Treatment of Medial Epicondylalgia Using Tissue Flossing, Local Eccentric Exercise, and Addressing Functional Chain Asymmetries – A Case Report

STUDY DESIGN: Case Report BACKGROUND: Medial epicondylalgia (ME), commonly known as golfer's elbow, is less frequently studied compared to lateral epicondylalgia. It presents significant treatment challenges, especially in active populations. This case report demonstrates a multifaceted therapeutic approach to ME in a CrossFit athlete. CASE DESCRIPTION: A 34-year-old male CrossFit athlete presented with a two-week history of medial elbow pain, worsened by intense workouts. The pain, described as achy and sometimes sharp, extended into the anterior forearm. Examination revealed tenderness at the medial epicondyle and weakness in wrist flexion and elbow movements. Initial treatment included activity modification and patient education, followed by a structured program of strengthening exercises to progressively reload the affected tissues and address functional chain impairments. OUTCOMES: After one month, the patient showed marked improvement. Pain during grip testing decreased from 7/10 to 0/10, and grip strength increased from 60 to 95 pounds. Pain during elbow flexion reduced from 4/10 to 0/10. The patient resumed all activities without pain, except for heavy front rack positions, which continued to provoke slight tension at his elbow. All outcomes exceeded minimal clinically important differences. CONCLUSION: This case underscores the effectiveness of a comprehensive rehabilitation program integrating manual therapy, patient education, and progressive loading in managing ME.