Tennis Elbow and Golf Elbow are common overuse injuries affecting the forearm tendons, causing pain around the elbow joint. Both conditions stem from repetitive stress leading to microscopic tears and tendon degeneration. However, they are distinct conditions requiring different treatment focuses. Tennis Elbow is formally known as Lateral Epicondylitis, and Golf Elbow is Medial Epicondylitis. Both involve tendons anchoring forearm muscles to the upper arm bone (humerus) at bony prominences called epicondyles.
Anatomical Location of Pain
The most fundamental difference between the two conditions is the precise location of the pain. Tennis Elbow, or lateral epicondylitis, involves the tendons attaching to the lateral epicondyle, which is the bony bump on the outside of the elbow. This area serves as the anchor point for the wrist extensor muscles, which are responsible for bending the wrist backward and straightening the fingers. Pain from this condition is typically felt on the outer side of the elbow and can radiate down the forearm.
Golf Elbow, or medial epicondylitis, affects the tendons attached to the medial epicondyle, the bony prominence located on the inside of the elbow. These tendons belong to the wrist flexor and pronator muscles, which are used to bend the wrist forward and turn the palm down. Pain is localized on the inner side of the elbow and may extend down the forearm toward the wrist.
Mechanisms of Injury
The differing anatomical locations directly correlate with the specific movements that cause the injuries. Tennis Elbow is primarily caused by repetitive motions that involve extending the wrist and forcefully gripping objects. Activities that strain the wrist extensor muscles, such as the backhand stroke in tennis, frequent use of hand tools like screwdrivers, or repetitive mouse use, contribute to the injury. The extensor tendons become overloaded when they repeatedly stabilize the wrist while the hand and fingers are gripping or extending.
Golf Elbow is triggered by repetitive motions that involve wrist flexion and forearm pronation, which is the movement of turning the palm downward. This condition often stems from activities like the powerful wrist flick during a golf swing, throwing sports, or performing manual labor that involves forceful lifting with the palm facing up. The repetitive strain on the wrist flexor and pronator muscle group leads to microtrauma at their attachment point on the inner elbow. Though named for sports, both conditions are more frequently caused by occupational activities like painting, carpentry, or assembly line work.
Treatment and Recovery Distinctions
Initial treatment for both Tennis Elbow and Golf Elbow share many common strategies, focusing on reducing pain and promoting tendon healing. These conservative measures include resting the affected arm, applying ice to the painful area, and taking over-the-counter anti-inflammatory medications. Bracing or wearing a specialized counterforce strap can also help reduce the strain on the injured tendons in both conditions.
The recovery process begins to diverge when physical therapy (PT) is introduced, which is the standard long-term treatment. PT for Tennis Elbow focuses on strengthening the forearm extensor muscles, often utilizing exercises like eccentric wrist extensions to load the lateral-side tendons progressively. Conversely, rehabilitation for Golf Elbow targets strengthening the forearm flexor and pronator muscles, using exercises such as eccentric wrist flexion. The goal in both cases is to improve the tendon’s capacity to handle stress, but the muscle groups being strengthened are mirror opposites. Recovery time frames vary widely based on severity, but consistent adherence to the specific strengthening protocol for the affected tendon group is key to recovery.