Golfer's Elbow: Why It Develops and How Physiotherapy Can Help
If you've previously had tennis elbow, golfer's elbow will probably sound familiar.
The two conditions are closely related. Both affect the tendons around the elbow and often develop when they're asked to do more than they can comfortably tolerate. The difference is simply where the pain occurs. Tennis elbow causes pain on the outside of the elbow, while golfer's elbow causes pain on the inside.
Despite its name, golfer's elbow doesn't just affect golfers. It commonly develops in anyone who performs repetitive gripping or wrist movements, including golfers, racquet sport athletes, gym-goers, tradespeople and office workers.
For golfers, however, the condition presents unique challenges. Every golf swing places considerable force through the forearm muscles and tendons, making it difficult to enjoy a round of golf when even gripping the club becomes painful.
The good news is that most people recover well with the right rehabilitation programme. The key isn't simply reducing pain—it's understanding why the tendon became overloaded in the first place and gradually rebuilding its capacity to cope with the demands placed upon it.
In this article, we'll explain what golfer's elbow is, how it differs from tennis elbow, why it develops, and how evidence-based physiotherapy can help you return to golf, work and everyday activities with confidence.
More Than Just 'Tennis Elbow on the Inside'
Although golfer's elbow and tennis elbow are often discussed as separate conditions, they are remarkably similar.
Both are tendon conditions that develop when the tendon is exposed to more load than it can comfortably tolerate. The main difference lies in which tendon is affected.
With golfer's elbow, the pain develops on the inside of the elbow, where the muscles responsible for gripping, bending the wrist and controlling the golf club attach to the bone.
With tennis elbow, the pain develops on the outside of the elbow, affecting the tendons that straighten the wrist and fingers.
Historically, golfer's elbow was often referred to as medial epicondylitis, suggesting inflammation was the primary problem. We now know that many long-standing tendon conditions involve changes to the tendon itself rather than ongoing inflammation. This is why modern rehabilitation focuses on progressively improving the tendon's ability to tolerate load, rather than simply trying to reduce inflammation.
What Are the Symptoms of Golfer's Elbow?
Symptoms usually develop gradually rather than after one specific injury.
Common symptoms include:
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Pain or tenderness on the inside of the elbow.
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Pain when gripping a golf club, racquet or everyday objects.
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Discomfort when lifting shopping bags, weights or a kettle.
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Pain when shaking hands or opening jars.
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Reduced grip strength.
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Stiffness around the elbow, particularly after activity.
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Pain that worsens during or after golf.
In the early stages, symptoms may only appear during activity. As the condition progresses, everyday tasks can become uncomfortable and recovery between activities may take longer.
Why Does Golfer's Elbow Develop?
One of the biggest misconceptions is that golfer's elbow is caused by one bad swing.
In reality, it usually develops over time.
Every tendon has a capacity to tolerate load. When the demands placed on that tendon increase faster than its ability to adapt, symptoms can develop.
This may happen after:
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Increasing the number of rounds played each week.
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Spending longer at the driving range.
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Returning to golf after time away.
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Starting a new gym programme.
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Repetitive lifting or gripping at work.
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Changes in golf technique or equipment.
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Poor recovery between activities.
The tendon isn't necessarily "damaged". More commonly, it is telling you that it is currently being asked to do more than it is capable of handling.
Understanding this concept is important because it changes how the condition is treated. Rather than simply resting until the pain settles, rehabilitation aims to gradually improve the tendon's capacity so it can comfortably cope with the demands placed upon it.
Why Golfers Are Particularly Susceptible
Golf places repeated demands on the muscles that control your wrist and grip.
During the golf swing, these muscles help stabilise the club while transferring force through impact. Repeating this movement hundreds of times during practice—or over many rounds of golf—can gradually increase the load placed on the tendon.
Factors that may contribute include:
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Sudden increases in practice volume.
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Hitting large numbers of balls at the driving range.
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Poor recovery between rounds.
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Changes in swing mechanics.
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Reduced forearm or shoulder strength.
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Limited mobility affecting swing mechanics.
Importantly, golfer's elbow rarely develops because of one single factor. It is usually the result of several contributing factors occurring at the same time.
Do You Have to Play Golf to Develop Golfer's Elbow?
Not at all.
Despite its name, many people diagnosed with golfer's elbow have never played golf.
The condition commonly affects:
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Tennis and racquet sport players.
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Weightlifters.
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Climbers.
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Tradespeople.
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Gardeners.
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Office workers.
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Anyone performing repetitive gripping or lifting activities.
The name simply describes the location of the pain rather than the people who develop it.
Can You Continue Playing Golf?
One of the most common questions golfers ask is:
"Do I need to stop playing?"
In many cases, the answer is no.
Completely stopping activity is rarely necessary or beneficial.
Instead, rehabilitation focuses on modifying the amount of load placed on the tendon while it recovers. This may include temporarily reducing practice volume, avoiding long driving range sessions, adjusting your training programme or modifying how often you play.
The goal is to keep you active while allowing the tendon to gradually rebuild its capacity.
Treating the Cause, Not Just the Pain
Tendons become painful because they are being asked to tolerate more load than they are currently capable of managing. Simply reducing pain isn't enough if the tendon doesn't regain the strength and capacity needed for golf, work or everyday activities.
At Melbourne Golf Physio, rehabilitation begins with understanding why your golfer's elbow developed. From there, treatment is tailored to address the contributing factors and progressively restore your ability to do the things that matter most to you.
Comprehensive Assessment
Although the pain is felt at the inside of the elbow, the contributing factors often extend beyond the tendon itself.
A comprehensive assessment considers your symptoms alongside factors such as forearm strength, shoulder function, mobility, recent changes in activity levels, training load, work demands and, for golfers, the physical demands of your swing.
Understanding these contributing factors allows rehabilitation to target the underlying cause of your symptoms rather than simply managing pain.
Education
Education is an important part of successful rehabilitation.
Understanding what is contributing to your symptoms, which activities are safe to continue and how to gradually increase your activity can help you recover with confidence while reducing unnecessary fear of movement.
Progressive Strengthening
Progressive strengthening is one of the cornerstones of evidence-based treatment for golfer's elbow.
Specific exercises are used to gradually improve the tendon's ability to tolerate load while restoring forearm strength, grip strength and upper limb function. As symptoms improve, rehabilitation progresses towards the specific demands of golf, work or sport.
Load Management
Complete rest is rarely the most effective treatment.
Instead, rehabilitation focuses on finding the right balance between allowing the tendon to recover and maintaining an appropriate level of activity. As your strength and capacity improve, activities are gradually progressed to support a safe return to your usual routine.
Taping and Bracing
For some people, taping or an elbow brace may help reduce discomfort during golf, work or everyday activities.
While these strategies don't address the underlying cause of the condition, they can provide short-term support while your rehabilitation programme takes effect.
Hands-On Treatment
Hands-on treatment, including manual therapy and soft tissue techniques, may help reduce pain and improve comfort in the short term. These treatments are most effective when combined with an active rehabilitation programme that includes strengthening exercises, education and appropriate load management.
Returning to Golf
Returning to golf involves more than simply waiting for your pain to settle.
The tendon needs to be prepared for the demands of gripping the club, repeated swings, practice sessions and full rounds of golf. Rehabilitation is gradually progressed to build confidence and improve the tendon's ability to tolerate these demands while reducing the likelihood of symptoms returning.
Why Isn't My Golfer's Elbow Improving?
If your elbow has been painful for several months despite stretching, massage or rest, you're certainly not alone.
Common reasons recovery stalls include:
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The tendon hasn't been progressively strengthened.
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Activities continue to overload the tendon.
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The factors contributing to your symptoms haven't been identified.
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Rehabilitation has progressed too quickly—or not enough.
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Another condition is causing similar symptoms.
Persistent pain on the inside of the elbow isn't always golfer's elbow. A thorough assessment can help confirm the diagnosis and ensure you're following the most appropriate treatment plan.
When Should You See a Physiotherapist?
It may be worth seeking an assessment if:
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Your symptoms have lasted more than a few weeks.
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Pain is affecting golf, work or everyday activities.
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Gripping objects has become difficult.
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Home treatments aren't improving your symptoms.
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Your elbow pain keeps returning.
Early assessment can help identify the contributing factors before symptoms become more persistent and difficult to manage.
When should I see a physiotherapist for golfer's elbow?
Consider seeking an assessment if your elbow pain has persisted for several weeks, is affecting your golf, work or everyday activities, keeps returning, or isn't improving despite modifying the activities that aggravate it.
A physiotherapy assessment can also help determine whether your symptoms are actually golfer's elbow and identify the factors that may be contributing to the problem.
What is golfer's elbow?
Golfer's elbow is a tendon condition that causes pain around the inside of the elbow. It affects the tendons connecting the forearm muscles to the inner elbow and is commonly aggravated by gripping, lifting, wrist movements and activities such as golf or racquet sports.
Despite its name, you don't need to play golf to develop golfer's elbow. It can also affect people who lift weights, perform repetitive manual work or regularly use their hands and forearms for gripping.
What are the symptoms of golfer's elbow?
The most common symptom is pain or tenderness on the inside of the elbow. You may also notice pain when gripping, lifting, shaking hands, opening jars or swinging a golf club.
Some people experience reduced grip strength or discomfort extending from the inside of the elbow into the forearm. Symptoms often develop gradually and may initially only occur during or after activity.
How Long Does Golfer's Elbow Take to Heal?
Recovery time varies considerably. Mild, recent symptoms may improve within several weeks, while persistent golfer's elbow can take several months to fully settle.
How long recovery takes can depend on how long symptoms have been present, the demands being placed on the elbow and whether the tendon is being progressively rehabilitated.
Rather than focusing only on whether pain has disappeared, rehabilitation should also prepare the elbow for the activities you want to return to.
Does a Golf Swing Cause Golfer's Elbow?
Golf can contribute to golfer's elbow because gripping the club and repeatedly swinging it places load through the forearm muscles and tendons.
However, golfer's elbow is rarely caused by one swing alone. Symptoms are more likely to develop when several factors combine, such as a sudden increase in practice, frequent rounds, changes in swing mechanics, gym training, work demands or inadequate recovery.
What are the best exercises for golfer's elbow?
Exercises that progressively strengthen the forearm and improve the tendon's ability to tolerate load are commonly used in golfer's elbow rehabilitation.
The most appropriate exercises and resistance will depend on your symptoms, current strength and the activities you need to return to. For a golfer, rehabilitation may eventually need to progress beyond basic wrist exercises to prepare the arm for gripping the club, repeated swings, practice sessions and full rounds.
Do Elbow Braces Help Golfer's Elbow?
Does a golfer's elbow brace work?
An elbow brace or forearm strap may reduce discomfort for some people during golf, work or everyday activities.
However, a brace doesn't address why the tendon became painful or rebuild its strength. It is therefore better considered a short-term symptom-management tool rather than a standalone treatment.
Should I rest golfer's elbow completely?
Complete rest isn't always necessary.
Temporarily reducing or modifying activities that significantly aggravate your symptoms can be useful, but rehabilitation generally aims to maintain an appropriate level of activity while gradually rebuilding strength and tendon capacity.
The goal is ultimately to make the elbow more capable of handling the activities you want to return to rather than simply avoiding them.
Does golfer's elbow go away on its own?
Mild symptoms may improve when the activity irritating the tendon is temporarily reduced. However, simply resting and waiting for the pain to disappear may not restore the strength and capacity required for golf, sport, work or exercise.
If symptoms keep returning when you resume activity, a structured rehabilitation programme may be needed to address the factors contributing to the problem.
Can You Play Golf with Golfer's Elbow?
In most cases, yes.
You may need to temporarily adjust how often you play, reduce the number of balls you hit at the driving range or modify other activities that place additional load on the elbow.
Whether you should continue playing depends on your symptoms and how your elbow responds during and after golf. Rehabilitation can then progressively prepare the tendon for increasing practice and playing demands.