Elbow

Tennis Elbow & Golfer's Elbow: Causes, Symptoms & Treatment

टेनिस एल्बो और गोल्फर एल्बो: कारण, लक्षण और उपचार

టెన్నిస్ ఎల్బో మరియు గోల్ఫర్స్ ఎల్బో: కారణాలు, లక్షణాలు మరియు చికిత్స

Tennis elbow and golfer's elbow are two of the most common causes of elbow pain, and patients often mix them up because they feel so similar. Both are overuse injuries of the tendons around the elbow — one on the outer side, one on the inner side — and despite the sporting names, most people who get them have never picked up a racquet or a golf club. The reassuring part is that both conditions usually respond very well to the right, patient treatment.

🕐 7 min read
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Dr. Sumit Dubewar

MBBS · DNB · DABRM (USA) · FIJR · FIASM · MNAMS
Orthopedic & Regenerative Specialist · Secunderabad · +91 9370498182

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What Causes These Overuse Injuries?

Understanding lateral and medial epicondylitis

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Tennis elbow (lateral epicondylitis) is irritation and microscopic tearing of the tendons that attach to the bony bump on the outer side of the elbow, where the muscles that extend and straighten the wrist originate. Golfer's elbow (medial epicondylitis) is the same process happening on the inner side of the elbow, where the wrist-flexor and gripping muscles attach. Both develop gradually from repeated strain rather than a single injury, and — despite the names — only a small fraction of cases actually come from playing tennis or golf.

  • Repetitive gripping or wrist movements at work — plumbing, carpentry, painting, gardening, or manual labour
  • Prolonged computer and mouse use, or repetitive typing — a very common cause today
  • Tennis, golf, badminton, and other racquet or throwing sports, especially with poor technique or equipment
  • Activities involving repeated lifting, twisting, or gripping of tools — like using a screwdriver or wringing wet cloth
  • Age — most common between 35 and 55 years, as tendons lose some of their elasticity and resilience over time
  • A sudden increase in activity or taking up an unfamiliar repetitive task without conditioning
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Symptoms

Recognizing the signs of tennis and golfer's elbow

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Symptoms usually build up gradually over weeks rather than appearing overnight, and their exact location depends on which tendon is involved.

  • Pain and tenderness over the outer elbow (tennis elbow) or inner elbow (golfer's elbow)
  • Pain that worsens with gripping, shaking hands, lifting objects, or twisting motions like turning a doorknob or wringing a cloth
  • Weak grip strength — difficulty holding a cup, shaking hands firmly, or opening a jar lid
  • Pain that may radiate a short distance down the forearm from the elbow
  • Mild stiffness in the elbow, often more noticeable first thing in the morning
  • Symptoms that tend to flare with a specific repetitive activity and settle somewhat with rest

Seek prompt medical attention if: pain follows a fall or direct injury with sudden severe pain (possible fracture), there is significant swelling, bruising or visible deformity, you notice numbness or tingling in the hand or fingers, you cannot move the elbow at all, or there are signs of infection such as redness, warmth, or fever.

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Diagnosis

How your doctor confirms the diagnosis

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Both tennis elbow and golfer's elbow are usually diagnosed clinically — through a careful history and physical examination — without the need for scans in most cases.

Clinical Examination

  • Tenderness directly over the lateral or medial epicondyle (the bony bump) on pressing
  • Pain reproduced with resisted wrist extension (tennis elbow) or resisted wrist flexion (golfer's elbow)
  • Grip strength testing, which is often noticeably reduced on the affected side
  • Checking elbow range of motion and ruling out other causes, such as nerve entrapment, arthritis, or ligament injury

Imaging

  • Usually no imaging is needed for typical cases that are diagnosed clinically
  • Ultrasound may be used to confirm tendon changes, or if symptoms are not improving as expected
  • X-ray if a fracture, arthritis, or calcification around the tendon is suspected
  • MRI is reserved for unclear or persistent cases, or before considering more invasive treatment options
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Treatment Options

From rest and physiotherapy to PRP and surgery

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Conservative Care (First-Line Treatment)

  • Relative rest and activity modification — avoiding or adjusting the specific movements that aggravate the pain
  • Ice application during acute flare-ups, 15-20 minutes at a time, several times a day
  • Physiotherapy focused on eccentric strengthening exercises of the wrist extensor or flexor muscles — this is the single most effective treatment for long-term recovery
  • A counterforce brace or strap worn just below the elbow, which helps offload strain from the tendon during daily activity
  • Short courses of anti-inflammatory medication to help manage acute flare-ups
  • Ergonomic adjustments — correcting mouse/keyboard set-up at work, or the grip size on a racquet or tool

When Conservative Care Isn't Enough

  • If symptoms persist despite several months of dedicated physiotherapy and activity modification, a PRP (Platelet-Rich Plasma) injection is a reasonable option for patients who haven't responded to first-line treatment. PRP uses concentrated growth factors from the patient's own blood to support the tendon's natural healing process, and is well-supported in orthopedic literature for elbow tendinopathy as a step before considering surgery. It is not needed for typical or mild cases that are already improving with physiotherapy.
  • Corticosteroid injections may relieve pain in the short term but are used cautiously, as repeated use can weaken the tendon further

Surgical Options (Rare)

  • Surgery is considered only for chronic cases that have failed 6 to 12 months of comprehensive conservative treatment, including physiotherapy and other options above
  • The procedure involves removing damaged, degenerated tendon tissue and repairing the healthy tendon
  • The large majority of patients recover very well without ever needing surgery

The vast majority of tennis elbow and golfer's elbow cases heal completely with rest, structured physiotherapy, and time — surgery is rarely required.

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Exercises

Strengthening exercises for lasting recovery

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A guided, progressive exercise programme — especially eccentric strengthening of the forearm muscles — is the cornerstone of recovery from both tennis elbow and golfer's elbow. Consistency matters more than intensity: done correctly and regularly under a physiotherapist's guidance, these exercises gradually rebuild the tendon's capacity to handle load.

Browse the Exercise Library
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Dr. Sumit's Advice

A word from Dr. Sumit

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"In my practice, tennis elbow and golfer's elbow are two of the conditions I see patients get most frustrated with — because the pain lingers for months even when nothing seems 'seriously wrong' on a scan. What I tell every patient is the same: these are tendon injuries, and tendons heal slowly, over months, not weeks. The exercises matter more than any injection, and rushing to a needle or the operating table before giving structured physiotherapy a real chance rarely serves the patient well. Patience, combined with the right, consistent exercise programme, resolves the overwhelming majority of these cases. For the small number who genuinely don't respond after months of honest effort, options like PRP exist — but they're a next step, not a shortcut."

— Dr. Sumit Dubewar · DABRM (USA) · Secunderabad

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