Elbow pain is an interesting problem. There are fractures of the radial head, ligament injuries, dislocations and infections that cause pain, but most of the time elbow pain is either tennis elbow (lateral epicondylitis) or golfer’s elbow (medial epicondylitis). Country club injuries.

If you pop open an anatomy book you will see that a number of muscles attach at each epicondyle of the elbow. I am going to list the muscles here so that you can look for a pattern in the names. The muscles that attach to the medial epicondyle are the flexor carpi radialis, the flexor carpi ulnaris, the flexor digitorum superficialis, and the palmaris longus muscles. The muscles that attach to the lateral epicondyle are the anconeus muscle, the supinator, extensor carpi radialis brevis, extensor digitorum, extensor digiti minimi, and extensor carpi ulnaris muscles.

The common theme is that the muscles that attach at the medial epicondyle all flex/pronate the wrist/hand/fingers and the muscles that attach at the lateral epicondyle all extend/supinate the wrist/hand/fingers (Translation help: radialis/ulnaris = wrist, palmaris/digitorum/digiti = hand/fingers).

That piece of the puzzle gives us a key to how to treat the ailments—>to treat tennis/golfer’s elbow keep the wrist/hand/finger complex from moving. In other words put them in a wrist brace and let the tendons at the elbow rest. That is the most simple and important step of treatment.

The exam for the epicondylities involves palpation at the epicondyle—it should hurt there—and resisted wrist movements.  For medial epicondylitis have them flex their wrist against resistance and then shake hands with the patient and resist as they try to pronate their wrist.  For lateral epicondylitis have the patient pull their wrist back against resistance, pull their middle finger back against resistance and then shake hands with them and resist as they try to supinate the wrist. You should get pain with one of these revisited movements.

Other than wrist bracing, there are two other treatment modalities that I use frequently. One is a counter force brace—these are the straps that go around the forearm just distal to the elbow. The concept is that if you squeeze hard on the muscles just past where the tendons insert to the bone, you can possibly allow the muscles to anchor/contract/pull off that strap instead of pulling on the bone. Patients can buy these are Walgreens/Walmart/Target/Amazon.

The second treatment option is physical therapy. It turns out rock climbers get these injuries frequently, so the rock climbing magazines have some helpful hints for rehab—this is one of my favorites using a frying pan:
https://rockandice.com/climbing-injury-prevention/tennis-elbow/