Golfer's elbow: why your inner elbow hurts and what helps

If you have a nagging pain on the inside of your elbow — the bony bump on the side nearest your body — and it bites when you grip a kettle, turn a screwdriver or shake someone's hand, you are most likely dealing with golfer's elbow. The medical name is medial epicondylalgia, often still written as medial epicondylitis.

And despite the name, most of the people we see with it have never swung a golf club.

What is golfer's elbow, really?

A group of muscles that bend your wrist and fingers all share one tendon, and that tendon attaches to the bump on the inside of your elbow — the medial epicondyle. Every time you grip something, those muscles pull on that one small attachment point.

Golfer's elbow is what happens when that attachment is loaded more than it can currently tolerate, for long enough that it stops coping.

The old name, medial epicondylitis, ends in "-itis", which means inflammation. That turned out to be misleading. When researchers looked at tissue from long-standing cases, what they mostly found was not an inflamed tendon but a disorganised one — collagen fibres in disarray, new blood vessels growing in, and very few of the inflammatory cells you would expect.

That distinction matters enormously for treatment, and it is the single most useful thing to understand about this condition:

• If the problem were inflammation, rest and anti-inflammatories would fix it.
• Because the problem is a tendon that has lost its capacity, the fix is rebuilding that capacity — carefully, with load.

This is why so many people find their elbow feels better after two weeks off and then hurts again within days of going back to normal. Rest lowers the demand. It does not raise the tendon's ability to meet it.

Why is it called golfer's elbow if I don't play golf?

The name stuck because the golf swing loads that tendon well. But in an ordinary week at our Seaton clinic, the people who walk in with inner elbow pain are far more likely to be:

• Tradespeople — carpenters, plumbers, electricians, mechanics. Repeated gripping, twisting and use of hand tools.
• Warehouse and factory workers — repetitive lifting, especially with the palm facing up.
• Kitchen and hospitality staff — chopping, carrying plates, long shifts with a loaded grip.
• Cleaners and carers — wringing, scrubbing, transferring.
• Gym-goers who have recently added pull-ups, deadlifts, kettlebells or heavy rows.
• New parents — genuinely common, and rarely believed. Lifting a growing child a hundred times a day with the palm up is a serious load.
• Desk workers with a sustained grip on a mouse and long hours without variation.
• And yes — golfers, throwers, racquet players and climbers.

The common thread is not the activity. It is a change in the activity: more of it, heavier, faster, or after a break. Tendons dislike sudden change far more than they dislike hard work.

What does golfer's elbow feel like?

Typical symptoms people describe to us:

• Pain or an ache on the inner side of the elbow, tender to press on that bony point
• Pain when gripping — the kettle, a jar lid, a door handle, a heavy shopping bag
• Pain when bending the wrist down against resistance, or turning the forearm
• A weaker grip, or dropping things unexpectedly
• Stiffness in the elbow first thing in the morning
• Sometimes an ache spreading down the inside of the forearm

Golfer's elbow or tennis elbow?

People mix these up constantly, and the difference is simply which side hurts:

• Golfer's elbow — pain on the inside, worse bending the wrist down and gripping.
• Tennis elbow — pain on the outside, worse lifting the wrist up, straightening the fingers, or lifting a cup. See our page on tennis elbow.

Hold your arm out with the palm up. The side closest to your body is the golfer's elbow side.

One thing that is not golfer's elbow

If your inner elbow pain comes with pins and needles or numbness in your ring and little fingers, that points towards the ulnar nerve rather than the tendon — the nerve that gives you the "funny bone" sensation. It runs in a groove right behind that same bony bump. That is a different problem called cubital tunnel syndrome, and it needs a different approach. The two can also occur together, which is one reason a proper assessment is worth more than a guess from a search result.

Why does it last so long?

Tendons have a poor blood supply compared with muscle, so they remodel slowly. That is normal biology, not a sign anything is badly wrong. But it means the usual pattern — rest until it settles, return to full activity, flare again — can repeat for months.

Three things commonly keep it going:

1. Complete rest. It reduces pain and reduces capacity at the same time, so you return to the same load with a weaker tendon than you started with.
2. Pushing through. The opposite error. Loading a sore tendon hard and often gives it no chance to adapt.
3. Treating only the elbow. Grip strength, shoulder and shoulder-blade control, and how you actually hold a tool all change the load arriving at that tendon. Treating the painful spot and ignoring the chain above it is why some cases stall.

How it is diagnosed

Golfer's elbow is usually diagnosed clinically — from your history and a physical examination, not a scan. A physiotherapist will typically ask what changed in the weeks before it started, press over the medial epicondyle, test your wrist and finger flexion against resistance, check your grip strength, and screen the neck, shoulder and ulnar nerve to make sure the pain is coming from where it seems to be.

Imaging is not usually needed. Ultrasound or MRI can show tendon changes, but those changes are common in people with no pain at all, so a scan often adds cost and worry without changing the plan. Scans become useful when the picture does not fit, when there was a sudden injury, or when things are not progressing as expected.

Physiotherapy management may include

Every plan is built around the individual, and what suits a plumber with a three-month history is not what suits a new mum in week two. But treatment for golfer's elbow commonly includes:

• Working out the cause. Identifying the change in load that set it off, and adjusting it in the short term — not stopping, but modifying.
• A graded loading programme. The core of it. Specific wrist and forearm exercises, started at a level your tendon tolerates and built up deliberately over weeks. Isometric holds are often used early because they load the tendon without movement and many people find them comfortable.
• Grip and forearm strengthening, progressed as the tendon responds.
• Shoulder and shoulder-blade work, where weakness further up is increasing the demand at the elbow.
• Hands-on treatment — soft tissue work, joint mobilisation, and sometimes dry needling — used to make movement more comfortable so the loading programme can proceed, rather than as a treatment on its own.
• Technique and equipment advice — tool grip size, workstation setup, lifting with the palm down rather than up, how you carry a toddler.
• Bracing or taping in some cases, as a short-term aid while capacity is rebuilt.
• Shockwave therapy may be considered for stubborn tendon pain that has not settled with loading and activity changes over a reasonable period. It is used alongside the exercise programme, not instead of it.
• A plan for flare-ups, so a bad week does not undo a good month.

What we would not do is hand you a sheet of exercises and send you away. The loading has to be matched to your tendon, reviewed, and progressed — that is the part that actually changes the outcome.

How long does golfer's elbow take to get better?

Being straight with you: this is usually a matter of months, not weeks, and anyone promising otherwise is guessing. Many people notice meaningful change within six to twelve weeks of consistent loading, and mild recent cases can settle faster. Long-standing cases take longer.

Function usually improves before pain disappears entirely. Waiting to be pain-free before resuming things you value generally means waiting a long time, which is why the plan is built around gradually returning to those things rather than avoiding them.

What you can do right now

• Do not stop using the arm. Reduce the aggravating load, keep moving.
• Turn the palm down when lifting and carrying where you can — it shifts load off the flexor tendon.
• Spread the load. Two hands instead of one. A trolley instead of bags. Bigger, softer grips on tools.
• Break up long tasks. Sustained gripping is harder on a tendon than the same work with pauses.
• Use pain as information, not an alarm. Discomfort during activity that settles within 24 hours is usually acceptable; pain that climbs for days is a sign the load was too much too soon.

When to get it checked properly

Book an assessment if the pain has lasted more than a few weeks, if it is affecting your work or sleep, if your grip is weakening, or if you have pins and needles or numbness in the hand. See a doctor promptly instead if the elbow is hot, swollen and red, if you have a fever, if it followed a significant fall or blow, or if you cannot use the arm at all.

Getting it seen in Adelaide's west

You do not need a referral to see a physiotherapist in Australia. A first appointment is mostly working out what changed, what it stops you doing, and what a realistic first step looks like.

If your GP has put you on a Chronic Condition Management Plan, we bulk bill those sessions in full. We claim every registered Australian health fund on the spot through HICAPS, and we handle NDIS, DVA and work injury claims. If the elbow started at work, a ReturnToWorkSA claim may cover your treatment rather than you.

We are at 177 Trimmer Parade, Seaton SA 5023, with free off-street parking, and we see people from Findon, Fulham Gardens, West Lakes, Woodville, Grange, Henley Beach, Royal Park, Kidman Park and across Adelaide's western suburbs. Our physiotherapists speak English, Hindi and Gujarati — see languages we speak.

Read more on our golfer's elbow page, or book online. You can also call 0403 907 587.

This article is general information, not individual medical advice. Elbow pain has several possible causes and the right approach depends on your circumstances and examination findings. Please discuss your own symptoms with a qualified health professional. Fees and funding arrangements mentioned are correct at the time of writing.