Both Tennis Elbow and Golfer’s Elbow are common musculoskeletal issues affecting the forearm tendons near the elbow joint. While both conditions involve pain and discomfort stemming from tendon overuse, they are medically termed epicondylitis. These injuries occur when the musculotendinous unit connecting the forearm muscles to the humerus bone becomes strained, leading to microtears and degeneration in the tendon structure. Understanding the location and function of the affected tendons is key to differentiating between these two painful conditions.
Location and Tendon Involvement
The primary distinction between the two conditions lies in the location of the affected tendons. Tennis Elbow, formally known as Lateral Epicondylitis, involves the tendons that attach to the lateral epicondyle, the bony bump on the outside of the elbow. This condition primarily affects the wrist extensor tendons, most notably the Extensor Carpi Radialis Brevis (ECRB), which is responsible for bending the wrist backward, leading to pain on the arm’s outer side.
Conversely, Golfer’s Elbow (Medial Epicondylitis) focuses on the tendons attaching to the medial epicondyle, the bony prominence found on the inside of the elbow. This injury affects the flexor-pronator muscle group, which includes the wrist flexors and the pronator teres. The function of this group is to bend the wrist forward and twist the forearm inward, causing damage to the common flexor tendon at its attachment point. The conditions are defined by which epicondyle is involved—lateral (outside) for Tennis Elbow and medial (inside) for Golfer’s Elbow.
Distinct Symptoms and Pain Patterns
The difference in tendon involvement results in specific pain patterns. For Tennis Elbow, the characteristic symptom is tenderness on the outside of the elbow, often radiating down the back of the forearm toward the wrist. Pain is aggravated by movements that require wrist extension or a firm grip with the palm facing down. Simple, everyday actions such as shaking hands, lifting a coffee cup, or turning a doorknob often trigger discomfort.
Golfer’s Elbow presents with pain and soreness localized to the bony bump on the inner side of the elbow. This pain may also extend down the forearm toward the wrist, but along the palm-side of the arm. The symptoms are intensified by actions that require wrist flexion and forearm twisting, which load the flexor-pronator muscles. Aggravating movements include making a tight fist, squeezing a ball, or lifting an object with the palm facing up.
Specific Causes and Contributing Activities
Both conditions are classic examples of overuse injuries, but the specific activities that overload the two different tendon groups vary significantly. Tennis Elbow is commonly linked to activities involving repeated wrist extension and forceful gripping. Although named for the sport, the injury frequently occurs in non-athletes whose work requires repetitive hand and wrist movements, such as carpenters, painters, and mechanics using hand tools. Excessive use of a computer mouse or keyboard can also contribute to the strain on the extensor tendons.
Golfer’s Elbow is caused by activities that involve repetitive and strong wrist flexion, combined with a powerful grip. While associated with the downward swing of a golf club, it is also common in baseball pitchers, javelin throwers, and weightlifters. Occupations that involve heavy lifting or using tools that require repeated twisting motions, like plumbing or chopping wood, place the flexor tendons under chronic stress. In both cases, poor technique or insufficient strength in the forearm muscles is often a contributing factor to the tendon breakdown.
Management and Recovery Approaches
Initial management for both Tennis Elbow and Golfer’s Elbow centers on conservative, non-surgical methods aimed at reducing strain and promoting tendon healing. Rest from the aggravating activity is paramount, combined with applying cold therapy (ice) and using non-steroidal anti-inflammatory drugs (NSAIDs) to manage discomfort. Many individuals find relief with a counterforce brace, an elastic strap worn below the elbow that helps reduce the tension on the tendon attachment site during use.
Physical therapy is a cornerstone of recovery, though the specific focus differs based on the condition. For Tennis Elbow, therapy concentrates on stretching and strengthening the wrist extensor muscles to build resilience in the damaged ECRB tendon. Conversely, treatment for Golfer’s Elbow emphasizes strengthening the wrist flexor and pronator muscles. An accurate diagnosis is necessary to ensure the rehabilitation program targets the correct, damaged tendon group for effective, long-term recovery.