Golfer’s Elbow

What is “golfer’s elbow”?

Golfer’s elbow (medial epicondylitis) occurs secondary to activities that place stress on the medial (inside) aspect of the elbow. Affected structures include the muscle and tendon at and just below the attachment site on the medial epicondyle (bony prominence on the inside of the elbow). These muscles are responsible for flexing your wrist and pronating (turning the palm down) your forearm. This condition occurs not only in golfers, but also in individuals who perform repeated resisted motions of the wrist. Despite its name “tendonitis,” which refers to inflammation (“itis”) of the tendon, there is no inflammatory component. The true pathology is what is now referred to as “tendinosis,” referring to degenerative changes in the tendon at the attachment site.

WOSM Elbow Experts

How does golfer’s elbow occur?

  • Chronic, repetitive stress and strain to the muscles and tendons of the wrist and forearm to the elbow
  • Sudden strains placed on the forearm, including wrist snap when serving balls with racket sports or throwing a baseball

What increases my risk?

  • Activities that require repetitive and/or strenuous forearm and wrist movements (tennis, squash, racquetball, carpentry)
  • Poor physical conditioning (strength and flexibility)
  • Inadequate warm-up before activity
  • Resumption of activity before healing, rehabilitation and conditioning are complete

What are the symptoms of golfer’s elbow?

  • Pain and tenderness on the inside of the elbow
  • Pain or weakness with gripping activities
  • Pain with twisting motions of the wrist (playing golf, using a screwdriver, or bowling)

How is golfer’s elbow diagnosed?

  • Reported history of medial elbow pain with focal tenderness over the bony prominence on the inside of the elbow (medial epicondyle)
  • Pain with wrist flexion (bending wrist towards the palm) against resistance
  • Pain with forearm pronation (turning palm down) against resistance.

Are there any special tests used to diagnose golfer’s elbow?

Your physician will let you know if special imaging studies are necessary. In certain conditions, the following tests may be indicated.

  • X-rays are usually normal
  • MRI is unnecessary except in cases that are atypical (i.e., history of prior surgery, significant trauma, swelling, difficulty with elbow motion).

How is golfers’ elbow treated?

Non-operative treatment is effective for many patients. Initial treatment consists of activity modification to minimize provocative activities, anti-inflammatory medications and ice.

Use of a “counterforce” brace that splints the muscle-tendon unit just below the site of attachment may be recommended. Gentle stretching and strengthening exercises are helpful as the symptoms subside. Persistent symptoms may justify referral to physical therapy for further evaluation and treatment. A cortisone injection may be effective for some patients, but may need to be repeated.

Operative treatment

Many patients respond to non-operative treatment, but for patients with persistent symptoms, surgery may be indicated. Surgical treatment involves surgical excision of the pathologic abnormal tissue responsible for the symptoms. The success rate with surgical treatment is better than 90 percent.

When can you return to your sport or activity?

If symptoms are treated shortly after onset, improvement with conservative measures may allow for a quick return to activity. Chronic cases may require three to six months to resolve, and may require referral to a physical therapist or athletic trainer.

How can “golfers’ elbow” be prevented?

  • Appropriately warm up and stretch before practice or competition
  • Maintain wrist/forearm flexibility and muscle strength/endurance
  • Ensure proper equipment fit (e.g., racquet size/weight and grip)
  • Maintain proper technique