Do you have Inner (medial) elbow pain when gripping and lifting things? Does it get better once warmed up but then feels worse after activities? It could be Golfer’s Elbow! It is one of the most common types of upper limb overuse injuries we see in the clinic, and often starts just when your training is starting to ramp back up. The good news is – it can definitely be fixed with the right treatment approach! The first step is confirming that it is indeed Golfer’s Elbow by understanding what it is and how it develops.

What is Golfer’s Elbow?

Golfer’s elbow occurs on the inner elbow

Golfer’s elbow, also known sometimes as “Thrower’s elbow” or “Medial Epicondylalgia”, is a common injury on the inner side of the elbow. It is often a chronic, overuse injury of the forearm muscles, where the attachment point (tendon) of the muscles to your arm bone becomes irritated and sometimes inflamed. (1)

It is very similar to its counterpart – “Tennis Elbow” – which occurs on the outer elbow. Check out our Tennis Elbow Blog here!

What causes Golfer’s Elbow? 

Golfer’s elbow is caused by repetitive stress of the flexor and pronator muscles (responsible for gripping/rotating forearm) (2). It can be seen in many types of sports such as:

• Hitting sports e.g. Golf, Hockey
• Racquet sports e.g. Tennis (forehand shot), Squash, Badminton
• Throwing sports e.g. Baseball, Cricket
• Combat sports e.g. BJJ, Wrestling, Judo
• Climbing sports e.g. Rock Climbing, Bouldering  
• Lifting sports e.g. Powerlifting, CrossFit, Bodybuilding, Olympic Lifting

It is also common in occupations involving heavy gripping such as carpentry and other trades.

It is possible for Golfer’s elbow to develop if you have previously injured other structures in your elbow, for example the Ulnar Collateral Ligament (UCL)  [add hyperlink to UCL injury blog post]. (1)

Like all other overuse injuries, the amount of stress placed on your flexor muscles surpasses the tendon’s ability to cope, causing it to get irritated. This commonly occurs from changes in load, for example:

• Returning to sports/gym after a long period of inactivity, e.g. lockdown
• Increasing amount of training/games suddenly, e.g. during Rep season
• Altering technique or equipment used, e.g. changing Baseball pitching technique

Do I need Imaging for Golfer’s Elbow?

Imaging is rarely required for diagnosis of Golfer’s elbow. The diagnosis can be performed in-clinic by your physiotherapist. Common injuries with similar symptoms that your physiotherapist will exclude are: UCL sprains, or an ulnar nerve irritation.

When other issues may be suspected as well, MRI’s are best suited due to the clarity of detecting soft tissue injuries. (2)

What are the Rehab options for Golfer’s Elbow? 

Golfer’s elbow is managed conservatively with a combination of:

• Relative rest from the aggravating activities
• Manual therapy
• Strapping/bracing
• Inflammation management
• Graded strengthening of the flexor/pronator muscles and entire upper limb.

In stubborn cases cortisone injections or PRP (Platelet-rich Plasma) therapy may be proposed by your doctor.(1, 2)

How long does Golfer’s Elbow take to Recover?

Golfer’s elbow can take just 3-4 weeks if treated early with minimal tissue irritation, but can be over 3 months if rehab is delayed and there is moderate tissue damage involved.

Muscle belly tissue vs ligament

The long recovery time is due to the tendon’s slower rate of healing. This is because tendons have limited blood supply compared to muscle tissue (making them appear white in the above diagram). Less blood supply means slower movement of cells needed for healing.

What Should I Do If I Think I Have Golfer’s Elbow?

I would make sure “Golfer’s Elbow” is indeed your issue by consulting your nearest Physiotherapist that has a great understanding and experience in dealing with this issue. All of our Physiotherapists have great experience with this issue as well as other elbow issues due to our extensive experience with Baseball players and Martial Arts athletes, to name a few sports.

If you are looking for top quality assessment and treatment of your elbow injury then click the ‘book now’ button for Kevin or Luke. They both will be able to help you decide what path to take and provide you the high quality assessment and treatment that you need.

Find out more about Luke and Kevin on our team page!

References

1. Reece CL, Susmarski A. Medial Epicondylitis. [Updated 2021 Jul 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK557869/
2. Amin, Nirav H. MD; Kumar, Neil S. MD, MBA; Schickendantz, Mark S. MD Medial Epicondylitis, Journal of the American Academy of Orthopaedic Surgeons: June 2015 – Volume 23 – Issue 6 – p 348-355
   https://journals.lww.com/jaaos/Fulltext/2015/06000/Medial_Epicondylitis__Evaluation_and_Management.4.aspx