Golfer’s Elbow

Introduction

If you have been told you have golfer’s elbow, or if pain on the inside of your elbow has been getting in the way of work, sport, or simple daily tasks like opening a jar or carrying a bag, you are not alone. Despite the name, golfer’s elbow affects far more than golfers. It is common in people who type for long hours, lift weights, do manual work, play racket sports, throw, or use hand tools regularly.

The good news is that most people with golfer’s elbow improve with non-surgical care over weeks to months. A smaller group with persistent or severe symptoms may need injections or, occasionally, surgery. This guide explains what golfer’s elbow is, why it develops, how it is diagnosed, the full range of treatments doctors use, what recovery typically looks like, and how to lower the chance of it coming back.

What Is Golfer’s Elbow?

Golfer’s elbow, known in medicine as medial epicondylitis, is a painful condition of the tendons that attach the forearm muscles to the bony bump on the inside of the elbow (the medial epicondyle). These tendons control wrist flexion (bending the wrist down) and gripping. Repeated stress on them causes small tears and changes in the tendon tissue, which leads to pain, tenderness, and weakness.

Although it is called “-itis,” which suggests inflammation, current understanding is that long-standing golfer’s elbow is more of a tendon degeneration problem (often called a “tendinopathy”) than a simple inflammation. This matters because it explains why simply resting or taking anti-inflammatory tablets is sometimes not enough — the tendon may need gradual, structured loading exercises to heal properly.

Golfer’s Elbow vs Tennis Elbow

Tennis elbow (lateral epicondylitis) affects the tendons on the outside of the elbow and is caused by overuse of the muscles that extend the wrist. Golfer’s elbow affects the inside of the elbow and involves the muscles that flex the wrist and fingers. The two conditions are closely related and are treated in similar ways, but the location of pain and the activities that aggravate them are different.

How Common Is It?

Golfer’s elbow is less common than tennis elbow but still affects a meaningful share of the working-age population. It usually appears between the ages of 30 and 60, and it affects men and women in roughly similar numbers.

Causes and Risk Factors

Golfer’s elbow develops when the forearm flexor tendons are loaded more than they can recover from. This can happen through a single hard episode of unusual activity, but more often it builds up over weeks or months of repeated low-grade stress.

Common Causes

• Repeated wrist flexion and gripping — for example, hammering, using screwdrivers, or chopping
• Sports that load the inner elbow: golf (especially a poorly executed swing), throwing sports such as baseball or cricket, racket sports, archery, and bowling
• Weight training, particularly with heavy pulling, gripping, or curling movements
• Long hours of typing or mouse use with poor wrist posture
• Carrying heavy bags, gardening, or playing certain musical instruments

Risk Factors

• Age between 30 and 60
• Sudden increase in training intensity, frequency, or duration
• Poor sports technique — for example, hitting the ground before the ball in golf, or a late wrist snap in throwing
• Ill-fitting equipment, such as a grip that is too small or strings that are too tight
• Lack of warm-up or general forearm conditioning
• Smoking and poorly controlled diabetes, which can affect tendon healing
• Repetitive job tasks without enough recovery time

It is important to know that you do not need to play golf, or any sport, to develop golfer’s elbow. Many people first notice it after a period of unusual activity at home or work.

Signs and Symptoms

If you have been diagnosed with golfer’s elbow, you are probably already familiar with most of these symptoms. Reviewing them is still useful, because the way symptoms change over time helps guide treatment and tells you whether things are improving or getting worse.

• Pain on the inner side of the elbow, sometimes spreading down the inside of the forearm
• Tenderness over the bony bump on the inside of the elbow
• Pain triggered by gripping, lifting, shaking hands, twisting a doorknob, or wringing a cloth
• Weak grip strength, with objects slipping or feeling heavier than usual
• Stiffness, especially in the morning
• Pins and needles or tingling in the ring and little fingers if the nearby ulnar nerve is irritated

Symptoms often start gradually. Many people first notice a dull ache that comes and goes. Without treatment or rest, the pain may become sharper, last longer, and start to interfere with sleep or routine tasks.

Diagnosis

Golfer’s elbow is usually diagnosed by a doctor based on your symptoms and a physical examination. Scans are not always needed.

Clinical Examination

During the examination, the doctor typically:

• Presses over the inner elbow to identify the exact tender spot
• Asks you to flex your wrist or grip against resistance to see if this reproduces the pain
• Tests the range of movement of your elbow and wrist
• Checks the strength of your grip and forearm muscles
• Examines the nearby ulnar nerve, which runs close to the medial epicondyle and can sometimes be irritated alongside the tendon

Imaging

Imaging is generally reserved for cases that do not improve with initial treatment, when the diagnosis is unclear, or when surgery is being considered.

• X-ray: Used to rule out other causes of elbow pain such as arthritis, bone spurs, or old fractures.
• Ultrasound: Can show thickening, tears, or changes in the tendon. It is widely used because it is quick and allows the doctor to look at the tendon while you move your arm.
• MRI: Provides the most detailed view of the tendon and surrounding structures. It is usually reserved for persistent cases or surgical planning.

Conditions That Can Mimic Golfer’s Elbow

Several other conditions can cause inner elbow pain and may need to be excluded:

• Ulnar nerve irritation (cubital tunnel syndrome), which can cause tingling in the ring and little fingers
• Ulnar collateral ligament injury, particularly in throwing athletes
• Cervical (neck) nerve root problems that refer pain to the elbow
• Elbow arthritis

Identifying or ruling out these conditions is part of why a careful clinical assessment matters.

Treatment and Management

Treatment for golfer’s elbow is usually arranged as a stepped approach, starting with the simplest and least invasive measures. Most patients improve at one of the earlier steps. The decision to move from one step to the next depends on how you respond, how long symptoms have lasted, and how much they limit your daily life.

Activity Modification

The first step is to reduce or change the activities that are loading the tendon. This rarely means complete rest — in fact, prolonged complete rest can weaken the tendon further. Instead, the aim is “relative rest”: avoiding the specific movements that flare the pain while keeping the rest of the arm active.

Practical changes might include:

• Pausing or modifying the sport that triggered the problem
• Switching to lighter tools or using power tools instead of manual ones
• Improving keyboard and mouse setup at work
• Sharing heavy lifting tasks or using both hands

Ice and Simple Pain Relief

Applying an ice pack wrapped in a thin cloth to the inner elbow for 10 to 15 minutes a few times a day can ease pain, especially after activity. Short courses of over-the-counter pain relievers such as paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen may help, though they should be used as advised by your doctor and not for long periods.

Physiotherapy and Exercise Therapy

Physiotherapy is central to recovery from golfer’s elbow. Major orthopaedic bodies, including the American Academy of Orthopaedic Surgeons, describe structured exercise as a cornerstone of treatment. A physiotherapist may use:

• Stretching exercises for the forearm flexor muscles
• Strengthening exercises, particularly “eccentric” exercises where the muscle slowly lengthens under load. This type of loading appears to help the tendon remodel and become more resilient.
• Hands-on therapy such as soft tissue massage and joint mobilisation
• Ultrasound, laser, or shockwave therapy, used by some clinicians as adjuncts
• Activity and technique advice, including ergonomic adjustments for work and sports-specific coaching where appropriate

Progress with physiotherapy is usually measured in weeks and months rather than days. Sticking with the exercise programme even when pain feels stubborn is often what makes the difference.

Bracing and Supports

A counterforce brace (a strap worn just below the elbow) may reduce the load on the tendon during activity. Some patients also use a wrist splint at night or during specific tasks to limit wrist flexion. Braces are best thought of as one part of a wider plan, not a standalone solution.

Corticosteroid Injections

If pain remains significant despite the measures above, your doctor may discuss a corticosteroid injection into the tender area. Steroid injections can reduce pain in the short term — often within days — but evidence suggests their benefit fades over weeks to months, and repeated injections may weaken the tendon. For these reasons, current orthopaedic guidance generally treats them as a short-term option to break a cycle of severe pain, not as a long-term solution. They are usually combined with continued physiotherapy.

Platelet-Rich Plasma (PRP) and Other Biological Injections

Platelet-rich plasma (PRP) is prepared by drawing a small amount of your own blood and concentrating the platelets, which are then injected into the affected tendon. The idea is to stimulate healing in the damaged tissue. Studies of PRP for medial epicondylitis show mixed but cautiously promising results, particularly in patients who have not responded to standard care. Other biological options, such as autologous blood injections, are used in some centres. Whether PRP is appropriate is a clinical decision based on how long symptoms have lasted, imaging findings, and your overall situation.

Shockwave Therapy

Extracorporeal shockwave therapy uses pulses of energy delivered through the skin to the affected tendon. It is offered in some clinics for tendinopathies that have not responded to first-line treatment. Evidence for medial epicondylitis specifically is more limited than for some other tendon conditions, but it remains one of the non-surgical options that doctors may consider.

When Surgery Is Considered

Surgery for golfer’s elbow is uncommon and is generally reserved for people whose symptoms have continued for at least six to twelve months despite a full course of non-surgical care, and whose daily life or work remains significantly affected. Imaging often shows clear tendon damage in these patients.

The aim of surgery is to remove the diseased portion of tendon and, where needed, to repair the healthy tendon back to the bone. Whether surgery is appropriate, and which approach to use, is a decision made between you and your orthopaedic surgeon based on the extent of damage, your activity goals, and any related issues such as ulnar nerve symptoms.

Surgical Approaches

Two main surgical approaches are used:

• Open surgery: The traditional approach. The surgeon makes a small incision over the inner elbow, identifies the diseased tendon tissue, removes it, and reattaches the healthy tendon to the bone if needed. Open surgery allows direct visualisation and is widely used.
• Arthroscopic or endoscopic surgery: A camera-guided approach using smaller incisions. It can mean less soft-tissue disturbance and, in some patients, a quicker early recovery. Not all cases are suitable for an arthroscopic approach, and it requires a surgeon experienced in the technique.

If the ulnar nerve is irritated or compressed, the surgeon may also address it during the same operation. Robotic assistance is not routinely used for this procedure.

The operation typically takes around 30 to 60 minutes and is often done as a day-care procedure under regional or general anaesthesia.

Lifestyle and Self-Management

Because golfer’s elbow is closely tied to how you use your arm day to day, self-management plays a large role in both recovery and prevention of recurrence.

Ergonomics at Work

• Keep your wrists in a neutral position when typing — not bent up or down
• Use a chair height that lets your forearms rest level with the desk
• Take short breaks every 30 to 60 minutes to stretch the forearm
• Consider a vertical mouse or a split keyboard if standard equipment aggravates symptoms

Sports and Training

• Warm up the forearm and shoulder before activity
• Increase training load gradually — a common rule is no more than around 10 percent per week
• Get coaching on technique for golf, throwing, or racket sports
• Check that equipment fits you: grip size, racket tension, club weight, and shoe support all matter

General Health

• Stop smoking if you smoke — smoking impairs tendon healing
• Manage diabetes carefully, as poor blood-sugar control is linked to tendon problems
• Maintain a healthy weight to reduce overall musculoskeletal load
• Sleep well and eat a balanced diet to support recovery

Recovery and Healing

Recovery from golfer’s elbow varies widely. The timeline depends on how long symptoms have been present, the severity of tendon changes, the treatment used, and how consistently you follow your rehabilitation plan.

Recovery with Non-Surgical Care

For most patients managed without surgery, gradual improvement over six weeks to several months is typical. Some people feel substantially better within a few weeks, while others — particularly those whose symptoms have been present for many months — may need six months or longer of consistent rehabilitation to recover fully.

• First 1–2 weeks: The arm is rested in a splint or sling. Wound care and gentle finger and shoulder movements help prevent stiffness.
• Weeks 2–6: Physiotherapy starts, focusing on restoring elbow and wrist motion and beginning gentle strengthening.
• Weeks 6–12: Progressive strengthening, including resistance exercises. Light activities of daily living are usually possible.
• 3–6 months: Return to heavier work, lifting, and sport, often guided by the surgeon and physiotherapist.

Full strength can take up to a year to return in some cases. Your specific timeline depends on the type of surgery, your tendon health, and how well rehabilitation goes.

Monitoring Progress

It helps to track your recovery with simple measures rather than relying only on how the elbow feels day to day. Useful markers include:

• How long you can grip or carry something before pain starts
• Whether sleep is disturbed by elbow pain
• How easily you can do specific tasks such as opening jars or turning a key
• Your tolerance to your physiotherapy exercises — can you progress the load?

If progress stalls for several weeks despite consistent rehabilitation, this is worth raising with your doctor, as the treatment plan may need adjusting.

Risks and Complications

Golfer’s elbow itself does not cause permanent harm to the elbow joint, but untreated or repeatedly aggravated cases can lead to long-term pain, weakness, and reduced function.

Potential Complications of the Condition

• Chronic pain lasting many months or years
• Persistent grip weakness affecting work or sport
• Stiffness from prolonged guarding or under-use of the arm
• Ulnar nerve symptoms (tingling, numbness) if the nearby nerve is irritated

Risks of Specific Treatments

• NSAIDs: Stomach upset, ulcers, and effects on kidneys or blood pressure with prolonged use
• Corticosteroid injections: Temporary pain flare, skin thinning or colour change at the injection site, and possible weakening of the tendon with repeated injections
• PRP injections: Pain and bruising at the injection site; less evidence of long-term harm
• Surgery: Infection, bleeding, scar tenderness, stiffness, nerve injury (particularly to the ulnar nerve, which lies close to the surgical area), incomplete pain relief, and recurrence

Overall, serious complications are uncommon, and most people who undergo treatment for golfer’s elbow improve significantly.

Preventing Recurrence

Once your elbow has settled, the focus shifts to keeping the tendon healthy and avoiding another episode.

• Continue forearm strengthening even after pain has gone, especially eccentric loading exercises
• Maintain good technique in sport and at work; consider a refresher lesson if you play golf or racket sports
• Vary your activities so the same tendons are not loaded the same way day after day
• Listen to early warning signs — a mild ache after activity is worth respecting before it becomes a flare
• Build up gradually after time off — a slow ramp-up after holidays or illness can prevent a relapse

Recurrence is possible, especially if the underlying cause has not changed. Many patients find that combining better technique, ergonomic changes, and ongoing exercise gives them the most reliable protection.

When to Seek Medical Attention

While most golfer’s elbow can be managed without urgency, some situations deserve prompter review by a doctor:

• Sudden severe pain after a clear injury, rather than a gradual onset
• A visible deformity, swelling, or bruising around the elbow
• Inability to move the elbow or wrist
• Numbness, persistent tingling, or weakness in the hand
• Fever, redness, or warmth around the elbow (possible infection, especially after an injection or surgery)
• Symptoms that worsen rapidly despite rest and basic care

Living with Golfer’s Elbow

Living with golfer’s elbow can be frustrating, particularly when the timeline of recovery is longer than expected. It is helpful to:

• Set realistic expectations — tendon problems improve in weeks and months, not days
• Build the rehabilitation exercises into your daily routine so they happen even on busy days
• Keep doing what you enjoy where possible, even if in a modified form
• Stay in touch with your physiotherapist or doctor if symptoms shift

For most people, golfer’s elbow is a condition you recover from rather than one you live with permanently. Long-term limitation is the exception, particularly when treatment is started before symptoms become deeply established.

Frequently Asked Questions

Do I have to be a golfer to get golfer’s elbow?

No. Many people with golfer’s elbow have never played golf. The condition is named after one common cause but affects anyone who repeatedly loads the forearm flexor tendons — including manual workers, office workers, weightlifters, throwers, and players of other sports.

Can golfer’s elbow heal on its own?

Mild cases can settle with rest and activity modification alone. However, leaving symptoms unmanaged for many months sometimes leads to longer recovery later. Most doctors recommend starting structured care — particularly physiotherapy — rather than waiting indefinitely.

How long does golfer’s elbow usually take to get better?

Mild cases can improve within a few weeks. More established cases often take three to six months of consistent treatment, and some take longer. Recovery is usually gradual rather than sudden.

Should I keep exercising or rest completely?

Complete rest is rarely the answer. Most current orthopaedic guidance favours “relative rest” — avoiding the specific aggravating movements while continuing general activity and doing structured tendon exercises. Your physiotherapist can help tailor what is safe to continue.

Are steroid injections a cure?

No. Steroid injections can reduce pain in the short term but do not appear to change long-term outcomes, and repeated injections may weaken the tendon. They are usually used as a short-term measure alongside ongoing rehabilitation, not as a substitute for it.

Will I need surgery?

Most patients with golfer’s elbow do not need surgery. Surgery is usually considered only when symptoms have continued for six to twelve months or more despite a full course of non-surgical care.

Can I still play sport with golfer’s elbow?

Sometimes, but often in a modified way. Reducing intensity, improving technique, using appropriate equipment, and adding forearm conditioning can allow many people to keep playing while they recover. Your doctor or physiotherapist can advise on what to adjust.

Can golfer’s elbow come back?

Yes. Recurrence is possible, particularly if the activity or technique that caused it has not changed. Continuing strengthening exercises and addressing the underlying cause are the best ways to reduce this risk.

Is golfer’s elbow the same as a pinched nerve?

No. Golfer’s elbow is a tendon problem. A pinched nerve at the elbow (cubital tunnel syndrome involves the ulnar nerve) can cause overlapping symptoms such as inner elbow discomfort and tingling in the ring and little fingers. The two conditions can coexist, which is why a careful examination matters.

Conclusion

Golfer’s elbow is a common overuse condition of the tendons on the inner side of the elbow. While it can be persistent and frustrating, most people improve with a stepped approach that starts with activity changes, ice, simple pain relief, and physiotherapy, and moves on to injections or surgery only when needed. The condition does not damage the elbow joint itself, and the long-term outlook for most patients is good.

Understanding what is happening in the tendon, working steadily through a rehabilitation plan, and adjusting the activities that triggered the problem are the elements most strongly linked to lasting recovery. With time, consistent care, and attention to technique and ergonomics, returning to work, daily life, and sport is a realistic goal for the great majority of people with golfer’s elbow.