What Muscles Cause Golfer's Elbow? Complete Anatomy Guide

Golfer's elbow is the inner elbow counterpart to tennis elbow, causing pain at the bony bump on the inside of your elbow. Like tennis elbow, most people who get it have never swung a golf club—it's an injury of repetitive gripping, wrist flexion, and forearm rotation.

This guide breaks down exactly which muscles cause golfer's elbow and why it develops.

What Is Golfer's Elbow?

Golfer's elbow (medial epicondylitis) is pain at the medial epicondyle—the bony bump on the inside of your elbow where the wrist flexor muscles attach. Like tennis elbow, it's a tendinopathy: degeneration from overuse rather than acute inflammation.

The attachment point: Multiple forearm muscles share a common flexor tendon attachment at the medial epicondyle. Overload of any of these muscles stresses this shared attachment point.

Golfer's Elbow vs. Tennis Elbow

| Feature | Golfer's Elbow | Tennis Elbow | |---------|----------------|--------------| | Location | Inner elbow (medial) | Outer elbow (lateral) | | Muscles | Wrist flexors, pronators | Wrist extensors | | Movement | Gripping, flexing wrist, rotating forearm | Gripping, extending wrist | | Less common | ~5x less common than tennis elbow | More common |

Why tennis elbow is more common: Wrist extensors work harder during gripping to stabilize the wrist against the flexors. This makes the extensors more prone to overload.

The Muscles That Cause Golfer's Elbow

1. Flexor Carpi Radialis (FCR) — The Primary Culprit

Impact: MAXIMUM

FCR flexes and radially deviates the wrist (bending toward thumb side). It's the muscle most commonly involved in golfer's elbow.

Why it causes golfer's elbow:

• Attaches directly to medial epicondyle
• Active in nearly all gripping activities
• High-use muscle in daily life
• Commonly develops tendinopathy

The golf connection: During a golf swing, FCR fires powerfully through impact and follow-through as the wrists flex. The repeated stress, especially with poor technique, overloads the tendon.

2. Pronator Teres — The Rotation Muscle

Impact: VERY HIGH

This muscle pronates the forearm (rotates so palm faces down) and assists elbow flexion. It's often involved alongside the wrist flexors.

Why it causes golfer's elbow:

• Attaches to medial epicondyle
• Active during gripping with rotation
• Stressed in throwing, golf, and tool use
• Can entrap median nerve (pronator syndrome)

The throwing connection: Overhead throwing loads pronator teres heavily. Baseball pitchers, javelin throwers, and quarterbacks commonly develop medial elbow problems partly due to pronator teres overload.

3. Flexor Carpi Ulnaris (FCU) — The Ulnar Flexor

Impact: HIGH

FCU flexes and ulnar deviates the wrist (bending toward pinky side). It's part of the common flexor tendon.

Why it causes golfer's elbow:

• Attaches via common flexor tendon
• Active in power gripping
• Works during wrist flexion activities
• Often involved with FCR

4. Palmaris Longus — The Variable Muscle

Impact: MODERATE

This muscle flexes the wrist and tenses the palm. Interestingly, about 14% of people are missing it entirely—and function just fine.

Why it causes golfer's elbow:

• Attaches to medial epicondyle (when present)
• Active during wrist flexion
• Often involved in overall flexor overload
• Relatively weak muscle

5. Flexor Digitorum Superficialis (FDS) — The Finger Flexor

Impact: MODERATE-HIGH

FDS flexes the fingers at the middle joints (PIP joints). It's critical for gripping and has a partial attachment at the medial epicondyle.

Why it causes golfer's elbow:

• Partially attaches to common flexor tendon
• Active in all gripping activities
• High volume muscle (every grip uses it)
• Can contribute to overall flexor overload

6. Flexor Digitorum Profundus (FDP) — The Deep Finger Flexor

Impact: MODERATE

FDP flexes the fingertips (DIP joints). It doesn't attach to the medial epicondyle directly but its dysfunction can affect the flexor system.

Why it relates to golfer's elbow:

• Works with FDS for gripping
• Overall flexor compartment overload
• Contributes to forearm fatigue
• Can develop trigger points referring to elbow

The Common Flexor Tendon

This is the ground zero for golfer's elbow. Multiple muscles share this attachment:

• Flexor carpi radialis
• Pronator teres
• Flexor carpi ulnaris
• Palmaris longus
• Flexor digitorum superficialis (partial)

When any of these muscles are overloaded, stress concentrates at this shared attachment. The tendon can't recover between exposures, leading to degeneration.

How Golfer's Elbow Develops

The pattern mirrors tennis elbow:

1. Repetitive wrist flexion/gripping/pronation (work, sports, gym)
2. Flexor muscle overload (demand exceeds recovery capacity)
3. Micro-tears accumulate (tendon can't heal between activities)
4. Tendon degenerates (failed healing, disorganized collagen)
5. Pain develops (usually gradual onset)
6. Continued use (most people push through initially)
7. Chronic tendinopathy (established golfer's elbow)

Activities That Cause Golfer's Elbow

Sports:

• Golf (especially with poor technique)
• Throwing sports (baseball, javelin, football)
• Racket sports (forehand, serve)
• Weightlifting (curls, rows, pull-ups)
• Rock climbing

Occupational:

• Carpentry and construction (hammering, tool use)
• Plumbing
• Painting
• Assembly line work
• Cooking (heavy pans, repetitive chopping)

Daily activities:

• Carrying heavy bags
• Prolonged computer use (mouse, keyboard)
• Gardening
• Home renovation projects

The Throwing Connection

Golfer's elbow is common in throwing athletes due to the valgus stress during throwing:

The throwing sequence:

1. Wind-up and cocking: Medial elbow loaded
2. Acceleration: Extreme valgus stress, flexors/pronators fire
3. Release: Peak stress on medial structures
4. Follow-through: Continued flexor/pronator activity

UCL vs. tendinopathy: In throwers, medial elbow pain can be the flexor tendon (golfer's elbow) or the ulnar collateral ligament (UCL injury). Different structures, different implications.

The Ulnar Nerve Complication

The ulnar nerve runs right behind the medial epicondyle (the "funny bone" spot). Golfer's elbow can irritate or compress this nerve.

Ulnar nerve symptoms:

• Numbness in ring and pinky fingers
• Tingling down inner forearm
• Weakness in grip
• Difficulty with fine motor tasks

The combination: Having both golfer's elbow AND ulnar nerve irritation is common. Inflammation in the area affects both structures.

Trigger Points in Golfer's Elbow

Trigger points can cause or perpetuate medial elbow pain:

Common trigger point locations:

• Flexor carpi radialis (mid-forearm, flexor side)
• Pronator teres (inner elbow area)
• Flexor carpi ulnaris (inner forearm)
• Brachialis (above elbow, can refer down)

The referral patterns: These trigger points refer pain to the medial elbow, wrist, and hand. Sometimes treating trigger points resolves "golfer's elbow" that hasn't responded to other treatments.

Why Conservative Treatment Works (Usually)

Golfer's elbow responds well to conservative treatment because:

• Tendon has healing capacity when properly loaded
• Addressing muscle dysfunction removes the cause
• Progressive strengthening builds tissue resilience
• Surgery is rarely needed (<10% of cases)

The Treatment Framework

Phase 1: Pain Reduction (Weeks 1-2)

Activity modification:

• Reduce aggravating activities
• Modify grip (larger handles, lighter loads)
• Avoid palm-down lifting

Pain management:

• Ice after activity
• Counterforce brace (below elbow on flexor mass)
• Short-term NSAIDS if severe

Phase 2: Load Introduction (Weeks 2-6)

Isometric exercises:

• Wrist flexion against resistance, hold 30-45 seconds
• Pronation isometrics
• Pain should stay ≤3/10 during exercise

Eccentric exercises:

• Wrist flexion lowering (start light)
• Forearm pronation eccentrics
• Slow, controlled 3-second lowering

Trigger point release:

• Self-massage of forearm flexors
• Lacrosse ball on flexor mass
• Address pronator teres

Phase 3: Strengthening (Weeks 6-12)

Progressive loading:

• Wrist curls (flexion)
• Reverse wrist curls (balance the extensors)
• Pronation/supination with weight
• Grip strengthening

Functional exercises:

• Sport or work-specific movements
• Gradual return to provocative activities

The Eccentric Wrist Flexion Protocol

Similar to Tyler Twist for tennis elbow:

1. Position: Forearm supported, palm up, wrist off edge
2. Load: Use other hand to help curl weight up (concentric assist)
3. Lower: Slowly lower the weight with the affected arm (eccentric focus)
4. Reps: 3 sets of 15, twice daily
5. Progress: Increase weight when 3/10 pain or less

Prevention Strategies

Technique:

• Proper golf swing mechanics
• Throwing technique assessment
• Grip size appropriate for hand
• Use whole body, not just arm

Strength maintenance:

• Regular forearm strengthening
• Balance flexors and extensors
• Include pronation/supination work

Load management:

• Gradual increases in activity
• Adequate recovery between sessions
• Recognition of early warning signs

Equipment:

• Proper grip size on tools and rackets
• Ergonomic tools when possible
• Gloves for shock absorption

The Bottom Line

Golfer's elbow is caused by overload of the wrist flexors and pronators:

1. Flexor carpi radialis — the primary culprit
2. Pronator teres — especially in throwers
3. Flexor carpi ulnaris — power gripping involvement
4. Other common flexor tendon muscles — contributing factors

Like tennis elbow, it's a tendinopathy (degeneration), not tendinitis (inflammation). This means:

• Rest alone doesn't fix it
• Progressive eccentric loading is essential
• Trigger points may be involved
• Recovery takes 3-6 months typically

The keys to recovery:

• Modify aggravating activities
• Progressive eccentric wrist flexion loading
• Address trigger points in flexor muscles
• Watch for ulnar nerve involvement
• Patience—tendons heal slowly

Most golfer's elbow resolves with proper conservative treatment. Build the tissue capacity through progressive loading, and the tendon will heal.

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Ready to address your golfer's elbow? Explore our elbow and forearm programs designed to progressively load the flexor tendons and restore pain-free function.