Golfer’s Elbow: Symptoms, Treatment, Exercises and Physiotherapy in Burlington
Cogent Rehab Blog
Folarin Babatunde, PT PhD, MScSEM, MScPT, BSCPT
August 14, 2026
Golfer’s or thrower's elbow, also called medial epicondylitis/epicondylalgia or medial elbow tendinopathy, is a common cause of pain on the inner side of the elbow. Despite the name, you do not need to play golf to develop it. Golfer’s elbow can affect people who perform repeated gripping, wrist flexion, forearm rotation, lifting, tool use, racquet sports, throwing, or other repetitive upper-limb activities.
At Cogent Physical Rehabilitation Center in Burlington, Ontario, physiotherapy can help identify the source of your medial elbow pain, reduce tendon overload, restore strength, and guide a safe return to work, sport, and daily activities.
What Is Golfer’s Elbow?
Golfer’s elbow affects the common flexor-pronator tendon where several forearm muscles attach to the medial epicondyle on the inner side of the elbow. This muscle group includes the pronator teres and the common flexor tendon, which encompasses the tendons of the flexor digitorum superficialis, flexor carpi ulnaris, flexor carpi radialis, and palmaris longus, with the flexor carpi radialis and pronator teres being most commonly affected. These muscles help with:
Bending the wrist
Turning the forearm with the palm downwards
Gripping with the hand
Controlling the hand and wrist
Stabiliing the hand during lifting and tool use
According to current evidence, medial epicondylitis can more accurately be described as a chronic case of epiconlylosis or epicondylalgia,which reflects a pattern of degeneration and formation of granulation tissue known as a tendinosis rather than a purely inflammatory condition. Continuous or excessive loading can lead to tendon degeneration, change in how collagen fibres are organized and reduced load tolerance over time.
What Does Golfer’s Elbow Feel Like?
Golfer’s elbow typically causes pain and tenderness on the inside of the elbow, around the medial epicondyle. Symptoms often develop gradually, although they can occasionally begin suddenly after an injury or forceful activity.
Common symptoms include:
Pain on the inner side of the elbow that may extend into the forearm or wrist.
Pain that worsens with gripping, lifting, throwing, wrist flexion, forearm pronation, or twisting activities.
Symptoms that improve with rest.
Increased discomfort in the morning.
Tenderness just below the medial epicondyle, where the flexor-pronator tendons attach.
Pain reproduced with resisted wrist flexion or forearm pronation.
Reduced grip strength, particularly in longstanding cases.
Occasional numbness or tingling into the ring and little fingers if the nearby ulnar nerve becomes irritated.
Swelling or redness may occur when symptoms begin suddenly, but the elbow often looks normal in longer-standing cases.
Can Golfer’s Elbow Cause Numbness or Tingling?
Sometimes because the ulnar nerve passes behind the medial epicondyle, close to the area affected by golfer’s elbow. If you experience tingling into the ring or little finger, numbness, hand weakness, electric or burning pain or symptoms worsening by prolonged elbow bending, your clinician may also assess for ulnar nerve involvement or cubital tunnel syndrome. This is very important because medial elbow pain is not always caused only by the flexor tendon.
What Causes Golfer’s Elbow?
Golfer’s elbow usually develops from repeated or excessive loading of the muscles and tendons that flex the wrist and rotate the forearm inward. Over time, repeated gripping, lifting, throwing, swinging, or twisting can place stress on the common flexor tendon where it attaches to the medial epicondyle on the inside of the elbow.
Symptoms commonly occur on the dorminant arm, because these activities are often performed more frequently with that side. The condition may affect people involved in golf, racquet sports, throwing sports, weight training, manual work, construction, mechanics, or other occupations that require frequent gripping and forearm rotation.
Risk may be higher in people who perform repetitive wrist flexion or forearm pronation for two or more hours per day such as mechanics, welders, consurtction workers, carpenters, plumbers, gardeners, healthcare workers, warehouse workers and office workers. Smoking, diabetes, and obesity have also been associated with an increased risk of developing medial epicondylitis.
How Is Golfer’s Elbow Diagnosed?
Golfer’s elbow is usually diagnosed through a clinical history and physical examination. A physiotherapy assessment may include:
Checking for tenderness just below the medial epicondyle.
Testing whether pain is reproduced with resisted wrist flexion and forearm pronation.
Assessing elbow and wrist range of motion, grip strength, and functional activities.
Screening the ulnar nerve if there is numbness, tingling, or hand weakness.
Performing ligament tests if elbow instability is suspected.
Functional testing targeting work or sport technique.
Your physiotherapist may also examine your neck, shoulder. Imaging is not always necessary. Ultrasound, X-ray, or MRI may be recommended when symptoms are persistent, traumatic, or unclear. EMG or nerve conduction testing may be considered if an ulnar nerve problem is suspected.
How Is Golfer’s Elbow Treated?
Most cases of golfer’s elbow improve with non-surgical treatment. Management typically progresses through three stages:
Stage 1 - Reduce irritation: temporarily modify or stop aggravating activities, use ice after activity, and consider appropriate pain-relieving medication or bracing.
Stage 2 - Rehabilitation: physiotherapy focuses on restoring pain-free movement, improving flexibility, and gradually strengthening the wrist, forearm, grip, and upper limb.
Stage 3 - Return to activity: work, sport, and exercise are gradually reintroduced with attention to technique, equipment, and workload to reduce recurrence.
A counterforce elbow strap, wrist splint, or taping may temporarily reduce symptoms in some patients.
This approach may be useful during aggravating work, selected sporting activities, a temporary flare-up or while rehabilitation is progressing
As symptoms settle, strengthening usually progresses from isometric exercises to more demanding resisted and task-specific exercises. A comprehensive rehabilitation program may include isometric, concentric, eccentric, endurance, and functional loading. Reduced shoulder strength, poor scapular control, or inadequate trunk contribution may increase the demand placed on the forearm and elbow during work or sport. Physiotherapy may include shoulder and scapular strengthening rather than focusing only on the elbow for individuals involved in golf, throwingor racquet sports, weight training or heavy manual work.
Other treatments such as corticosteroid injections, PRP, shockwave therapy, massage, electrical stimulation, or other modalities may be considered in selected cases, although the evidence for some of these options is limited or inconsistent.
Surgery is rarely required and is generally reserved for persistent symptoms that have not improved after approximately 6–12 months of appropriate conservative management.
Should You Completely Rest Golfer's Elbow?
Usually not. Complete rest may reduce pain temporarily, but prolonged unloading can also reduce the tendon’s ability to tolerate activity. A better approach is often relative rest, which may include:
Reducing the most painful activities
Temporarily avoiding repeated high-force gripping
Modifying lifting techniques or loads
Reducing sport or training volume
Continuing comfortable, pain-limited movement
Beginning progressive strengthening as tolerated
The goal is to keep the arm active without repeatedly aggravating symptoms, while gradually rebuilding the tendon’s strength and capacity.
When Should You Seek Assessment?
Consider a physiotherapy assessment if your symptoms are persistent, recurrent, or beginning to interfere with everyday activities. This may include:
Pain on the inside of the elbow lasting more than a few weeks
Pain with gripping, lifting, wrist flexion, or forearm rotation
Reduced grip strength
Difficulty performing work, exercise, golf, or other sports
Symptoms that repeatedly return when activity increases
Numbness or tingling into the forearm or hand
Neurological symptoms such as numbness, tingling, or hand weakness should be assessed promptly because the ulnar nerve can also be involved.
How Physiotherapy Can Help
Physiotherapy treatment is tailored to the cause of your symptoms and the demands you place on your arm. Assessment and treatment may include:
Elbow, wrist, grip, and tendon-load testing
Ulnar nerve assessment
Screening of the shoulder and cervical spine when indicated
Manual therapy and mobility treatment
Progressive tendon, forearm, and grip strengthening
Shoulder and scapular strengthening
Education on activity and load management
Work-specific or sport-specific rehabilitation
Gradual return-to-work, golf, and exercise planning
At Cogent Physical Rehabilitation Center in Burlington, rehabilitation can be individualized around your work, sport, and daily activity demands, with the goal of restoring strength, improving load tolerance, and reducing the risk of recurrence.
Need Treatment for Golfer's Elbow in Burlington?
Elbow pain shouldn’t keep you from work, exercise, or the activities you enjoy. Book a physiotherapy assessment at Cogent Rehab in Burlington to identify the cause of your golfer’s elbow and start a personalized treatment plan focused on reducing pain, restoring strength, and improving arm function.
Selected References
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