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Golfer's Elbow: Causes, Symptoms & Treatment

Golfer's elbow is a painful overuse condition affecting the tendon attachments on the inner side of the elbow, often caused by repetitive arm movements.

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Things worth knowing about "Golfer's elbow"

Golfer's elbow is a painful overuse condition affecting the tendon attachments on the inner side of the elbow, often caused by repetitive arm movements.

What is Golfer's Elbow?

Golfer's elbow (medically known as medial epicondylitis or epicondylitis humeri ulnaris) is a painful condition caused by irritation or inflammation of the tendon attachments on the inner side of the elbow. The muscles and tendons responsible for flexing the wrist and fingers are primarily affected. Despite its name, golfer's elbow can affect anyone who regularly performs repetitive arm and wrist movements, not just golfers.

Causes

Golfer's elbow typically develops due to overuse of the forearm muscles. Contributing factors include:

Repetitive gripping, flexing, or rotating movements of the wrist and forearm
Sports activities such as golf, tennis, baseball, or rock climbing
Occupational tasks such as typing, writing, carpentry, or using hand tools
Sudden overexertion from unaccustomed physical activity
Muscle weakness or poor movement mechanics

Symptoms

The typical symptoms of golfer's elbow include:

Pain on the inner side of the elbow, which may radiate down the forearm
Tenderness when pressing on the medial epicondyle (the bony prominence on the inside of the elbow)
Increased pain when flexing the wrist or gripping objects
Stiffness and weakness in the forearm, especially in the morning
Tingling or numbness in the fingers (particularly the ring and little fingers) if the ulnar nerve is involved

Diagnosis

The diagnosis of golfer's elbow is usually made clinically. The doctor will first take a detailed medical history and then perform a physical examination. Key diagnostic steps include:

Medical history: Reviewing the patient's activities, symptoms, and their progression
Palpation test: Pressing on the medial epicondyle to check for tenderness
Provocation tests: Such as the wrist flexion test or forearm pronation test
Imaging: Ultrasound or MRI may be used to visualize tendon changes or associated injuries when the diagnosis is unclear

Treatment

Conservative Treatment

In most cases, golfer's elbow heals with conservative measures:

Rest and activity modification: Avoiding painful movements and reducing overload
Cooling: Ice application for pain relief during the acute phase
Physiotherapy: Stretching and strengthening exercises to stabilize the forearm muscles
Orthoses and braces: Forearm straps or bands can help offload the tendon attachment
Medications: Pain relievers or anti-inflammatory drugs (e.g., ibuprofen) may be used short-term
Shockwave therapy: Extracorporeal shockwave therapy may be beneficial for persistent cases
Corticosteroid injections: A targeted cortisone injection may be considered for severe pain

Surgical Treatment

If conservative treatments fail to provide sufficient relief after several months, surgery may be considered. The procedure involves removing damaged tendon tissue and reattaching the tendon. Surgery is rarely required.

Prevention

To prevent golfer's elbow, the following measures are recommended:

Warming up thoroughly before sports activities
Regularly strengthening and stretching the forearm muscles
Setting up an ergonomic workspace
Adapting training intensity and technique in sports
Using appropriate sports equipment (e.g., correct grip size in golf)

References

Shiri R, Viikari-Juntura E. - Lateral and medial epicondylitis: role of occupational factors. Best Practice & Research Clinical Rheumatology. 2011;25(1):43-57. PubMed PMID: 21663852.
Svernlov B, Adolfsson L. - Non-operative treatment regime including eccentric training for lateral humeral epicondylalgia. Scandinavian Journal of Medicine & Science in Sports. 2001;11(6):328-334.
World Health Organization (WHO): Musculoskeletal conditions - Overview and management strategies. WHO Technical Report, Geneva, 2021.

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