Medial Overload Syndrome covers a range of syndromes related to pain on the inside part of the elbow (medial epicondyle).
Medial elbow pain on gripping can start as an annoying ache but rapidly degenerate into a debilitating problem, with pain on gripping, opening bottles or shaking hands.
ME maybe related to repetitive manual tasks and is also commonly reported in bowlers, archers, and weight lifters (as well as golfers!).
Pain and tenderness is then felt over the medial aspect of the elbow joint. As condition develops, clients report pins and needles or numbness in the 4th or 5th fingers.
Wrist weakness may also develop and pain is reported to be especially bad at night, just before sleep. Pain also increases typically when using tools, shaking hands, turning a doorknob, gripping, lifting or trying to stabilize or move the wrist.
The pathology is similar to a tennis elbow with repetitive micro-tears in the zone where the tendon of the muscle meets the bone.
Key facts about ME:
• Mostly affects those between 35 and 50 years of age
• Men more than women
• Develops due to overuse of the flexor muscles of the arm and wrist. Commonly linked to repetitive use/occupation: cooks, cleaners, butchers, gardeners, assembly line workers
• Now referred to by authorities as ‘Medial Epicondalgia’
• Not inflammation of the bone but micro‐tears and traumata with small bleeds
• Can become chronic so early treatment is advised
• Associated with golf due to the stress this sport places on the muscles, tendons and joints
• Tendons do not like sudden eccentric loads. A sudden eccentric load of 3% can tear a tendon. A sudden eccentric load of 5% can rupture a tendon.
• Tendon damage might be considered as a muscle fracture (Lewis 2014), it takes six weeks of very low loading to repair. Any increase in loading should be incremental.
• Stretching is Key
The pain from ME is often associated with ‘trigger points’ in the wrist flexors (especially Flexor Carpi Ulnaris, Flexor Digitorum Superficialis, Palmaris Longus and Medial Head of Triceps muscles).
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