Golfer's Elbow & Tennis Elbow
What Are Golfer's Elbow and Tennis Elbow?
Golfer’s elbow and tennis elbow are two closely related overuse conditions affecting the tendons at the elbow, named for the sports most classically associated with them, though both occur far more often from everyday activities than from the sports themselves.
- Tennis elbow (lateral epicondylitis) affects the tendons on the outer side of the elbow, which attach the forearm muscles responsible for extending the wrist and fingers
- Golfer’s elbow (medial epicondylitis) affects the tendons on the inner side of the elbow, which attach the forearm muscles responsible for flexing the wrist and gripping
Despite the “-itis” suffix suggesting inflammation, both conditions are now understood to be primarily a degenerative process within the tendon from repetitive overuse, rather than a simple inflammatory reaction — which is part of why they can be more stubborn and slower to resolve than a typical bout of inflammation.
What Causes Golfer's Elbow and Tennis Elbow?
- Repetitive gripping and wrist motion, common in racquet sports, golf, and weightlifting
- Repetitive occupational activities, such as typing, using hand tools, or repetitive manual labor — in fact, most cases have nothing to do with playing sports at all
- A sudden increase in a repetitive activity that the tendon isn’t conditioned for
- Poor technique in sports that places excess strain on the forearm tendons
- Age-related tendon changes that make the tissue more prone to overuse injury
What Are the Symptoms of Golfer's Elbow and Tennis Elbow?
- Pain localized to either the outer elbow (tennis elbow) or inner elbow (golfer’s elbow), often radiating partway down the forearm
- Pain that worsens with gripping, lifting, or specific wrist motions — for tennis elbow, this is often noticed extending the wrist or shaking hands; for golfer’s elbow, gripping and flexing the wrist
- Tenderness directly over the affected tendon attachment
- Weakened grip strength
- Symptoms that build up gradually over weeks, rather than starting from a single specific injury
How Can You Tell Which One You Have?
The location of the pain is the most reliable clue: tennis elbow causes pain on the outer, thumb-side bony bump of the elbow, while golfer’s elbow causes pain on the inner, pinky-side bony bump. A simple way to help distinguish them at home is to notice which motion reproduces the pain — resisted wrist extension (bending the wrist backward against resistance) typically aggravates tennis elbow, while resisted wrist flexion or gripping typically aggravates golfer’s elbow. That said, a physical exam is the most reliable way to confirm which tendon is involved, since the two conditions can sometimes overlap.
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Treatment Options for Golfer's Elbow and Tennis Elbow
The large majority of cases improve with nonsurgical treatment, though it often requires patience, since tendon healing is a gradual process:
- Rest and activity modification, temporarily reducing the repetitive motion that’s aggravating the tendon
- A counterforce brace worn over the forearm, which can help redistribute stress away from the irritated tendon
- Physical therapy, including stretching and a specific type of strengthening called eccentric exercise, which has strong evidence for helping these tendons remodel and heal
- Anti-inflammatory medication for symptom relief, particularly earlier in the course
- Corticosteroid injections, which may provide short-term relief, though they carry some risk of weakening the tendon further if used repeatedly
- PRP injections, which have grown in popularity for these conditions given their degenerative, rather than purely inflammatory, nature
Surgery is reserved for the small percentage of cases that don’t improve after a thorough, extended course (often 6 to 12 months) of nonsurgical treatment. Surgical treatment involves removing the damaged, degenerated portion of the tendon and reattaching the healthy remaining tissue, which can be performed either through a small open incision or arthroscopically.
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Dr. Palsis specializes in the treatment of knee, shoulder, and sports injuries.