Medial Epicondylitis (Golfer’s Elbow)

You may have heard of tennis elbow, but are you familiar with its counterpart, golfer’s elbow? Both are tendon injuries; the connective tissue that attaches muscle to bone. So what’s the difference? This problem in the outer elbow is known as tennis elbow (lateral epicondylitis), while golfer’s elbow (medial epicondylitis) is located in the inner elbow and forearm.

Read on to learn more about the causes and symptoms of golfer’s elbow, and how it is treated.


What causes golfer’s elbow?

Firstly, you don’t have to be an avid golfer to develop it! It’s an overuse injury caused by any repetitive movement of the wrist, hand and forearm.

Besides overdoing it on the golf course, what are the types of activities that may cause golfer’s elbow?

  • Racket sports like tennis or squash – gripping a racket that is too heavy or too light. Make sure you check your technique as well.
  • Weight training with poor technique causes you to overwork the tendons and muscles of the arms.
  • Ball sports: repeatedly throwing a ball in sports such as bowling, softball and baseball.
  • Manual labour: painting, plumbing, and construction work that involves forceful and repetitive movements cause golfer’s elbow. Doing repetitive work using tools like hammers or screwdrivers may also cause it.
  • Computer work: frequently typing on a keyboard and using a mouse with a poor ergonomic set up.


What are the symptoms of golfer’s elbow?

There are some common symptoms you may experience if you have golfer’s elbow. It’s worth noting that the pain develops over weeks or months, often starting out as pain in the inner elbow.

You might experience pain and tenderness that radiates from the inside of the elbow down the forearm. Your elbow may be stiff or difficult to move. Although rare, there may be numbness or tingling in your fingers, or weakness in the hand and wrist also.


How is golfer’s elbow treated?

Most of the time this condition is managed at home, following simple steps used to treat tendon injuries:


Rest your arm: this one’s important! You need to give the tendon a break for a few days so that it has a chance to heal. Avoid any activity that makes the pain worse. You can gradually re-introduce these activities once the pain is under control.


Apply ice: in the initial stages of injury, ice can help to control pain. For the first few days, apply to your elbow and forearm for 15 to 20 minutes, three to four times a day. Contrary to popular belief, you want to limit ice application because the cold temperature can inhibit the natural inflammatory process the body goes through when a new injury develops. We want to allow the body to do its thing, so use ice sparingly and only early on.


How can I prevent golfer’s elbow?

  • Take regular breaks from repetitive exercises.
  • Stop any activity that causes elbow or forearm pain.
  • Learn proper techniques for exercise and sport to avoid putting extra stress on your wrists and elbows.
  • Warm up properly before you begin exercise or sports.
  • Increase your arm strength.


How can osteopathic treatment help?

Your osteopath can help you to recover from golfer’s elbow. They may use soft tissue techniques such as massage and stretching to reduce muscular tension and increase blood flow to the tendon.

We can also treat golfer’s elbow with shockwave treatment , acupuncture and dry needling.

They will also help you to prevent the injury from reoccurring by conducting an assessment and diagnosing the root cause. Don’t be surprised if your osteo treats your neck, mid-back and shoulder to help with this issue. These areas often need attention too!


We’ll put together a treatment plan with you to see you gradually return to your former glory. Tendon injuries like these need an approach that focusses on strength and mobility and ultimately, time.


If you are experiencing elbow pain, we are here to help! Don’t let golfer’s elbow impact your handicap. Give us a call on (416) 546-4887 or email [email protected] to make an appointment.


Described by patients as “debilitating pain and fatigue which has been going on forever and all my doctors say there is nothing wrong”.

Unfortunately for all fibromyalgia patients they must wait for many tests to be done to finally get a diagnosis, this is called a diagnosis of exclusion, all other potential diagnoses must be rule out first. This can cause extra hardship during the wait as most patients will go without any treatments over the months it can take to rule out all the other diseases.


What is Fibromyalgia?

It is a condition of widespread pain and can include sleep issues, fatigue and mood disorders. It is believed that the brain/spinal cord are processing signals differently and causing this amplification of pain sensations. Most patients report the symptoms beginning after an event: physical trauma, infection, stress (emotional or traumatic event) or obesity. Every presentation of fibromyalgia differs but may include any of the following symptoms: dull ache widespread pain, fatigue, restless leg syndrome, sleep apnea, depression/anxiety, sleep disturbances, memory/concentration issues, and headaches. Also most Fibromyalgia patients also suffer from co-existing conditions like: IBS, chronic fatigue syndrome, interstitial cystitis, TMJ disorders and tachycardia. Fibromyalgia affects women 5 times more than men. There may also be a genetic predisposition.


How is fibromyalgia diagnosed?

Again, it is a diagnosis of exclusion, so all other symptoms must be rule out. A full work up will be performed which will include full patient history, physical examination, imaging and bloodwork.


How is fibromyalgia treated?

The main goal of treatment is to improve the patients quality of life and may not completely resolve the condition. I first recommend physical activity, even daily walks to start can significantly improve quality of life. Next, I recommend things to improve quality of sleep. We will also incorporate an aspect of therapy to change the way you may act or think of past events. Lastly, if needed we will add in supplements, acupuncture or other physical therapies.


If you have any further questions you can book an appointment with Dr. Pace, ND

Book at or 416.546.4887

Pain management: Acupuncture and more

Acupuncture can help relieve pains such as: Low back pain, headaches, menstrual cramps, nerve pain, all
muscles and joint pains, fibromyalgia and much more. The needle may be inserted where the pain is and
may be inserted in other points along the body that help treat pain. When the needles are inserted they
cause the release of endorphins which are the body’s natural pain killer. Depending on the type of pain the
needles may be inserted and left in for 20 minutes, in other situations the needles may be manipulated.
The needle would be twisted or could be moved in and out quickly to break up a trigger point.

Electro-stimulation: This is an add on to acupuncture, a small current is passed through the needles or
beside them with pads. The frequency is adjusted to a threshold that is comfortable but also therapeutic.
The run time of this method is around 20 minutes. This option is not painful but may be uncomfortable
for some.


Moxibustion: This is also an add on to acupuncture, heat is applied to the area. This can be done with
infra red lamps or with burning moxa. This increases temperatures which increases circulation to the area.
This is great for pain management or circulation issues. Again this is a none painful treatment.


Cupping: Although sometimes used with acupuncture, most treatments with cupping are done before or
after an acupuncture treatment. A suction cup is placed on the skin, and either kept in place or dragged
along the skin. This is a great options for releasing muscle tension, it also increases circulation.
If you are interested in any of these treatments please contact Beachealth and Dr. Pace ND can answer
any of your questions.


Acupuncture: much more than just pain relief

If you have never had acupuncture before, the thought of a “needle” being inserted into your body may be scary. Let me put your mind at ease, we can insert an acupuncture needle into the hole of a blood draw needle. They are extremely small in comparison and do not cause as much pain, if any at all. Also a personalized acupuncture protocol can help you with so much more than just muscle pain relief.


Why would you get acupuncture?

The most common reasons people receive acupuncture is for pain: headaches/migraines, muscle pain, arthritis, menstrual cramps, TMJ syndrome. Once your personalized protocol has been made acupuncture can even help with stress, anxiety, sleep issues, GI issues, high blood pressure, nausea, vertigo, strengthen immune system, and addictions.


What to expect in each appointment? 

In your initial appointment a guided examination surrounding your complaint will take 20-30 minutes. This will allow the practitioner to make an informed Chinese Medicine diagnosis and prepare your personalized protocol. During the initial appointment you will also receive your first treatment, which will last roughly 20 minutes. Follow up appointments are roughly 30 minutes, which will only include your treatment unless something new has come up. In each treatment you will have the choice to talk with the practitioner or simply relax and listen to some music. The number of treatments vary depending on the complaints and severity but the average is 1-2 visits per week for 4-5 weeks.


What to expect during the treatment?

 Each protocol is customized to your specific diagnosis and severity. There are 361 points that follow 12 meridians along the whole body. There are also Aschi points which are trigger points that form in muscles. A protocol can consist of 10-20 needles, and can be located anywhere from the forehead to the foot/hand or where the pain is located. Each needle is inserted to specific depths, depending on the location, this is done to activate Qi, when the right depth and location is achieved, you may feel a dull ache. Shooting or severe pain should not be felt. Once the needles have been inserted, they will remain in place for an initial 10 minutes. After this the practitioner many manipulate the needles, twist or move the needle to reactivate the Qi, there again they will remain for another 10 minutes. After the full 20 minutes the needles will be removed, it is not uncommon for a little blood to come out, but there is no reason for concern, especially for some protocols, bleeding will help resolve the issue.


What to expect after the treatment?

After the treatment most patients feel relaxed or energized, it depends on the protocol and the goal. It is suggested after a treatment to not lift anything heavy, to relax, stay away from stimulants and depressants for 12 hours, The practitioner may also make diet and lifestyle recommendations that go along with your diagnosis. A key to success with acupuncture is open dialogue, be open with your practitioner and give feedback so that he can make and adapt your protocol to be right for you. If you do not start to see improvements after a couple of weeks, the protocol may need to be changed or acupuncture may not be right for you.


Book your initial acupuncture appointment with Dr. Matthew Pace, ND

Cosmetic Acupuncture

Facial rejuvenating acupuncture is a low to no-risk treatment for prevention or treatment of wrinkles and blemishes on the face. Treatments can also help with acne, rosacea, puffiness, sagging skin, and dark circles. A treatment consists of multiple fine needles placed in specific areas on the face and neck and complementary needles in the feet and hands. Each treatment lasts roughly 60-90 minutes. A study conducted and published in the International Journal of Clinical Acupuncture showed that of 300 test cases who received facial rejuvenation, 90% showed results after one course of treatment. The results included: improvement in skin texture and colouring, increased elasticity, reduction of wrinkles and overall rejuvenation.
For best results 1-2 treatments per week for 6-10 weeks is recommended with one touch up treatment every 3-4 months.
Matthew Pace, ND is now offering Facial Rejuvenating Acupuncture at Beachealth.