Overview
what it is and why it mattersGolfer's elbow is the inside-of-the-elbow cousin to tennis elbow, the same kind of overuse tendon problem, just on the opposite side. The tendons that flex your wrist and turn your palm down attach to the bony bump on the inside of your elbow; with repeated stress, they degenerate and become painful. Like tennis elbow, the underlying issue is tendon degeneration, not active inflammation. It shows up in golfers, baseball pitchers, and workers who do repetitive gripping or twisting (palm-down) motions. It is less common than tennis elbow. Worth noting: the ulnar nerve runs right behind the painful spot, so problems with that nerve (cubital tunnel syndrome) often coexist with golfer's elbow.
Symptoms
what you may notice- Inner elbow pain with gripping. Aching on the inside of the elbow that flares when you squeeze something, turn a doorknob, or shake hands.
- Tenderness at the bony bump. Pressing directly on the medial epicondyle (the bony point on the inner elbow) reproduces the pain precisely.
- Pain with resisted wrist flexion. Curling your wrist against resistance or twisting your palm downward (pronation) fires up the inner elbow.
- Grip weakness. Difficulty maintaining a firm grip, especially during the activity that caused the problem.
- Possible tingling in the ring and small fingers. The ulnar nerve runs right behind the medial epicondyle; if it is irritated too, you may notice numbness or tingling in the last two fingers.
Diagnosis
exam first, imaging secondPain on the inside of the elbow, made worse by gripping or by resisting someone pulling your wrist up; your surgeon can usually pinpoint the tender spot just below the bony bump. Two important things to check at the same time: a stress test that loads the inner side of the elbow (to rule out a UCL injury, which is more common in throwing athletes), and a careful exam of the ulnar nerve (to rule out coexisting cubital tunnel syndrome). Ultrasound and MRI show the degenerated tendon when imaging is needed.
How We Treat It
what we try first, in orderGolfer's elbow is a tendon problem, and tendons heal slowly. The good news is that most people get better without surgery. Care is built up in layers: each step below is added on top of the ones before it, not swapped in for them. We start with the simplest changes and only move down the list if the inner-elbow pain keeps interfering.
1
Activity modification
Cutting back on the gripping and palm-down twisting activities that drove the irritation.
2
Physical therapy
Eccentric (lengthening-under-load) wrist exercises plus a progressive loading program, the same approach that works for tennis elbow, mirrored to the opposite side of the elbow.
3
Counterforce brace
A small Velcro strap worn around the upper forearm absorbs some of the load that would otherwise pull on the painful tendon attachment; many patients get meaningful relief from this alone.
NSAIDs
NSAIDs like ibuprofen for short-term symptom relief during a flare.
Corticosteroid injection
A cortisone shot can give fast short-term relief, but it does not change the long-term course and may slow tendon healing; used sparingly. Particular care is needed near the ulnar nerve at the inner elbow.
PRP injection
A PRP (platelet-rich plasma) injection: concentrated growth factors taken from your own blood and injected into the degenerated tendon. Sometimes considered for persistent symptoms after rest, activity changes, physical therapy, NSAIDs, and a cortisone shot have been tried. Evidence for medial epicondylitis is limited and mixed. It is not covered by insurance (self-pay).
Surgical Options
if non-operative care isn't enoughSurgery is reserved for the small minority of patients with persistent, disabling symptoms after a real trial of non-operative care including PRP. The procedure cleans out the degenerated portion of the tendon and may decompress the ulnar nerve at the same time when needed.
Frequently Asked
questions we hear in clinicIs golfer's elbow the same as tennis elbow?
It's the same kind of problem on the opposite side of the elbow. Golfer's elbow is the inside-of-the-elbow cousin to tennis elbow. The tendons that flex your wrist and turn your palm down attach to the bony bump on the inside of your elbow, and with repeated stress they degenerate and become painful. Golfer's elbow is less common than tennis elbow.
Is it caused by inflammation?
Not really. Like tennis elbow, the underlying issue is tendon degeneration, not active inflammation. That is part of why a tendon takes time to settle down and why steroid shots don't change the long-term course.
Why do my ring and small fingers tingle?
The ulnar nerve runs right behind the medial epicondyle, the painful spot on the inner elbow. If that nerve is irritated too, you may notice numbness or tingling in the last two fingers. Nerve problems behind the elbow (cubital tunnel syndrome) often coexist with golfer's elbow, so the nerve is checked carefully at the visit.
Do I need an MRI?
Usually no. Your surgeon can often pinpoint the tender spot just below the bony bump on exam. Ultrasound and MRI show the degenerated tendon when imaging is needed, but the diagnosis starts with the history and physical exam.
Will a cortisone shot fix it?
A cortisone shot can give fast short-term relief, but it does not change the long-term course and may slow tendon healing, so it is used sparingly. Particular care is needed near the ulnar nerve at the inner elbow.
Will I need surgery?
Most likely not. Surgery is reserved for the small minority of patients with persistent, disabling symptoms after a real trial of non-operative care including PRP. When it is needed, the procedure cleans out the degenerated portion of the tendon and may decompress the ulnar nerve at the same time.
Providers Who Treat Golfer's Elbow (Medial Epicondylitis)
sports-medicine team
Further Reading
authoritative sourcesExternal patient-education references and related OSI pages for additional background: