Golfer’s Elbow

September 15, 2026

Understanding the Condition and the Role of Physiotherapy in Recovery

If you have pain on the inner side of your elbow whenever you lift something, carry a shopping bag, squeeze someone’s hand, or even hold your phone for a long time, there is a chance that you may be dealing with Golfer’s Elbow, also known as Medial Epicondylitis.

In my clinic, I often meet patients who initially think the pain is coming from their wrist or forearm. After a detailed assessment, we sometimes discover that the real source of the problem is a tendon attached to the inner side of the elbow.

Many patients tell me:

“Doctor, the pain started gradually. At first it was only annoying, but now even simple activities are uncomfortable.”

That is a very common story with Golfer’s Elbow.

The good news is that most people recover very well with physiotherapy when the condition is treated early and the tendon is gradually strengthened again.

Understanding the Anatomy

Before we discuss the condition itself, let me explain the area involved.

On the inner side of your elbow there is a bony prominence called the Medial Epicondyle.

Several forearm muscles attach to this area through a common tendon. These muscles help you:

Bend your wrist
Grip objects
Hold tools
Carry bags
Twist objects
Make a fist
Perform daily hand activities

The muscles most commonly involved belong to what we call the flexor-pronator group. These muscles work hard throughout the day whenever you grip, lift, squeeze, or twist something.

I usually explain it to patients like this:

“Think of the tendon as a strong rope connecting your muscles to the bone. If that rope is pulled repeatedly every day without enough recovery time, it starts becoming irritated and painful.”

What is Golfer’s Elbow?

Golfer’s Elbow is a condition in which the tendons attached to the inner side of the elbow become irritated and overloaded.

It is usually not caused by one major injury. Instead, it often develops slowly after repeated use of the forearm muscles.

Golfer’s elbow is similar to Tennis Elbow, but the pain usually occurs on the inner side rather than the outer side of the elbow.

Over time, repeated gripping, lifting, wrist bending, and twisting movements place stress on the tendon. Tiny areas of damage develop, and eventually pain starts appearing around the inner elbow.

What Causes Golfer’s Elbow?

There are many possible causes.

Common causes include:

Repetitive gripping activities
Weight training
Repeated lifting
Manual labor
Construction work
Plumbing work
Carpentry work
Long hours of tool use
Repetitive computer work
Poor exercise technique
Sudden increase in physical activity

In my clinic, I frequently see this condition in gym members who increase their training intensity too quickly and workers whose jobs require repeated gripping and lifting throughout the day.

Common Symptoms

Symptoms usually develop gradually.

Patients often tell me:

“Doctor, I can still move my arm, but lifting things hurts.”

“The pain is right here on the inside of my elbow.”

“My grip feels weak compared to before.”

Common symptoms include:

Pain on the inner side of the elbow
Tenderness when touching the area
Pain during gripping activities
Weak grip strength
Pain while lifting objects
Pain during wrist bending
Forearm discomfort
Morning stiffness
Difficulty carrying heavy items
Pain that may travel down the forearm

In some patients, especially long-standing cases, I have also seen mild tingling or discomfort extending toward the ring finger and little finger because the nearby ulnar nerve can become irritated.

How is Golfer’s Elbow Diagnosed?

Diagnosis starts with a detailed history and physical examination.

As physiotherapists, we assess:

Pain location
Grip strength
Wrist strength
Elbow movement
Daily activity limitations
Work and exercise habits

Special tests may include:

Golfer’s Elbow Test
Resisted Wrist Flexion Test
Resisted Forearm Pronation Test

If needed, doctors may request:

Ultrasound
MRI
X-ray

These investigations help confirm tendon involvement and rule out other causes of elbow pain.

For more information about golfer’s elbow and therapeutic exercises, see the American Academy of Orthopaedic Surgeons (AAOS).

Why Physiotherapy is Important

One question I hear frequently is:

“Doctor, should I completely stop using my arm?”

Not necessarily.

The goal is not complete rest forever. The goal is to reduce irritation, allow healing, and then gradually rebuild the strength of the tendon.

Physiotherapy helps:

Reduce pain
Improve tendon healing
Restore flexibility
Improve grip strength
Improve forearm endurance
Restore function
Prevent recurrence

I have seen many patients spend months relying only on painkillers. The pain temporarily improves, but it returns because the underlying weakness and tendon overload have not been addressed.

Physiotherapy Goals

When treating Golfer’s Elbow, our goals are:

Reduce pain
Reduce tendon irritation
Improve flexibility
Restore normal movement
Improve grip strength
Strengthen forearm muscles
Improve functional activities
Return the patient to work and sports
Prevent future episodes

Physiotherapy Treatment Protocol

Phase 1: Pain Reduction and Protection Phase

Goals

Reduce pain
Protect the tendon
Prevent further irritation

Treatment

Activity Modification

Initially, I advise patients to temporarily reduce activities that increase pain.

Examples include:

Heavy lifting
Forceful gripping
Repetitive wrist bending
Painful gym exercises

Ice Therapy

Cold packs can help reduce pain and irritation after activity.

Counterforce Brace

Some patients benefit from a forearm brace during daily activities.

Gentle Mobility Exercises

I usually begin with:

Elbow Flexion and Extension
Wrist Circles
Forearm Pronation and Supination
Gentle Active Wrist Flexion

These exercises help maintain movement without placing excessive stress on the tendon.

Phase 2: Mobility and Flexibility Phase

Goals

Restore flexibility
Reduce stiffness
Improve movement quality

Stretching Exercises

Wrist Flexor Stretch

One of the most important stretches for this condition.

Forearm Flexor Stretch

Helps reduce tension through the affected muscle group.

Prayer Stretch

A gentle stretch commonly used for wrist and forearm flexibility.

Forearm Pronation Stretch

Useful for patients with tight forearm muscles.

I always remind patients that stretches should create a gentle pulling sensation, not sharp pain.

Phase 3: Strengthening Phase

Goals

Improve tendon strength
Restore grip power
Improve endurance

This phase is where real recovery starts happening.

Strengthening Exercises

Isometric Wrist Flexion

One of my favorite early strengthening exercises.

Ball Squeeze Exercise

Helps restore grip strength.

Theraband Wrist Flexion

Provides controlled resistance.

Wrist Curl with Dumbbell

A simple but effective strengthening exercise.

Eccentric Wrist Flexion

Very useful during tendon rehabilitation.

Forearm Pronation with Dumbbell

Improves control and endurance.

Finger Grip Strengthening

Targets the muscles used during daily gripping activities.

Towel Squeeze Exercise

A practical exercise that many patients find easy to perform at home.

I have personally seen excellent improvements when patients consistently perform progressive strengthening rather than avoiding arm use completely.

Phase 4: Functional and Return-to-Activity Phase

Goals

Restore full function
Improve endurance
Return to normal activities

Exercises may include:

Carrying drills
Functional gripping activities
Resistance band training
Work-specific movement training
Gym-specific rehabilitation
Functional lifting exercises

This phase prepares the patient for real-life activities again.

Manual Therapy Techniques

Depending on the patient’s condition, physiotherapy may also include:

Soft Tissue Mobilization
Deep Friction Massage
Myofascial Release
Trigger Point Release
Joint Mobilization

These techniques are often combined with exercise to achieve the best results.

Home Exercise Program

I always tell my patients that recovery does not happen only inside the clinic.

The home program is equally important.

A typical home plan may include:

Wrist Flexor Stretch
Prayer Stretch
Ball Squeeze Exercise
Isometric Wrist Flexion
Theraband Wrist Flexion
Forearm Pronation Exercise
Towel Squeeze Exercise

Consistency is usually more important than intensity.

Recovery Time and Prognosis

One of the most common questions I hear is:

“Doctor, when will I be completely fine?”

The answer depends on:

Severity of the condition
Duration of symptoms
Work demands
Exercise compliance

In most cases:

Mild cases improve within a few weeks.
Moderate cases often require several weeks of rehabilitation.
Long-standing cases may require a few months of structured treatment.

From my clinical experience, patients who follow their exercise program regularly usually recover much faster than those who depend only on rest and medication.

The overall prognosis is generally very good, and most patients return to their normal work, gym activities, and daily life without surgery.

Final Thoughts

Golfer’s Elbow is a common condition that can make simple daily tasks uncomfortable. Activities such as lifting a bag, gripping a tool, shaking hands, or carrying groceries may become painful.

The good news is that this condition usually responds very well to a structured physiotherapy program that focuses on education, activity modification, stretching, and progressive strengthening.

As a physiotherapist, I have seen many patients recover successfully after following a proper rehabilitation plan. The key is not to ignore the symptoms and not to wait until the pain becomes severe.

With the right guidance, patience, and a well-designed exercise program, most people can regain their strength, reduce pain, and return to their normal activities with confidence.

This article is for educational purposes and should not replace professional medical advice.

Written by Dr Areej Nadeem PT
College of Physiotherapy
JPMC Karachi