Golfer’s Elbow (aka Medial Epicondylitis)
⌚️ read time: 5 minutes
If you’ve been reading my articles for any length of time, you’re probably familiar with tennis elbow (read article here) by now. It’s a nasty tendinitis that is extremely common (upwards of 50% of us will get it during our lives).
Did you know there’s a far less common, but equally painful analog to tennis elbow? Appropriately, the colloquial term for it is golfer’s elbow.
(By the way, I have no idea what the deal is with all these country club sport names).
The official term for this one is medial epicondylitis.
I will say, tennis elbow affects just about everyone, no matter the activity. Garden projects, labor work, tennis, etc. But golfer’s elbow, while certainly can be caused by things other than golf, is almost primarily something I see in…golfers.
Let’s dive in and learn a few things to keep this condition out of your life.
Golfer’s elbow is a tendinitis of the muscles that flex your wrists/fingers (and pronate your arm)
Medial epicondylitis is a condition that affects the connection between your upper arm bone (humerus bone) and the muscles of your forearm. Specifically, the muscles involved are the muscles that help you flex your wrist, flex your fingers, and pronate your forearm.
Pronation is the motion when you rotate from a palm “up” position to a palm “down” position.
All of the muscles that help you perform these actions start at an anchor point on your humerus bone near the inside of your elbow (see below).
• The wrist & finger flexor muscles attach at yellow arrow.
• Most feel pain through red arc, and even down the forearm.
Just like in tennis elbow, golfer’s elbow typically occurs with a combination of either poor technical form, overuse, or just bad luck. These can all combine to cause the accumulation of small tears in the muscles/tendons where they attach themselves to the inner elbow.
This phenomenon of small tears at muscle/tendon anchor points constantly happens in our muscles all over our body. But one of the main reasons this is such a problem in the elbow is the relatively poor blood supply to these muscle junctions.
Again, the golfer’s elbow muscles have better blood supply than the tennis elbow muscles, so it’s less common. But, poor blood supply means slowed healing…and prolonged pain.
Not to mention that we are constantly rotating our forearms, flexing our wrists, and closing our fingers throughout the day to do…well just about anything.
Pain, pain, and more pain
Golfer’s elbow is a clinical diagnosis, meaning no advanced tests are needed to determine the cause of your symptoms.
Tenderness directly over the bone-muscle interface on your inner elbow means you almost certainly have golfer’s elbow. There are essentially no other conditions with pain in this exact spot.
Here’s another test. Turn your palm up and grasp a friend’s hand in that position. Now have them try to resist against you pronating (turning your palm down). Did this cause pain in your inner elbow?
Seal the deal. You’ve got medial epicondylitis.
There’s no magic fix
I have good news. Mostly.
The treatment of golfer’s elbow is almost entirely non-surgical.
It really is good news! Surgery for golfer’s elbow is only considered after more than a year of symptoms and failure of all other treatment options.
The bad news?
Symptoms can last a year. Yikes.
Everything we do for treatment is an attempt to shorten this timeframe and manage the symptoms while your body is naturally healing. If you have medial epicondylitis, you need to understand that you may be in for it for the long haul.
But think about it. So many conditions in our bodies cannot naturally heal themselves. Arthritis, fractures, tendon lacerations.
This one can heal itself! It’s quite remarkable. It just takes time. 6-9 months is the average.
How to treat golfer’s elbow
Ok, here’s your tough love. This almost perfectly mirrors what I wrote for tennis elbow. This is the WAM-BAM quickest breakdown of everything you need to do.
Starting today. It’s a lot — are you ready?
Stop the offending activity (yes, that means stop playing golf. If you know me personally, you know I would never say this if I didn’t really mean it).
Pick your favorite: ice (read my thoughts on icing here), gentle massage, heat, topical menthol (ie, Icy Hot), CBD oil, diclofenac gel (ie, Voltaren), compression wraps, etc etc. None of them is the answer, but each can help with the discomfort.
You need a wrist brace, not an elbow brace. Yes, please read that again. Don’t buy what the internet markets you, those silly little forearm/elbow wraps. Remember, you now understand where this problem originates. And it’s in the wrist flexor muscles. So the answer is a wrist brace. This will prevent you from continuing to flex the wrist hundreds of times a day and over-stress those muscles — giving them a chance to heal.
Nighttime: Sleep in the wrist brace full-time for a minimum of 6 weeks.
Daytime: Wear the brace 24/7 for 3 weeks. Then slowly use it less and less during the day, letting pain be your guide. My full bracing framework is here.
Home physical therapy: You can get fancy with this and go to a PT or you can boil it down to 2 exercises and 2 stretches you can do at home (Go to page 3 of this link). If you’re religious about these, you will improve!
Use a can of soup as weight (instead of the bands pictured). Perform resisted wrist extension and flexion exercises. The key here is the slow count of 3 as you lower the weight (the eccentric phase of the exercise).
Perform wrist extension and flexion stretches.
Consider working with a coach to check your golf swing form. I hate to tell you, but many of these issues begin and end with proper mechanics.
Did you notice I didn’t include injections? There’s some evidence they may delay recovery
You may be wondering about steroid injections. It’s a good thought.
However, evidence has been mounting in the tennis elbow literature that while steroid injections will temporarily make you feel better, they may actually prolong the duration of symptoms. And since tennis elbow is far more common than golfer’s elbow, but the pathology is the same, we should pay attention.
Now sometimes this condition is just so painful that you can’t even get through the day. In those cases, an injection may still be worth it. But when I have this talk with my patients, the ones who have a mild enough case that they only describe their symptoms as ’annoying’ rather than ‘debilitating’ will typically choose to hold off on injections.
By far the hardest part about both golfer’s elbow and tennis elbow is the waiting.
Takeaways:
Golfer’s elbow, or medial epicondylitis, is a surprisingly painful condition that results from overuse of the wrist and finger flexor muscles, as well as the forearm pronator muscles
Symptoms commonly last many months — and we don’t yet have any treatments that provide quick relief
Repeat after me. You need a wrist brace, not an elbow brace.
Hopefully, this gives you enough information on which to base your treatment decisions. There’s no perfect way to get rid of medial epicondylitis quickly.
But. For those of you who like to trust your body, it WILL heal. We just need to get you from A to Z while we wait for that to happen.
The outline above is your first step.
