Golfers Elbow: Symptoms, Types, Causes and Treatment

Golfers elbow, medically known as medial epicondylitis, is a surprisingly common condition that affects not just golfers, but anyone who relies on repetitive wrist and forearm movements. Whether you’re a weekend athlete, a manual worker, or someone who simply enjoys the occasional game of golf, understanding this injury is key to managing pain, staying active, and preventing long-term complications. In this article, we’ll explore the symptoms, types, causes, and treatments for golfers elbow, drawing from the latest research and expert insights.

Symptoms of Golfers Elbow

Recognizing golfers elbow starts with understanding its hallmark symptoms. While the pain can be subtle at first, it often progresses, impacting daily activities and athletic performance. Early detection can make a big difference in recovery outcomes.

Primary Symptom	Location	Activity Trigger	Source(s)
Pain	Inner elbow	Gripping, wrist movement	1 3 5 7
Tenderness	Medial epicondyle	Palpation of inner elbow	3 4 5
Weakness	Forearm/wrist	Lifting, shaking hands	3 4 5
Stiffness	Elbow joint	Morning/after rest	5 7

Table 1: Key Symptoms

Pain and Location

The most prominent symptom of golfers elbow is pain on the inner side of the elbow, precisely where the tendons of the forearm muscles attach to the bony prominence called the medial epicondyle. The pain often radiates along the inner forearm and may intensify with certain movements, such as gripping objects, shaking hands, or flexing the wrist 1 3 5 7.

Tenderness and Localized Discomfort

On examination, individuals typically experience tenderness directly over the medial epicondyle or just below it. This area may feel sore to the touch, especially after repeated use or strain 3 4 5.

Weakness and Stiffness

Golfers elbow can lead to weakness in the wrist and forearm, making it difficult to perform everyday tasks like holding a coffee cup, turning a doorknob, or lifting items. Some people notice stiffness in the elbow, especially in the morning or after periods of inactivity 3 4 5 7.

Symptom Progression

Initially, discomfort may only occur during activity, but as the condition worsens, pain can persist even at rest. Chronic cases may show swelling or a burning sensation along the elbow, and in rare instances, nerve involvement can cause numbness or tingling down the arm 1 4 5.

Types of Golfers Elbow

Golfers elbow isn’t a one-size-fits-all condition. There are nuanced variations based on severity, underlying tissue changes, and even confusion with other elbow injuries. Let’s break down the main types and classifications.

Type	Characteristic	Distinguishing Factor	Source(s)
Acute	Sudden onset	Recent injury or overload	1 7 8
Chronic	Lasting >3 months	Degenerative tendon changes	1 4 5 8
Partial tear	Microtears in tendon	Localized pain, partial function	1 7
Complete tear	Full tendon rupture	Severe loss of function	7

Table 2: Types of Golfers Elbow

Acute vs. Chronic Golfers Elbow

Acute golfers elbow occurs after a sudden injury or a single episode of overuse, resulting in pain and inflammation. Chronic golfers elbow develops gradually over weeks or months due to ongoing stress and microtrauma to the tendon, often leading to degeneration and structural breakdown 1 4 5 7 8.

Partial and Complete Tendon Tears

Most cases involve microscopic tears (partial tears) at the tendon insertion, causing pain and weakness but retaining some function. Rarely, a full rupture (complete tear) may occur, leading to significant disability and requiring advanced intervention 1 7.

Overlap with Other Elbow Injuries

Medial epicondylitis can sometimes be confused with or coexist alongside other conditions, such as ulnar nerve entrapment or injuries to the ulnar collateral ligament complex. Detailed clinical assessment is essential to distinguish between these 7.

Causes of Golfers Elbow

Understanding what causes golfers elbow is the first step in both prevention and effective treatment. While the name suggests a link to golf, the reality is much broader.

Cause	Mechanism	At-Risk Population	Source(s)
Overuse	Repetitive wrist/forearm motion	Golfers, workers, athletes	1 2 3 4 5 7
Poor technique	Faulty swing or grip mechanics	Amateurs, beginners	2 6
Weakness/Imbalance	Muscle/tendon strain	Untrained individuals	6
Occupational strain	Manual labor, repetitive jobs	Construction, assembly	1 5 7

Table 3: Causes of Golfers Elbow

Repetitive Overuse

The primary cause is repetitive stress on the forearm muscles and tendons responsible for flexing the wrist and rotating the forearm. Activities that repeatedly engage these motions—like golfing, throwing, lifting, or typing—can trigger microtears and degeneration at the tendon’s bony attachment 1 3 4 5 7.

Faulty Technique and Inadequate Conditioning

Improper swing mechanics, grip technique, or sudden increases in activity can overload the tissues, especially in amateur athletes or those new to certain sports. Similarly, a lack of strength or flexibility in the forearm muscles places additional strain on the tendon 2 6.

Occupational and Lifestyle Factors

Golfers elbow is not exclusive to athletes. People who perform repetitive manual tasks—such as carpenters, plumbers, painters, or assembly line workers—are also at risk. Even routine activities like carrying groceries, gardening, or frequent typing can contribute 1 5 7.

Age, Gender, and Other Risk Factors

Golfers elbow most commonly affects adults aged 40–50, with men and women equally susceptible 3. Previous injury, poor equipment, and inadequate warm-up routines further increase risk 2 6.

Treatment of Golfers Elbow

Treating golfers elbow requires a multi-pronged approach tailored to the individual’s needs, severity of symptoms, and underlying causes. Most cases respond well to conservative care, while persistent or severe cases may require advanced interventions.

Treatment	Approach/Modality	Indication	Source(s)
Rest/Modification	Reduce aggravating activity	First-line, all cases	1 3 4 5 7
NSAIDs	Oral/topical anti-inflammatories	Pain, inflammation	1 3 4 5 7
Physical therapy	Stretching/strengthening	Rehabilitation, prevention	1 4 6
Bracing	Counterforce/forearm braces	Symptom relief, protection	4
Injections	Corticosteroid/local therapies	Persistent pain	1 3 4 5 8
Surgery	Debridement/repair	Refractory, >6 months failure	1 4 5 7
Alternative	Dry needling/manual therapy	Select chronic cases	8

Table 4: Treatments for Golfers Elbow

Conservative (Non-Surgical) Management

Activity Modification and Rest: The first line of management involves reducing or temporarily halting activities that aggravate symptoms. Ergonomic adjustments, improved technique, and equipment modifications can help offload the tendon 1 3 4 5 7.

NSAIDs and Ice: Nonsteroidal anti-inflammatory drugs, either oral or topical, help alleviate pain and reduce inflammation. Applying ice to the affected area can also provide relief, especially in acute flare-ups 1 3 4 5 7.

Physical Therapy and Rehabilitation: A guided rehabilitation program is crucial. Stretching and strengthening exercises are introduced in a phased manner to restore flexibility, improve muscle balance, and prevent recurrence. Physical therapy may also incorporate modalities such as ultrasound or manual therapy 1 4 6.

Bracing: Counterforce or forearm braces can offload the affected muscles and provide symptomatic relief during activities 4.

Injection Therapies

Corticosteroid injections may be considered for persistent or severe pain that does not respond to initial conservative measures. While these can provide short-term relief, repeated use is generally discouraged due to potential tendon weakening 1 3 4 5 8.

Alternative and Adjunct Treatments

Emerging therapies such as dry needling, shockwave therapy, or platelet-rich plasma injections are being explored, especially in chronic cases. For example, a case study demonstrated significant improvement in pain and function following a single session of dry needling for chronic golfers elbow 8.

Surgical Intervention

Surgery is reserved for individuals with debilitating pain that persists beyond 6 months despite well-managed nonoperative care and after ruling out other causes. The procedure typically involves excising the diseased tendon tissue, repairing the defect, and reattaching the muscle origin to the medial epicondyle. Most patients experience substantial pain relief, though some may have lingering strength deficits 1 4 5 7.

Prevention Strategies

Key preventive strategies include:

• Regular strength and flexibility training for the forearm
• Proper warm-up and cool-down routines
• Attention to technique and equipment (e.g., grip size, swing mechanics)
• Gradual progression of activity intensity 6

Conclusion

Golfers elbow is a multifaceted condition that extends well beyond the fairways. By recognizing symptoms early, understanding the various types and causes, and implementing evidence-based treatments, most individuals can expect significant improvement and a return to their favorite activities.

Key takeaways:

• Golfers elbow presents with pain and tenderness on the inner side of the elbow, often worsened by gripping or wrist movement 1 3 5 7.
• Types include acute, chronic, and, rarely, partial or complete tendon tears 1 4 5 7 8.
• Causes span repetitive overuse, poor technique, lack of conditioning, and occupational strain—not just golf 1 2 3 4 5 6 7.
• Treatment is primarily conservative—rest, NSAIDs, physical therapy, and bracing; injections and surgery are reserved for stubborn cases 1 3 4 5 7 8.
• Prevention is attainable through strength, flexibility, proper technique, and gradual progression of activity 6.

Understanding golfers elbow empowers you to take proactive steps for elbow health—on and off the course.