4 Step Golfers Elbow Treatment Plan | Precision Movement

4 Step Golfers Elbow Treatment Plan

How to Test for and Treat Medial Epicondylitis

By Coach E

how to treat golfers elbow

When elbow pain keeps you off the greens, you need a golfers elbow treatment plan. I’ll teach you the 4 steps to follow to treat the issue properly so you can get back out there.

Golfers elbow is a common overuse injury of the elbow [1].

Golfers elbow is obviously commonly associated with the game of golf, but really it can be caused by anything requiring a repetitive movement of the arm that puts stress on an area called the medial epicondyle. In fact, if you’ve heard the term “Thrower’s Elbow”, it’s the same thing.

Signs of Golfers Elbow

The symptoms of golfers elbow are usually felt most at a central point on the inside of your elbow. This point may be painful and tender to the touch.

golfers elbow treatment for golfers

The pain may start to spread down your forearm, and certain movements including gripping or grabbing objects, flexing your wrist or fingers and supinating your forearm. Stretching your forearm muscles may also trigger symptoms [2].

Beyond just pain, a feeling of weakness is also common.  You might feel like it’s hard to keep a strong grip on your golf club or weak when you try to make a fist with your hand (a big problem if boxing is your sport).

Golfers Elbow Anatomy

So what’s going on to cause these annoying symptoms?

I mentioned that the pain and tenderness of golfers elbow is usually located at the medial epicondyle.

Your medial epicondyle is a bony bump on your humerus, or upper arm bone, located at the inside of your elbow. This point is the origin point of several muscles that extend into your forearm and wrist, including your wrist and finger flexors [3].

wrist flexor muscles and golfers elbow treatment

Several of these flexors share a common tendon that attaches at your medial epicondyle [4]. Suffice to say that there is a lot of action happening at this small bony bump.

If repetitive forces go through this area, say from rounds of golf a few days in a row, it can cause result in microtears to the tissues that accumulate due to insufficient recovery.

When this damage happens, pain follows, and you’ll start to notice symptoms of the injury called “golfers elbow” – also known as medial epicondylitis in the medical world.

This area experiences a lot of force when this common flexor tendon is contracted – like when you grab something, flex your wrist or twist your forearm downwards – the exact motion required when you hit a golf ball or throw a baseball [5].

Root Causes of Golfers Elbow: Golf & Beyond

Golfers elbow, at its root, is a repetitive strain injury. It’s not that swinging a golf club or throwing a baseball once is going to generate enough force at the medial epicondyle to cause this pain.

What does happen is through excessive use and/or insufficient recovery, the tissues become damaged and never heal.

This usually shows up (for those of us in the northern hemisphere at least) when you suddenly jump back into golfing once the course thaws after 6 months of not really working the same muscles or movements.

The injury is also really common for folks who take a golf vacation. In these cases, you suddenly go from golfing every weekend to hitting the course 5 days in a row – much to your elbow’s displeasure.

Your wrist flexors don’t just help you grip the golf club and run through the motions – they are the powerhouse adding that snap to your golf swing.

Similarly, these are the muscles that allow you to really whip a baseball like when a reliever is trying to close out a game in the bottom of the 9th – not just float it in to home plate.

treatment and root causes of golfers elbow

It’s precisely because these muscles are generating so much force during these activities that they often get overworked when we do them repetitively.

And it’s not just these 2 sports that can trigger the issue.

Let’s say you’ve been hitting the DIY home improvement projects pretty hard – operating hand tools, shoveling, or chopping wood can all cause the same force on the medial epicondyle and the resulting golfers elbow pain [6].

Now that you understand the anatomy and biomechanics behind the injury, let’s talk about how to treat it.

4 Step Golfers Elbow Treatment Plan

Step 1: Perform the Golfer’s Elbow Test

The first step in golfers elbow treatment is to make sure that’s actually what you’re dealing with. There is a simple golfers elbow test you can perform to do just that.

  1. Flex the elbow to 90°
  2. Extend the wrist and pull the fingers to further stretch the wrist and fingers into extension
  3. If you feel pain in the medial epicondyle region along the inside of your elbow, you’ve got a positive result and a likely case of golfers elbow

Step 2: Acute Stage

Once you know you’re dealing with medial epicondylitis, you will want to really take it easy in the first stage – also called the acute stage.

This period can last up to 72 hours after your pain begins or after it flares up from trying to tough it out. Your symptoms might be fairly intense so you want to be sure to get some real, COMPLETE rest for at least 48 hours and for as long as 72 hours.

That means no golfing, no throwing, and basically no working with that arm (as much as is possible).

During this first stage you should apply ice and use compression on the elbow.

golfers elbow treatment - compression sleeves

One easy way to do this is with a elbow compression sleeve. These sleeves are designed to reduce the muscular demands in the area, which in turn helps promote healing.

Step 3: Post-Acute Stage

The post-acute stage will come next as that acute pain starts to fade. You can plan to spend up to 14 days in this phase and there are a couple of methods to help speed your healing.

One important method is self-massage. Spend some time each day giving your flexor muscles some attention, as well as the tissues surrounding your medial epicondyle region.

massage treatment for golfer's elbow

This massage can help promote blood flow, which aids in recovery.

You should still be taking it easy and avoiding triggering activities as much as possible during this phase of recovery. However, if you must do activities that flare up the area, it is wise to incorporate some taping.

taping method - golfers elbow treatment

Image by csmc.sg

Taping has been found to help improve grip strength and wrist extension ability while also reducing pain in folks with tennis elbow [7]. (Tennis elbow shares similar mechanisms as golfers elbow, but is centered around the lateral epicondyle.)

During the post-acute phase, you should also start to introduce some low intensity exercises. Go for moves that work your wrist through the full range of motion while maintaining a strong grip.

For example, try 3 sets of 15 reps of dumbbell flexions and extensions with light weights – think 2 -5 pounds. Do these exercises daily for a full week.

If you don’t have dumbbells, you can a small piece of equipment called a Flexbar by Theraband that helps you do similar movements as you’d do with dumbbells.

Most people should start with the red flexbar (the second lightest resistance) unless you are quite weak or have very intense pain, in which case you should start with the yellow, then progressing up to green is the goal.

Research has shown that exercises focusing on wrist flexor strength are helpful to reducing golfers elbow pain.

For example, one study looked used the Flexbar for people with chronic golfers elbow and found that incorporating these exercises reduced symptoms and the interference of those symptoms on activities like sports and daily living [8].

UPDATE: I’ve posted 3 exercises that are great for this stage and the next, which you can read about in this article.

Step 4: Return to Sport & Work

Once you hit the 2 week mark in your golfers elbow treatment, things should begin to progress and you should be feeling stronger.

After those first 14 days, you can start to increase the intensity of your exercises and start working back up to those activities that demand a lot of your wrist flexors.

Be patient, but begin to progress to exercises that require multi-joint movements (like pushups or shoulder presses). And as appropriate, start to increase the intensity, speed, and power demands required during these exercises.

Slowly progressing in this way will help you build resistance to further injury. And incorporating multi-joint moves will help make sure your body is well-balanced – not just strong in certain areas.

Using this 4 step golfers elbow treatment process will help ensure that you don’t just jump headfirst back into the same overuse situation and end up with a recurring injury a few weeks later.

4 step golfers elbow treatment

By giving yourself time to rest and heal, incorporating gentle wrist flexor exercises, and then building up your strength gradually, you can help build your wrist flexors up better than they were before.

And this means more time on the greens and less time stuck at home with FOMO while your golfing buddies work on their skills.

About the Author

Eric is the founder of Precision Movement and has a degree in Kinesiology from the University of Waterloo. He's been a coach since 2005 and spent his early career training combat athletes including multiple UFC fighters and professional boxers. He now dedicates himself to helping active people eliminate pain and improve mobility. He lives in Toronto (Go Leafs Go!) with his wife and two kids and drinks black coffee at work and IPAs at play. Click here to learn more about Eric.