Medial Epicondylitis
Golfer's Elbow
Protection → Controlled Motion → Return to Function
What Golfer's Elbow Is
Golfer's elbow is the inner-elbow cousin of tennis elbow — a tendon problem where the wrist-flexor and pronator tendons anchor on the inside of the elbow, overloading and breaking down from repetitive gripping, wrist flexion, or twisting. Like all tendinopathies, the fix is the right progressive load, not rest alone.
- Primary — Load-related tendinopathy — inner-elbow pain that flares with gripping, wrist flexion, and twisting. Most common, and this protocol is for it.
- Secondary — Nerve-related — the ulnar nerve runs right by the inner elbow, so numbness or tingling in the ring and little fingers means a nerve may be involved and needs assessment.
Involved tissues: The common flexor-pronator tendon on the inside of the elbow, where the wrist flexors and pronator muscles anchor to the bone.
Two pillars for golfer's elbow: first, offload the aggravating gripping, wrist flexion, and twisting; second, progressively load the tendon — isometrics, then eccentric wrist flexion, then heavier — because tendons get stronger and less painful when loaded correctly. Check the grip and shoulder too.
Tendons need load, not just rest
Golfer's elbow follows the same rules as any tendinopathy: total rest leaves the tendon weak and just as reactive, while graded loading rebuilds it. Start with gentle isometric holds (which ease pain), progress to slow eccentric wrist-flexion lowering (the tendon-builder), then heavier and faster loading — all while temporarily offloading the gripping and twisting that flares it. One extra thing to watch on the inner elbow: the ulnar nerve runs right there, so pins-and-needles in the ring and little fingers means get it assessed.
⚠️ Screen Before You Start — Get Assessed First If You Have:
- ●Numbness or tingling in the ring and little fingers (ulnar nerve)
- ●Pain radiating down the forearm, or the elbow locking or giving way
- ●A hot, red, swollen elbow, or pain after a fall or direct blow
- ●Weakness or clumsiness in the hand
- ●Night pain unrelated to position, fever, or feeling unwell
This is education, not a diagnosis, and doesn't replace hands-on care.
🌡️ Finding your stage
Take your movement temperature. Pain with light gripping or at rest = Protection. Pain only with firmer gripping or loaded wrist flexion = Controlled Motion. Pain only with heavy or fast demand = Return to Function. Brief loading discomfort that settles is okay; a lasting flare means back off. Re-check every session.
Phase 1 · Acute
Protection Phase
🌡️ Pain with light gripping or at rest
Goal: Calm the reactive tendon, offload the aggravating grip/twist tasks, and begin gentle isometric loading.
Manual treatment: Pain-relief modalities and pain-free wrist and forearm mobility.
Frequency: Daily · short, pain-free sessions.
A. Calm & Offload
SoftWave Therapy
Video coming soon- Dose
- As scheduled
- How
- Applied to the involved tendon to calm symptoms and stimulate the healing response.
- Watch for
- The anchor of the early phase while you offload the aggravating task.
Activity Modification (offload grip/twist)
Video coming soon- Dose
- Ongoing
- How
- Use a lighter grip and bigger handles, cut back on the repetitive gripping/twisting, and a counterforce brace can unload the tendon.
- Watch for
- Find and reduce the one repetitive grip/twist task driving it.
Pain-Free Wrist & Forearm Mobility
Video coming soon- Dose
- Gentle, 8–10 reps
- How
- Move the wrist and forearm gently through a comfortable, pain-free range.
- Watch for
- Keep it easy — no forcing into pain.
B. Isometric Loading
Wrist Flexor Isometrics
Video coming soon- Dose
- 5 × 30–45 sec · low-moderate
- How
- Hold a gentle, sustained wrist-flexion push against your other hand — no movement, just a steady hold.
- Watch for
- Isometrics load the tendon and ease pain. Keep it below a sharp-pain level.
Grip Isometrics
Video coming soon- Dose
- 5 × 20–30 sec
- How
- Gentle sustained grip on a soft ball within a comfortable effort.
- Watch for
- Start gentle — the first rung of loading.
Protection-phase precaution: don't push into sharp pain — isometrics should ease symptoms. The biggest early win is offloading the specific repetitive gripping and twisting that re-irritates the tendon.
✅ Ready for the next phase when:
Rest pain settles and the isometric holds feel comfortable.
Tracking Your Progress
The weekly stability check: am I better, the same, or worse than last week?
Better
Stay the course; progress the load as pain shrinks to only heavier demand.
Same
Change the load, tempo, or volume; make sure you're doing true slow eccentrics.
Worse
Drop back a phase and reduce load; re-check you've offloaded the aggravating task.
The Rules That Govern This Protocol
- 1Offload the aggravating gripping, wrist-flexion, and twisting while you rebuild.
- 2Load the tendon progressively — isometrics, then eccentrics, then heavier and faster.
- 3Watch the ulnar nerve — pins-and-needles in the ring/little fingers means get assessed.
- 4No lasting increase in pain after a session (brief discomfort that settles is okay).
Movement You Love Is Therapy. This protocol is general education based on course rehabilitation materials and standard principles. It is not medical advice, diagnosis, or treatment, and does not create a provider–patient relationship. If pain is severe, worsening, or unexplained, see a licensed provider.