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Golfer's Elbow: Causes, Symptoms and Treatment
Golfer's elbow is a painful condition affecting the tendons on the inner side of the elbow. It is caused by overuse of the forearm muscles and can affect anyone, not just golfers.
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Golfer's elbow is a painful condition affecting the tendons on the inner side of the elbow. It is caused by overuse of the forearm muscles and can affect anyone, not just golfers.
What is Golfer's Elbow?
Golfer's elbow (medically known as medial epicondylitis) is an overuse injury affecting the tendon attachments on the inner side of the elbow. The tendons of the muscles responsible for flexing the wrist and fingers attach at this point. Repetitive or excessive strain on these tendons can lead to irritation and inflammation, causing pain and reduced function.
Causes
Despite its name, golfer's elbow is not limited to golfers. Common causes include:
- Repetitive wrist and forearm movements (e.g., in golf, tennis, throwing sports, or using hand tools)
- Physically demanding occupations with one-sided arm use (e.g., carpenters, painters, musicians)
- Sudden, uncontrolled movements or direct trauma to the elbow
- Insufficient warm-up before physical activity
- Muscular weakness or imbalance in the forearm
Symptoms
The most common symptoms include:
- Pain on the inner side of the elbow, which may radiate down the forearm
- Pain when flexing the wrist or gripping objects firmly
- Tenderness directly at the bony prominence on the inside of the elbow (medial epicondyle)
- Stiffness and weakness in the hand or forearm
- Occasional numbness or tingling in the ring and little fingers (if the ulnar nerve is involved)
Diagnosis
Diagnosis is primarily clinical. A doctor will take a thorough medical history and perform specific physical tests such as the Resisted Wrist Flexion Test or Valgus Stress Test. Additional diagnostic tools may include:
- Ultrasound: To assess tendon structure and detect calcifications
- MRI (Magnetic Resonance Imaging): For unclear findings or suspected associated injuries
- X-ray: To rule out bony changes or fractures
Treatment
Conservative Treatment
In most cases, golfer's elbow responds well to conservative management:
- Rest and activity modification: Avoiding movements that trigger pain
- Ice therapy: Local cooling to reduce pain during the acute phase
- Physiotherapy: Stretching and strengthening exercises to restore normal muscle function
- Elbow braces or epicondylitis straps: To offload the tendon attachment site
- Pain medication: Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen for short-term pain relief
- Shockwave therapy: Particularly useful for chronic cases
Injection Therapy
For persistent symptoms, a physician may administer corticosteroid injections into the affected area to reduce inflammation. PRP (Platelet-Rich Plasma) injections are an alternative approach aimed at stimulating the natural healing process of the tendon tissue.
Surgical Treatment
Surgery is rarely needed and is only considered for long-standing, treatment-resistant cases (typically after more than 6–12 months of failed conservative treatment). The procedure involves removal of damaged tendon tissue or reattachment of the tendon to the bone.
Prognosis and Prevention
With consistent treatment and targeted rehabilitation, the vast majority of patients recover fully. Preventive measures include:
- Regular warm-up before sports or physical activity
- Strengthening the forearm muscles
- Ergonomic adaptation of workplaces and sports equipment
- Taking regular breaks during repetitive tasks
References
- Shiri R, Viikari-Juntura E. - Lateral and medial epicondylitis: role of occupational factors. Best Practice & Research Clinical Rheumatology, 2011.
- Sims SE, et al. - Lateral epicondylitis: a review of diagnosis and management. British Medical Bulletin, 2014.
- Rineer CA, Ruch DS. - Elbow tendinopathy and tendon ruptures: epicondylitis, biceps and triceps ruptures. Journal of Hand Surgery, 2009.
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