Physical Therapy for Golfer’s Elbow

Golfer’s elbow is an overuse injury that develops when the tendons on the inside of the forearm become inflamed and painful. It occurs due to repetitive use of the forearm, hand, wrist, and elbow, affecting golfers, baseball players, and tennis players. Physical therapy provides timely and effective treatment for golfer’s elbow to reduce pain, restore function and strength to the elbow, forearm, and wrist, and address body mechanics to prevent the condition from recurring. Mangiarelli Rehabilitation physical therapist, Bobby, demonstrates exercises for golfer’s elbow to strengthen the wrist, forearm, and elbow.

What is Golfer’s Elbow? 

Golfer’s elbow (medial epicondylitis) is an overuse injury that develops when the tendons on the inside of the forearm become irritated, inflamed, and painful. It is caused by repetitive use of the hand, wrist, forearm, and elbow. Golfer’s elbow can affect golfers due to the repetitive swing of the golf club and baseball players, tennis players, and field and track athletes due to the repetitive throwing involved in these sports. This condition can develop with any activity requiring repetitive gripping, twisting, and throwing, including gardening or certain work tasks.

In golfer’s elbow, the group of muscles that bend and turn the wrist, fingers, thumb; stabilize the elbow; and allow for wrist movement are affected. This muscle group comes together in a common sheath called the common flexor tendon that attaches to the upper arm bone. Inflammation occurs in the tendon when the load placed on the tissue exceeds the tissue’s capacity, causing the tendon to become tender and irritated with continuous overuse and insufficient recovery and repair time. When golfer’s elbow becomes chronic, degenerative changes can occur in the tendon, causing the collagen tissue of the tendon to deteriorate, leading to weakness and pain.

Symptoms of golfer’s elbow include:

  • Pain along the inside of the forearm with hand, wrist, and elbow movements

  • Tenderness to touch and swelling along the inside of the forearm

  • Weakness in the hand and forearm when gripping objects

  • Stiffness in the elbow

  • Pain or numbness and tingling that radiates from the inside of the elbow into the hand and fingers when gripping or squeezing 

Physical Therapy Treatment for Golfer’s Elbow

It is crucial to treat golfer’s elbow as early as possible to prevent the condition from becoming chronic. Physical therapy provides timely and effective treatment to reduce pain, restore function and strength to the elbow, forearm, and wrist, and address body mechanics to prevent the condition from recurring. 

The therapist initially performs an evaluation that involves conducting strength and motion tests of the wrist, forearm, and elbow; job and sports history; postural evaluation; assessing muscle imbalances of the upper extremity, particularly from the shoulder blade through to the hand; and palpating the elbow area to determine which tendons are inflamed.

Physical therapy treatment for golfer’s elbow involves:

  • Pain management: rest from aggravating movements to allow the tendon to heal; use of ice, heat, ultrasound, bracing and splinting to reduce pain

  • Manual therapy: use of soft tissue and joint mobilization techniques to regain full movement in the affected area; stretching of the elbow, forearm, wrist, shoulder, and thoracic spine

  • Strengthening exercises: targeted strengthening exercises of the forearm, elbow, and hand incorporating resistance exercises using weights and resistance bands to address muscle weaknesses and imbalances

    • Isometric exercises: these exercises can be used during the acute phase of golfer’s elbow. Isometric exercises generate force without changing the length of the muscle.

    • Eccentric exercises: these exercises cause muscles to elongate in response to a greater opposing force and build muscle flexibility. Eccentric exercises strengthen muscles, tendons, and ligaments and can help reduce the risk of muscle strains and tears. Eccentric exercise, a progressive loading program on the tendon, helps the tendon gradually adapt to tolerate the demands placed on it.

  • Patient education and functional training: modifying specific movement patterns to lessen the stress on the tendons, forearm, elbow, and wrist and reduce risk of injury, such as adjusting your golf swing and throwing techniques or altering work tasks to reduce the pressure placed on the tendons of the forearm

Mangiarelli Rehabilitation physical therapist, Bobby, demonstrates several exercises for golfer’s elbow to strengthen the wrist, forearm, and elbow in the video below:

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Physical Therapy for Common Baseball Injuries