Golfer’s elbow — known clinically as medial epicondylitis — is pain felt over the bony bump on the inner side of the elbow. It is a tendon overuse problem and, despite the name, you do not have to play golf to get it. This page explains what is happening at the elbow, how to tell it apart from tennis elbow, and what shockwave therapy at our Haywards Heath clinic involves.
What golfer’s elbow is
The muscles that bend your wrist forwards and turn your palm downwards — the flexor–pronator group — share a common tendon anchoring onto the medial epicondyle, the bony prominence on the inner side of the elbow. Golfer’s elbow, or medial epicondylar tendinopathy, is an overuse condition of that tendon attachment.
Every time you grip something, bend the wrist forwards or rotate the forearm, that tendon takes load. When the load outpaces the tissue’s ability to adapt, the tendon’s structure changes and the attachment becomes painful and tender to touch. Although the traditional name ends in “-itis”, the changes found in longstanding cases are degenerative rather than inflammatory — which is why “tendinopathy” is now the more common term.
How it usually shows up
- Pain and tenderness over the inner elbow, sometimes spreading down the forearm
- Discomfort when gripping — opening a jar, carrying shopping, turning a screwdriver
- Pain on bending the wrist forwards or turning the palm down against resistance
- Morning stiffness that eases with movement, then returns after activity
- A grip that feels weaker or less reliable than it was
Numbness or tingling in the ring and little fingers is not typical of golfer’s elbow, and is worth mentioning when you get in touch.
How to tell it apart from tennis elbow
The two are frequently confused. The distinction is which side of the elbow is involved, and which movements provoke it. Both are overuse problems of a tendon attachment at the elbow, and neither requires you to play the sport it is named after.
| Golfer’s elbow | Tennis elbow | |
|---|---|---|
| Clinical name | Medial epicondylitis / medial epicondylar tendinopathy | Lateral epicondylitis / extensor tendinopathy of the elbow |
| Where the pain is | Inner side of the elbow | Outer aspect of the elbow |
| Tendon group involved | Wrist flexors and forearm pronators | Wrist and finger extensors |
| Provoked by | Gripping, bending the wrist forwards, turning the palm down | Gripping, lifting palm-down, bending the wrist back |
Tennis elbow is otherwise known as extensor tendinopathy of the elbow: pain on the bony prominence on the outer aspect of the elbow, usually caused by repetition of movements of the wrist or by gripping activities that pull on the tendon attachment. We see both conditions. Elbow pain can also come from the biceps tendon at the front of the elbow, which is covered on our distal biceps tendinopathy page.
What tends to bring golfer’s elbow on
Golfer’s elbow is a loading problem. The movements that stress the flexor–pronator tendon are gripping, bending the wrist forwards and turning the palm down — so the activities associated with it tend to involve those, repeated or recently increased:
- Trade and manual work — plumbing, carpentry, decorating, tiling, mechanics
- Gardening, particularly secateur and spade work over a few days
- Pulling and gripping work in the gym, climbing, rowing, racket and throwing sports
- A sudden increase in a familiar activity, or an unfamiliar new one
The common thread is change: more of an activity than the tendon has adapted to.
How golfer’s elbow is usually approached
There is no single route. The options set out on this site for elbow tendinopathy are:
- Rest
- Avoidance of aggravating factors
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Manual therapy
- Eccentric loading (lengthening under load) to the tendon and muscle group
- Orthotic devices
- Injection therapy
Which of these is appropriate for you is not something a web page can decide.
Where shockwave therapy fits
Shockwave therapy — extracorporeal shockwave therapy, or ESWT — is a non-invasive treatment carried out at the clinic, in which energy produced by compressed air is focused on the area being treated. Tennis and golfer’s elbow are among the conditions listed on our shockwave therapy page, which also covers how the treatment works, the full fee list, the side effects and the contraindications.
What the published evidence says
NICE has produced patient information on treating tennis elbow using shockwave therapy. Its position is that the evidence on efficacy is inconsistent, because the available evidence is limited and contradictory. A systematic review published in 2014 similarly reported mixed evidence.
The NICE information and the studies cited below concern tennis elbow — lateral epicondylitis. This page does not cite equivalent guidance for golfer’s elbow, and none of this literature tells you what will happen in your own case.
You can read the NICE leaflet on treating tennis elbow using shockwave therapy in full.
Fees
| Appointment | Fee | Duration |
|---|---|---|
| Shockwave, new patient | £100 | Up to 60 minutes |
| Shockwave, follow-up | £80 | 45 minutes |
These are the shockwave appointment fees. Other appointment types are priced separately — the full list is on our shockwave therapy page.
Booking an appointment
To book at the Clinic at Borde Hill, call 01444 616797 or email info@clinicatbordehill.com. Tell us what’s going on and we’ll match you with the right practitioner — no experience or diagnosis needed.
You will find us at Naldred Farm Offices, Borde Hill Lane, Haywards Heath, RH16 1XR, with free on-site parking and disabled access. Our coverage area includes Haywards Heath, Lindfield, Cuckfield, Burgess Hill, Crawley, Horsham and East Grinstead.
Frequently asked questions
Do I have to play golf to get golfer’s elbow?
No. It is an overuse condition of a tendon attachment on the inner elbow, and any repeated gripping or wrist movement can load that tendon — at work, in the garden or in the gym.
How do I know whether it is golfer’s elbow or tennis elbow?
Which side of the elbow is tender is the simplest indicator: golfer’s elbow affects the inner side (the medial epicondyle), tennis elbow the outer (the lateral epicondyle). If you are not sure, tell us where the pain sits when you get in touch.
How many shockwave sessions are usually needed?
Typically 3–5 treatment sessions may be required, but it can take 7 or 8 in some cases. Treatment also involves some home-based exercise.
Does shockwave treatment hurt?
Pain during and after treatment is one of the possible side effects listed for shockwave therapy, along with redness or irritation of the skin. The full list is on our shockwave therapy page.
Is shockwave therapy suitable for everyone?
No. There is a list of contraindications — among them taking anticoagulants such as warfarin, and having cardiac stents or implants where treatment would be near the heart region. The full list is on our shockwave therapy page. Please tell us about your medical history and medication when you book.
References
- Speed C. A systematic review of shockwave therapies in soft-tissue conditions: focussing on the evidence. Brit Jour Sports Med. 2014;48(21)
- Haake M, Konig MA, Decker T et al. Extracorporeal shock wave therapy in the treatment of lateral epicondylitis. Journal of Bone and Joint Surgery. 2002;84A:1982-1991.
- Speed CA, Nichols D, Richards C et al. Extracorporeal shock wave therapy for lateral epicondylitis – a double blind randomised controlled trial. Journal of Orthopaedic Research. 2002;20:895-898.