Golfer’s elbow (medial epicondylitis) causes discomfort where the forearm tendons attach to the bony bump on the inside of the elbow joint. This overuse injury involves the common flexor tendon, which controls wrist bending and forearm rotation. Although named for golf, the condition frequently affects people engaged in activities involving repetitive gripping, wrist flexion, or forceful forearm movements. Common causes include throwing sports, improper weight training technique, and occupational tasks like carpentry. The pain typically results from degeneration and micro-tearing within the tendon structure (tendinosis or tendinopathy), rather than inflammation.
Initial Home Management and Pain Relief
The first step in managing a flare-up is implementing immediate, non-invasive strategies to reduce pain. Relative rest is crucial; you must significantly modify or stop activities that provoke pain. Avoid movements that cause a sharp increase in discomfort, but complete rest is generally not recommended, as tendons need some load to remain healthy.
Applying ice to the tender inner elbow area helps manage pain, especially after activity. Use an ice pack for 15 to 20 minutes, several times daily. Over-the-counter NSAIDs, such as ibuprofen, may offer temporary pain relief, but they only address symptoms and should not be relied upon long-term.
Wearing a counterforce brace or elbow strap applies pressure to the forearm muscles just below the elbow. This pressure redistributes tension away from the injured tendon attachment point, reducing strain during daily movements. This passive support is a temporary aid while you begin rehabilitation.
Targeted Rehabilitation Exercises
Lasting recovery requires progressing from passive pain relief to active rehabilitation, focusing on strengthening and stretching the affected muscles. The goal is to improve the tendon’s ability to handle stress through a controlled loading program. Consistent, gentle stretching improves wrist and forearm mobility, reducing chronic tension on the tendon.
Wrist Flexor Stretch
The wrist flexor stretch involves extending the affected arm straight out with the palm facing up. Use your opposite hand to gently pull the fingers downward toward your body, creating a stretch along the inner forearm. Hold this position for 30 seconds and repeat a few times daily. You should feel a stretch, but never sharp pain.
Eccentric Strengthening
Eccentric strengthening exercises are beneficial for tendon repair, involving the controlled lengthening of the muscle under load. To perform an eccentric wrist curl, sit and rest your forearm on a table or thigh, palm upward, with your hand hanging off the edge. Hold a very light weight, such as a one-pound dumbbell.
Use your unaffected hand to lift the weight up, flexing your wrist completely. The eccentric phase is the slow, controlled lowering of the weight back down over a count of three to five seconds. This slow lowering motion specifically loads and strengthens the damaged tendon structure. Start with three sets of 10 to 15 repetitions, only increasing the weight when you can complete the exercise without pain.
When Professional Medical Treatment is Needed
While many cases resolve with home care, professional medical help is necessary if pain does not improve after four to six weeks of consistent home management. Persistent pain that significantly interferes with daily activities or sleep also warrants a medical evaluation.
Immediate medical attention is necessary for symptoms suggesting a more serious issue. These include:
- Intense swelling accompanied by a fever.
- A visible deformity of the elbow.
- Sudden, complete loss of mobility.
- Numbness or tingling radiating into the hand (ring and little fingers), which may indicate nerve involvement like cubital tunnel syndrome.
A physician may refer you to a physical therapist for a customized strengthening program. Interventions might include a corticosteroid injection, which offers short-term pain relief but does not address the underlying tendon issue. For chronic symptoms lasting six to twelve months that fail conservative treatment, rare surgical intervention may be considered to remove damaged tissue and reattach healthy tendon.
Preventing Recurrence Through Technique and Equipment
Sustained recovery requires addressing the mechanical factors that caused the initial tendon overload. You must modify repetitive activities that strain the forearm flexor-pronator muscles.
Technique Adjustments
For athletes, refining swing mechanics with a coach is important, focusing on using the core and larger muscle groups instead of relying on the wrist and forearm for power. For non-sports activities, ergonomic adjustments reduce strain. Ensure computer peripherals keep wrists in a neutral position, avoiding prolonged flexion. When lifting, use a palm-up grip whenever possible; this engages the stronger biceps muscle and reduces the load on the forearm tendons.
Equipment Modifications
Equipment can contribute to recurrence. Using lighter tools or sports equipment, such as graphite golf clubs, decreases overall stress on the elbow. For racquet sports, using a slightly larger grip size helps prevent excessive gripping force, which reduces strain on the tendons. Making these long-term adjustments is paramount to preventing the condition from returning.