Elbow
Tennis and golfer’s elbow
Tennis elbow (lateral epicondylitis) and golfer’s elbow (medial epicondylitis) are the same process on opposite sides of the joint: degenerative change in the common tendon where the forearm muscles attach to the bony prominence of the elbow. Despite the "-itis" in both names, the tissue changes are degenerative rather than inflammatory, which is why treatments aimed purely at inflammation often disappoint and why loading the tendon is central to recovery. Most cases occur in people who play neither sport.
Symptoms
The location of the tenderness distinguishes the two, and both are provoked by grip.
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Pain at the outer or inner elbow
Tennis elbow is felt on the outside, golfer’s elbow on the inside, usually at a precise point on the bony prominence and often radiating into the forearm.
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Worse with gripping
Shaking hands, carrying a bag, turning a door handle or lifting a kettle are the activities people most often report.
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Weak grip
Grip strength commonly reduces, more often because of pain than because of true muscle weakness.
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Gradual onset
Symptoms usually build over weeks rather than starting with a single event, though a sudden increase in activity may precede them.
Causes and risk factors
The common thread is repeated load on the tendon beyond what it has adapted to tolerate.
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Repetitive forearm use
Gripping, twisting and lifting at work or in hobbies. Trades using hand tools are affected more often than racquet sports players.
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A change in activity
A new task, a new tool, or a sudden increase in volume frequently precedes onset.
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Age
Most common between about thirty-five and fifty-five, when tendon tissue is less tolerant of sudden increases in load.
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Technique and equipment
In racquet and club sports, grip size and technique influence the load transmitted to the tendon.
Diagnosis
Usually a clinical diagnosis; imaging is reserved for atypical cases or where symptoms do not improve.
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Examination
Point tenderness over the affected epicondyle, with pain reproduced by resisted wrist extension for tennis elbow or resisted wrist flexion for golfer’s elbow.
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Ultrasound
Can show tendon thickening, degenerative change and tearing, and is useful where the diagnosis is uncertain or symptoms persist.
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Considering other causes
Nerve entrapment at the elbow, referred pain from the neck, and joint pathology can produce similar symptoms and are assessed where the picture does not fit.
Common questions
How long does it take to settle?
Recovery is usually measured in months rather than weeks. Most cases resolve eventually, and the main determinant is consistent loading rehabilitation rather than any single treatment.
Should I rest it completely?
Complete rest is generally not advised. Aggravating activity is reduced while the tendon is loaded progressively, because tendons adapt to load and deteriorate without it.
Do steroid injections work?
They often provide short-term relief, but studies have found worse outcomes at one year compared with exercise or with no injection. That is why they are used selectively rather than routinely.
Do braces and straps help?
A counterforce strap helps some people manage symptoms during activity. It is a way of tolerating load rather than a treatment for the tendon itself.
General reference information, and not advice about your own case. It may not reflect the most recent guidance or what is offered on a given day — call (201) 408-5151 to check.
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