The terms “Tennis Elbow” and “Golfer’s Elbow” describe two distinct types of tendinopathy affecting the elbow joint. Both conditions involve pain and tenderness caused by the overuse of forearm muscles, but they are medically known as Lateral Epicondylitis and Medial Epicondylitis, respectively. These injuries develop when repetitive strain causes microscopic tears and degeneration where the forearm tendons attach to the bone. Understanding the specific differences is important for accurate self-assessment and effective treatment.
The Core Difference: Location of Pain
The primary distinction lies in the precise location of the pain on the elbow. Tennis Elbow (lateral epicondylitis) causes discomfort on the outside of the elbow, centered around the lateral epicondyle. This is the bony bump on the outer side of the arm where the wrist extensor muscles attach. The pain may also radiate down the back of the forearm toward the wrist and hand.
Golfer’s Elbow (medial epicondylitis) is characterized by pain and tenderness on the inner side of the elbow. The discomfort is localized to the medial epicondyle, the bony prominence on the inside of the elbow. This is the origin point for the common flexor tendon, connecting the forearm flexor and pronator muscles. The pain often travels down the forearm along the palm side of the arm and can sometimes include weakness in the hand or wrist.
The different anatomical locations mean the two conditions affect opposing muscle groups responsible for different wrist movements. Tennis Elbow involves tendons that extend the wrist backward and straighten the fingers. Golfer’s Elbow involves tendons that flex the wrist forward and allow the fingers to grip. Therefore, the movements that trigger or worsen the pain are unique to each condition.
Causative Activities and Muscle Groups
The activities leading to each condition directly correlate with the muscle group being overused. Tennis Elbow develops from repetitive or forceful movements requiring wrist extension or tight gripping. While it includes the forceful backhand stroke in tennis, it more commonly involves activities like using hand tools, painting, or heavy manual labor with the palm facing down. These actions strain the wrist extensor muscles, such as the extensor carpi radialis brevis, that originate on the lateral epicondyle.
Golfer’s Elbow results from repeated motions involving strong wrist flexion and forearm pronation (inward rotation). Activities like the downswing in golf, throwing a baseball, and weightlifting that heavily engage the grip can cause this strain. The affected muscle group is the common flexor-pronator mass, including the flexor carpi radialis and the pronator teres. Non-athletic causes often involve tasks requiring repetitive squeezing, such as using a screwdriver or raking.
Diagnosis and Self-Assessment
A medical professional typically diagnoses both conditions through a clinical exam focused on the location of tenderness and specific provocative tests. A simple self-check involves pressing directly on the bony bump on the outside (lateral) or inside (medial) of the elbow to check for localized tenderness. The next step involves testing the strength of the affected muscle groups against resistance.
For Tennis Elbow, pain is reproduced when you resist the movement of extending your wrist and fingers against pressure. If you have Golfer’s Elbow, the characteristic pain is triggered when you attempt to flex your wrist or pronate your forearm against resistance. While a physical examination is usually sufficient, imaging like X-rays or MRIs are sometimes used to rule out other issues, such as arthritis or nerve compression.
Treatment and Recovery Strategies
Initial recovery steps for both conditions share a similar approach, focusing on reducing strain and inflammation. First-line treatments include rest from the offending activity, applying ice, and temporarily using over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs). However, long-term recovery requires targeted physical therapy exercises that differ significantly between the two injuries.
For Tennis Elbow, exercises focus on stretching and strengthening the wrist extensor muscles to improve load tolerance and function. Conversely, treatment for Golfer’s Elbow involves specific routines for the wrist flexor and pronator muscles. A common non-invasive treatment is the use of a counterforce brace, a strap worn just below the elbow joint, which redistributes force away from the damaged tendon attachment. Modifying the technique and equipment used in the causative activity, such as adjusting grip size or swing mechanics, is also necessary to prevent recurrence.