Golfer's Elbow: Causes, Treatment, and Exercises That Work

Tennis Elbow's Less Famous Cousin

Golfer's elbow (medial epicondylitis) is pain on the inside of the elbow, where the forearm flexor tendons attach. Like tennis elbow, most people who get it aren't actually playing the sport it's named after.

Any activity involving gripping, twisting, or wrist flexion can cause it: rock climbing, weightlifting, throwing sports, carpentry, typing, and yes—golf.

Tennis Elbow vs. Golfer's Elbow

Tennis elbow (lateral epicondylitis):

Golfer's elbow (medial epicondylitis):

Both are tendinopathies—degeneration from overuse, not acute inflammation.

Symptoms

Risk Factors

What Doesn't Work

Rest alone:

Pain goes away, but the tendon doesn't heal. Symptoms return when you resume activity.

Cortisone injections:

Short-term relief, worse long-term outcomes. Can weaken tendon.

Anti-inflammatories:

Tendinopathy isn't primarily inflammatory. NSAIDs don't fix the problem.

Braces alone:

Reduce pain but don't address the underlying tendon degeneration.

What Works: Progressive Loading

Like all tendinopathies, golfer's elbow requires progressive loading to heal. The tendon needs stress to remodel and get stronger.

Phase 1: Isometrics (Weeks 1-2)

Hold positions without movement. Good for pain relief and starting tendon loading.

Wrist flexion isometric:

1. Rest forearm on table, palm up, wrist hanging off edge

2. Use other hand to push down on palm

3. Resist without moving (no wrist movement)

4. Hold 30-45 seconds

5. Repeat 3-5 times, 3x daily

Grip isometric:

1. Squeeze stress ball or rolled towel

2. Hold 30 seconds

3. Repeat 3-5 times

Phase 2: Eccentric Exercises (Weeks 2-6)

Eccentric (lengthening) exercises are the gold standard for tendon rehabilitation.

Eccentric wrist flexion:

1. Rest forearm on table, palm up, wrist off edge

2. Hold light weight (1-2 lb)

3. Use other hand to lift wrist up (flexion)

4. Slowly lower weight over 3-4 seconds (this is the key part)

5. 3 sets of 15, once daily

6. Progress weight as tolerated

Eccentric pronation:

1. Hold hammer or weighted bar at the end

2. Start with palm up

3. Slowly rotate to palm down (3-4 seconds)

4. Use other hand to return to start

5. 3 sets of 15

Reverse Tyler Twist (using FlexBar):

1. Hold FlexBar with affected arm, wrist flexed

2. Twist bar with other hand while maintaining flexion

3. Bring arms in front of you

4. Slowly release the twist using affected wrist

5. 3 sets of 15, once daily

Phase 3: Concentric + Eccentric (Weeks 4-8)

Once eccentrics are comfortable, add the full range of motion.

Wrist curls (full):

1. Forearm on table, palm up, wrist off edge

2. Curl wrist up and lower slowly

3. 3 sets of 12-15 with moderate weight

Pronation/supination with weight:

1. Hold hammer or weight at end

2. Rotate forearm palm up, then palm down

3. Full range, controlled speed

4. 3 sets of 12-15

Grip strengthening:

1. Hand grippers or stress ball

2. Progress resistance over time

3. 3 sets of 12-15

Phase 4: Functional Strengthening (Weeks 6+)

Rows:

1. Cable or dumbbell rows

2. Focus on grip strength component

3. 3 sets of 10-12

Farmer's carries:

1. Hold heavy weights at sides

2. Walk for distance or time

3. Challenges grip endurance

Gradual return to activity:

Addressing Contributing Factors

Technique correction:

Work with a coach or professional to address form issues in your sport or work.

Equipment:

Flexibility:

Proximal strengthening:

Weakness in the shoulder and upper back increases load on the forearm.

Ulnar Nerve Involvement

Some people with golfer's elbow also have ulnar nerve irritation (the nerve runs close to the medial epicondyle). Signs include:

If you have nerve symptoms:

Timeline

Tendon healing is slow. Expect 3 months for significant improvement in most cases.

Prevention

Once healed, prevent recurrence:

When to See a Professional

Options include physical therapy, shockwave therapy, PRP injections (mixed evidence), and rarely surgery.

The Bottom Line

Golfer's elbow is a tendon problem that requires tendon loading to heal. Rest, injections, and passive treatments don't work long-term. Progressive strengthening—especially eccentric exercises—is the evidence-based solution.

Be patient. Stay consistent. The tendon will heal.