GOLFER’S ELBOW PHYSICAL THERAPY
                     GOLFER’S 
ELBOW 
PHYSICAL 
THERAPY
http://www.virtualphysicaltherapists.com/
Pain on the inside of the elbow is commonly called Golfer’s Elbow or Medial 
Epicondylitis. It is a condition that develops from repetitive use of the hand 
and elbow. Activities that can trigger this condition include repeatedly 
swinging a golf club or other activities that require repetitive gripping, 
twisting or throwing. Working at a computer, performing yard work, athletes 
with repetitive overhead motions, carpenters, and plumbers are most at risk. 
Golfer’s Elbow physical therapy consists of target exercises to treat the 
specific cause of your pain.
History of Golfer’s Elbow:
“Medial Epicondylitis” was traditionally the medical term for Golfer’s Elbow, 
with “itis” indicating an inflammatory component. Treatments were focused on 
reducing inflammation, such as ice, anti-inflammatories, and steroid injections. 
But ten years ago, the research found this to be a misconception. The 
inflammatory stage only lasts a few days. Pain that continues for more than six 
days could no longer be attributed to inflammation.
The cause of epicondylitis was then theorized to result from the tendon not healing 
correctly (where the muscle attaches to the bone). With continued use, micro-
retearing would occur due to a weakened tendon. Tendonitis was changed to 
“Tendinosis” – instead of inflammation, the focus was poor tendon healing. 
Treatments for tendinosis consisted of stretching and eccentric strengthening to 
improve the recovery of the tendon. Some did find relief, but many also went on to 
become chronic.
Recent research has found that a high percentage of those with elbow pain have a 
“joint derangement” or mechanical disorder that interferes with the normal function 
of the medial elbow joint. It sounds daunting but is usually easily treated!
The Cause of Golfer’s Elbow:
Golfer’s elbow is a condition that occurs due to repetitive use of the forearm, either 
disrupting the cartilage within the elbow joint or causing irritation to the medial 
tendons of the forearm. Pain from Golfer’s elbow is located at a bony bump on the 
inside of your elbow, known as the medial epicondyle. This is where the tendons to 
your wrist/finger flexors and pronator muscles attach. It is also where the pain is 
referred from a problem within the joint or a ligamentous tear. 
1.  Inflammatory
Acute damage to the medial elbow will initiate a chemical process producing 
inflammation. A constant throbbing pain characterizes the inflammatory phase. 
Inflammation is critical to the healing process. It allows chemicals to be released 
to clean up the area, increase blood flow, and heal any damaged tissues and 
bone. The inflammatory stage is short-lived, only lasting a few days.
2.  A problem within the medial elbow joint:
Joints have cartilage protecting the outer layer of bone and an extra buffer 
between the bones. (Examples of cushions between bones: Meniscus in the 
knee; labrum in the hip/shoulder, the disc in the spine.) 
Repetitive motion strains the joint, especially if the movement is awkward or has 
poor mechanics. This strain can cause microscopic tears in the cartilage and even 
give rise to a tiny piece of your cartilage breaking off. This is part of the natural 
wear and tear process, but excessive activity combined with poor mechanics will 
advance this breakdown, known as a “derangement .”Even though this piece is 
very small, it can cause pain and loss of motion if it interferes with the joint’s 
smooth mobility. Derangements are characterized by intermittent pain, pain 
during movement, and a loss of motion (can be constant pain if joint is held in an 
abnormal position such as a dislocation). 
Golfer’s Elbow physical therapy will address will address internal joint 
derangments by repeatitive movments to clear the derangement.
3. A problem within the medial muscle tendons
Tendons are soft tissue at the end of the muscle that attache the muscle to a 
bone. Repetitive forces can cause a microscopic breakdown in the cartilage 
and/or cause the tendon to become tender and irritated. When the tendons 
break down, the newly repaired tissue needs to be stretched and strengthened 
to imitate its original state. When a repaired tendon does not regain proper 
strength and flexibility, it is prone to re-injury. The group of muscles affected by 
Golfer’s elbow are those that bend the wrist, fingers, and thumb and pronate 
(turn or hold) the wrist so that the palm faces downward. Pain secondary to a 
tendon dysfunction is characterized by tissue tightness and muscular weakness.
Golfer’s Elbow physical therapy will address will address damaged tendons by 
specific stretching and strengthening exercises.
Symptoms
 Pain along the inside of the forearm with wrist, hand, or elbow movements, 
especially gripping or squeezing.
 Tenderness to touch and swelling along the inside of the forearm.
 Weakness in the hand and forearm when gripping objects.
 Elbow stiffness and loss of ability to fully straighten the elbow the last 5-10 
degrees.
Importance of a Proper Diagnosis?
Golfer’s Elbow is a generalized term for any localized injury to your medial 
elbow. Golfer’s Elbow physical therapy must start with a thorough evaluation to 
decipher the true cause of your elbow pain. Other conditions first need to be 
ruled out, including referred pain from your neck, inflammatory arthritis, gout, 
fracture, ligament tear/instability, dislocation, and infection.
 Observe for any abnormalities (edema, redness, irregularities in bones, ligaments, 
muscles, etc)
 Rule out your spine as the source of pain
 Test your strength 
 Assess your range of motion in your wrist, forearm, and elbow.
 Assess for ligamentous laxity
 Perform repeated movements and assess their effect on your baselines
Physical Therapy Treatment for Golfer’s Elbow:
Proper treatment must begin with an accurate diagnosis. Unfortunately, elbow pain 
is often misdiagnosed as tendonitis or an inflammatory condition. Chemical or 
inflammatory pain is constant and short-lived. Examples of pain from inflammation 
are a toothache or hitting your thumb with a hammer – a continuous, throbbing 
pain. When tissue damage is from an injury or infection, the body releases 
chemicals to initiate the healing process to clean the area and increase blood flow 
to repair tissues.
Elbow pain brought on with activity such as turning a doorknob, brushing your hair, 
gripping, but not painful at rest cannot be from inflammation. Intermittent pain is 
from a mechanical source or disruption within the joint.
Most often, medial elbow pain is intermittent and brought on only with activity. A 
mechanical exam is required to determine the root cause of your pain. An MRI will 
show abnormalities but does not differentiate painful from non-painful tissues. We 
can only ascertain what is working and what is painful by using and moving the joint 
and soft tissues.
Most pain from Golfer’s Elbow is the result of a problem within the joint, known as 
a derangement. Pain from a derangement is usually easily corrected. This 
mechanical problem needs to be cleared. (If you have a pebble in your shoe, 
walking is painful. If you shake your foot, so the pebble moves into your toe box, 
you can now walk without pain. The stone is still there. You just moved it out of the 
way.) Similarly, if you can move the small particle out of the joint’s arc of motion, 
you will no longer have pain. The body will break down the particle when it is out of 
the joint space.
The derangement can be anywhere within the joint. Often there is a loss of the 
ability to straighten the elbow fully and pain when attempted. This particle must be 
cleared or removed out of the joint space. A way to test is to find a baseline or 
activity that causes pain. It could be squeezing something or resisting as you extend 
your fingers. Perform that painful activity and assess your pain. Next, straighten 
your elbow and then relax by bending it slightly. Perform this ten times, each time 
trying to go a bit further into extension or straightening your elbow. Retest your 
baseline activity. Do you have more, less, or the same amount of pain performing?
If you have less…Great…you found your self-treatment!
If there is no change, then it could still be a derangement. It would help if you had 
further guidance to find the right direction to clear the derangement. Or you may 
have poor tissue healing – Tendinosis. A clinician specializing in Mechanical 
Assessment and Treatment will advise you on what you need to abolish the pain. 
How Can Virtual Physical Therapists Help?
There is no reason for you to suffer in pain when you can get relief now with 
Golfer’s Elbow physical therapy! It is also essential to get treatment for Golfer’s 
elbow as soon as it occurs because the tendons are affected and do not have a good 
blood supply. An inflamed tendon that goes untreated can begin to tear, and a more 
severe condition can result. If you have a derangement, it can easily be treated, and 
you can get relief right away!
Can Golfer’s Elbow Be Prevented?
Golfer’s Elbow physical therapy will help you understand the risk of injury and 
awareness of your daily movements to help prevent elbow pain. 
 Use proper form and technique when repetitive tasks or sports movements, like 
golf swings.
 Maintain shoulder, forearm, and wrist muscle strength.
 Perform gentle forearm muscle stretches before and after performing tasks.
 When lifting heavy objects, use proper posture and body mechanics to 
reduce joint strain.
 Listen to your body when you have pain. Active rest periods are critical for full 
healing after exercise.
Golfer’s Elbow physical therapy is now conveniently available by online physical 
therapists.
Each of our virtual physical therapy provider(s) has also received an additional 
specialty in Mechanical Diagnosis (Cert. MDT) to assure you receive the highest 
quality online physical therapist.
Tennis/Golfer’s Elbow – 5 Mistakes to Avoid
VIRTUAL 
PHYSICAL 
THERAPISTS
[email protected]
HTTP://WWW.VIRTUALPHYSICALTHERAPISTS.COM/
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