Explanation of Diagnosis

Medial epicondylitis, commonly known as golfer’s elbow, is caused by inflammation or degeneration of the tendons that attach to the medial epicondyle (inner elbow). It occurs due to overuse, repetitive gripping, or wrist flexion movements (bending the wrist downward). Symptoms include pain on the inside of the elbow, tenderness, weakness in grip strength, and stiffness.

Specific Work Modifications

• Avoid repetitive gripping, wrist flexion (bending the wrist downward), or lifting heavy objects.
• Use ergonomic tools with larger grips to reduce strain.
• Take frequent breaks to stretch and rest the arm.
• Wear a counterforce brace (forearm strap) to relieve stress on the tendon.
• Modify workstation setup (ergonomic mouse, keyboard, or wrist support if typing).

Specific Activity Modifications

• Avoid sports or activities requiring repetitive wrist flexion or gripping (e.g., golf, tennis, weightlifting).
• Modify technique in sports to reduce strain (lighter grip, proper wrist positioning).
• Use a brace during activities to reduce tendon stress.
• Gradually return to hobbies with proper warm-ups and strengthening exercises.

Recommended Supplements

• Collagen peptides (10 g daily) – Supports tendon repair.
• Vitamin C (500 mg daily) – Aids in collagen synthesis.
• Magnesium (300-400 mg daily) – Helps muscle relaxation and recovery.
• Turmeric (500 mg twice daily) – Reduces inflammation and pain.
• Omega-3 fatty acids (1000 mg daily) – Helps reduce stiffness and swelling.

Recommended Nutrition and Hydration

Diet Recommendations:

• Anti-inflammatory foods: Leafy greens, berries, nuts, and fatty fish (salmon).
• Protein-rich foods: Chicken, eggs, lentils, and dairy to support tendon healing.
• Collagen-boosting foods: Bone broth, citrus fruits, and bell peppers.
• Avoid processed foods and excessive sugar, which can worsen inflammation.

Hydration Tips:

• Drink 2–3 liters of water daily to maintain tendon hydration.
• Limit caffeine and alcohol, which can slow healing.

Home Exercise Prescription

Perform 2-3 times daily to reduce pain and improve mobility:

1. Eccentric Wrist Flexion Exercise

1. • Hold a light dumbbell (1-3 lbs) in the affected hand.
   • Slowly lower the wrist downward over 3-5 seconds, then use the other hand to bring it back up.
   • 10 reps, 2-3 times daily.

2. Wrist Flexor Stretch

1. • Extend the arm with the palm facing up.
   • Use the opposite hand to gently pull fingers back.
   • Hold 20-30 seconds, repeat 3 times.

3. Isometric Grip Strengthening

1. • Squeeze a soft stress ball gently for 5 seconds.
   • Repeat 10-15 reps, 2 times daily.

4. Forearm Pronation/Supination

1. • Hold a light weight (or a hammer) with the elbow bent at 90°.
   • Rotate the palm up and down slowly.
   • 10 reps, 2-3 times daily.

5. Towel Twist Exercise

1. • Hold a towel with both hands and twist as if wringing water out.
   • Perform 10 reps in each direction, 2 times daily.

Avoid heavy lifting, repetitive gripping, or direct elbow pressure until symptoms improve.

Helpful Books

1. "Framework for the Shoulder: A Practical Guide to Preventing Injury and Returning to Activity" – Nicholas A. Dinubile, MD
2. "Rebuilding Milo: The Lifter’s Guide to Fixing Common Injuries and Building a Strong Foundation" – Aaron Horschig

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.