Golfer’s elbow (medial epicondylitis): understanding your elbow pain and getting back to your activity

What is golfer’s elbow (medial epicondylitis)?

Medial epicondyle anatomy

The medial epicondyle is the bony prominence on the inner side of the elbow, where the tendons of the wrist flexor and forearm pronator muscles attach. Medial epicondylitis, better known as “golfer’s elbow”, is a painful condition of these tendons at their attachment, the mirror image of tennis elbow but on the inner side.

Why does this area become painful?

Pain appears when the wrist flexor tendons are subjected to too much repeated load, typically during wrist flexion and forced pronation movements (a golf swing, throwing).[1] As with tennis elbow, it’s not limited to golfers and can affect any activity that heavily loads these tendons.

Golfer’s elbow vs tennis elbow: what’s the difference?

Both are elbow tendinopathies that respond to the same treatment principles, but affect opposite tendons: tennis elbow affects the wrist extensors on the outer side, golfer’s elbow affects the flexors on the inner side. Golfer’s elbow is notably less common than tennis elbow.[2]

The flexor muscles involved

Several tendons attach to the medial epicondyle:

• The flexor carpi radialis
• The flexor carpi ulnaris
• The pronator teres, which also contributes to forearm rotation

Symptoms and diagnosis of golfer’s elbow

Typical pain and its triggers

Pain sits on the inner side of the elbow, sometimes radiating into the forearm. It’s typically triggered by a golf swing (especially at impact), throwing, gripping in pronation, or a firm handshake.

How symptoms progress without treatment

Without treatment, pain tends to be triggered by increasingly minor movements, eventually interfering with simple activities like gripping an object or turning a key.

Differential diagnosis

Several types of elbow pain can resemble golfer’s elbow:

• Tennis elbow: the same condition, but on the outer side of the elbow
• Cubital tunnel syndrome (ulnar nerve compression): medial pain combined with tingling in the ring and little fingers, worth telling apart since treatment differs[3]
• Medial collateral ligament instability, more common in elite throwing athletes

Causes and risk factors

Golfer’s elbow results from repeated overload of the flexor tendons that exceeds their capacity to recover between bouts of strain.

Biomechanical and personal factors

• Incorrect swing technique, particularly excessive wrist rotation at impact
• Gripping a club or tool too tightly
• Lack of overall forearm strength
• A sudden increase in practice volume or manual activity

Which sports contribute to golfer’s elbow?

All sports and activities that heavily load wrist flexion and pronation carry a risk of this condition:

• Golf, at the moment of ball impact
• Throwing sports (baseball, javelin)
• Climbing and grip-intensive sports
• Weight training with heavy grip exercises
• Racquet sports
• Repetitive manual activities

Why does elbow pain appear with no obvious cause?

As with tennis elbow, golfer’s elbow affects many non-athletes too: it’s a cumulative overload injury, linked to repeated movements at work or at home. The tendon wears down gradually until it reaches the pain threshold, without any single identifiable event.

Treating golfer’s elbow in rehab with a sports physio

The goal of treatment is to progressively strengthen the wrist flexor tendons to restore their capacity to absorb load, while correcting the movement causing the overload.

Phase 1, reducing pain (isometric exercises)

In the first few days, isometric contractions of the wrist flexors often provide quick pain relief while keeping the tendon active.

Phase 2, progressive strengthening (eccentric)

Eccentric strengthening of the wrist flexors is the foundation of treatment: this is the work that lets the tendon regain its capacity to bear load.[4]

Phase 3, returning to sport or activity

The final phase progressively reintroduces specific movements (swing, gripping tools) before a full return to activity.

In practice, this programme breaks down into 10 concrete steps:

1. 1Reducing pain and managing load
2. 2Elbow and wrist mobility
3. 3Isometric strengthening
4. 4Progressive concentric strengthening
5. 5Eccentric strengthening
6. 6Overall forearm work
7. 7Correcting sporting technique
8. 8Strengthening under sport-specific load
9. 9Progressive return to your sport
10. 10Return to competition

“It’s not that the tendon is fragile, it’s that the load needs to be better dosed and distributed.”

Eccentric strengthening, the cornerstone of treatment

Strengthening the wrist flexors, particularly eccentrically, is the foundation of medial epicondylitis treatment.[4] It’s complemented by overall forearm work and, if needed, correcting technique (golf swing, work-related movement).

In brief

• Eccentric strengthening of the wrist flexors
• Progressive overall forearm strengthening
• Correcting technique if needed
• Gradual return: mobility, then load, then sport

Should you rest or keep playing sport?

Total rest is generally not the most effective solution. It’s better to temporarily adapt the movements that clearly reproduce the pain, while starting eccentric strengthening as soon as possible.

When should you see a specialist for golfer’s elbow?

If pain persists for more than four to six weeks despite adapting your activities and a well-conducted strengthening programme, a medical opinion is recommended to consider further treatments.

Recovery timeline: how long does it take to recover from golfer’s elbow?

Like tennis elbow, golfer’s elbow heals slowly. A clear improvement in day-to-day pain is often seen within 6 to 8 weeks of rehab, but a full return to full-intensity movements more typically takes 3 to 6 months.

Factors that speed up or slow down healing

Preventing recurrence

Golfer’s elbow recurs easily if strengthening isn’t kept up and the movement responsible isn’t corrected.

The 10% progression rule

Not increasing your training or manual-activity volume by more than 10% per week durably protects the tendon from a new overload.

Ongoing eccentric strengthening

Regular eccentric wrist flexion work (light load or a resistance band, slow and controlled return), kept up even after rehab ends, helps maintain the tendon’s capacity to bear load. Good swing technique, reviewed with a professional if needed, rounds out this prevention.

The HOPP care programmes to treat your golfer’s elbow and get back to sport

This medial epicondylitis requires rigorous, progressive eccentric strengthening. HOPP offers you a precise exercise programme, allowing you to get back to your activities as quickly as possible.

The programme runs from 3 to 9 weeks depending on the injury and ends with a reconditioning phase allowing a return to competition in the best possible conditions. Each programme is designed by the HOPP team, made up of two sports physiotherapists who are experts in assessing and treating athletes. You’ll also find theoretical content throughout your progression, so you master every aspect of your recovery and can adjust your treatment independently. If needed, our team of physiotherapists is on hand to support you.

A programme that adapts to you every day

Every day, how you feel (RPE) is factored in to automatically adjust the rest of your programme: more load if all is well, a bit less if your elbow is complaining. This daily personalisation is what makes the difference compared to a fixed, paper-based programme.

Ready to start your programme?

Join the HOPP support programme designed by sports physios.

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