Golfer's Elbow: The Inner-Elbow Tendinopathy That Loading Fixes

Tennis elbow gets all the attention, but its inner-elbow counterpart, golfer's elbow, is just as common and just as treatable. The lack of awareness costs people time, because they often try the wrong things first. The reassuring news is that golfer's elbow follows the same rules as every other tendinopathy, and the fix is a well-established one.

What golfer's elbow is

Golfer's elbow, clinically called medial epicondylalgia, is a tendinopathy of the wrist-flexor tendons where they attach on the inner side of the elbow. Like its outer-elbow cousin, the name is misleading: most people who develop it do not play golf. It usually comes from repetitive gripping, lifting, and wrist flexion, the demands of manual work, gym training, racquet sports, or everyday tasks like carrying and lifting.

The pain shows up on the inner side of the elbow, often with gripping, lifting palm-up, and certain wrist movements, and it can be tender right over the bony point on the inside of the elbow. It is part of the family of golfer's elbow and related tendon problems we treat.

The same problem as tennis elbow, on the other side

Golfer's elbow and tennis elbow are essentially the same type of problem on opposite sides of the elbow. Tennis elbow affects the wrist-extensor tendons on the outer elbow, while golfer's elbow affects the wrist-flexor tendons on the inner elbow. Both are tendinopathies driven by load, and both respond to the same core principle.

That means the lessons from our piece on tennis elbow loading versus cortisone apply directly here. The tendon gets better when you give it a reason to adapt, through progressive loading, and it does not get better from rest alone.

Why rest disappoints

The instinct with a sore tendon is to rest it. But complete rest tends to leave the tendon weaker and just as sensitive when you return to activity, so the pain comes straight back the first time you grip something heavy. This is the recurring theme across every tendinopathy we treat, from the Achilles to the gluteal tendons: rest is not the cure, and often makes the eventual return harder.

What works instead is modifying the aggravating activities while loading the tendon progressively. We strip back the worst grip and lift provocations early, keep the tendon loading at a tolerable level, and build the load as it settles.

The loading program

A loading program for golfer's elbow centres on progressive strengthening of the wrist-flexor tendons, the muscles that flex the wrist and grip. We start at a level the tendon can handle, often with light resistance through a controlled tempo, and progress the load over time as tolerance builds.

Alongside the loading, we look hard at the daily tasks that keep re-irritating the tendon, the grip pattern at work, the lifting technique, the gym exercises that flare it. Fixing those inputs is often half the result, because a tendon that gets re-aggravated every day cannot settle no matter how good the loading is.

The guideline we use for how much discomfort is acceptable is the same one across tendon rehab: a mild ache during or shortly after loading that settles by the next morning is fine, while pain that climbs day to day means the dose is too high and we back off.

What about braces?

A counterforce brace, worn around the forearm just below the elbow, can reduce symptoms during aggravating activities for some people, making loading and daily tasks more comfortable. It is a symptom aid rather than a treatment on its own. We may use it alongside the loading program when it helps someone stay active and load the tendon more comfortably, but the loading is what actually rebuilds the tendon's tolerance. A brace on its own, without loading, tends to disappoint.

A realistic timeline

Like other tendinopathies, golfer's elbow is often slow, improving over a couple of months or more with consistent loading rather than in a few weeks. The timeline depends on how irritable the tendon is and how long it has been there before treatment starts. The slow pace tempts people toward quick fixes, but the unglamorous combination of progressive loading and activity modification is what reliably settles it.

We reassess against function, your grip strength and pain-free lifting, rather than chasing the pain alone, because pain is a noisy signal in tendons and tends to lag behind the actual recovery.

When to get it assessed

If you have pain on the inner side of your elbow with gripping and lifting, an assessment confirms it is golfer's elbow, rules out other causes, and builds a loading program to settle it. Pain with numbness or tingling into the hand, or pain that does not follow the usual grip-related pattern, is worth assessing to be sure it is a simple tendinopathy.

Book a 30-minute appointment and we will assess the elbow, screen the aggravating tasks, and build a loading plan that rebuilds the tendon's tolerance.

This article is general information about golfer's elbow (medial epicondylalgia). It is not personal medical advice. A regulated practitioner can confirm whether the patterns described apply to you.

Sources

• Vinod & Ross — An effectiveness and cost-effectiveness analysis of conservative interventions for medial epicondylitis, Journal of Hand Therapy (2015)
• Stasinopoulos & Stasinopoulos — Comparison of effects of eccentric training, eccentric-concentric training, and eccentric-concentric training combined with isometric contraction in the treatment of lateral elbow tendinopathy, Journal of Hand Therapy (2017)
• College of Physical Therapists of BC (CPTBC)

This article is for general information only and does not constitute medical advice, diagnosis, or treatment. Individual presentations vary — assessment findings and treatment plans differ from person to person. If you are experiencing severe symptoms, neurological changes (numbness, weakness, bowel or bladder changes), or a significant trauma, contact your physician or emergency services. Care at Medstar Sport Physio & Health is provided by practitioners registered with their respective British Columbia regulatory colleges.