or tennis, strain the tendon attachments.
• Occupational strains:
  • Activities like painting, hammering, or working on a computer lead to overload due to monotonous movements.
• Leisure activities:
  • Gardening, playing music (e.g., playing guitar), or DIY can also promote its development.
• Mechanical misloads:
  • Poor technique or ergonomically unfavorable postures increase the strain on the inner side of the elbow.

The symptoms vary depending on the severity and course of the disease:

- **Pain on the inside of the elbow:**

- Initially, pain occurs only under stress, later also at rest.

- **Tenderness:**

- The tendon attachments on the inside of the elbow are sensitive to pressure.

- **Radiating pain:**

- Pain can radiate into the forearm and wrist.

- **Loss of strength:**

- Affected individuals often have difficulty gripping or lifting objects.

- **Stiffness:**

- The elbow often feels stiff, especially in the morning.

The diagnosis is made through a combination of medical history, clinical examination, and, if necessary, imaging techniques:

- Medical history:

- Recording of symptoms, duration, and possible causes of stress.

- Clinical examination:

- Checking for pain points and mobility. Tests such as the Mittelgriff test can confirm the diagnosis.

- Imaging techniques:

- Ultrasound: Visualization of inflammation or tendon damage.

- MRI: Detailed assessment of soft tissues, especially in chronic cases.

Conservative Therapy

Most cases of golfer's elbow can be treated without surgery:

• Physiotherapy:
  • Stretching and strengthening exercises to relieve the flexor muscles.
  • Manual therapy to resolve tension and adhesions.
• Pain therapy:
  • Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen for pain relief and anti-inflammation.
• Orthoses or braces:
  • Support for the elbow to reduce strain.
• Shock wave therapy:
  • Promotion of blood circulation and healing through mechanical stimuli.
• Injections:
  • Local injections with cortisone or hyaluronic acid for severe pain.

Surgical Therapy

If symptoms persist despite conservative measures, surgery may be necessary:

• Tendon release:
  • Surgical release of the stressed tendon attachments.
• Minimally invasive procedures:
  • Modern techniques to spare the surrounding tissue.

To prevent golfer's elbow, it is recommended to:

1. Optimize technique: Use ergonomic aids and seek professional guidance during sports activities.
2. Take regular breaks: Avoid unilateral strain by allowing sufficient recovery periods.
3. Perform stretching and strengthening exercises: Enhance muscles to reduce stress on tendons.
4. Ensure ergonomic workplace design: Adjust work equipment to prevent poor posture.
5. Seek early treatment: Immediate therapy at the first signs of discomfort.