Golfer's Elbow: Why the Inside of Your Elbow Hurts (and What Actually Fixes It)
Updated: Aug 21
Golfer's Elbow Has Almost Nothing to Do With Golf
Most people who come to see us with golfer's elbow have never swung a club in their life. They are gardeners pulling weeds, tradespeople gripping tools all day, gym-goers who added heavy rows or deadlifts, new parents hauling car seats, and yes, the occasional golfer. Golfer's elbow (clinicians call it medial epicondylalgia) is pain on the inside of the elbow that comes from repetitive load through the muscles that flex your wrist and grip your hand, not from any one sport. If you are searching for golfer's elbow treatment in Burlington and you have never played a round in your life, you are in the right place.
It is the quieter, less famous cousin of tennis elbow. Both are overuse tendon problems at the elbow, but tennis elbow hits the outside and golfer's elbow hits the inside. At Pursuit Physiotherapy, we see both, and we see a lot of people who have been told the wrong things about how to fix them.
What Golfer's Elbow Actually Is
The muscles that curl your wrist down and turn your palm toward the floor all share a common anchor point: a bony bump on the inner side of your elbow called the medial epicondyle. Grip something, twist a screwdriver, swing a kettlebell, and those tendons pull on that anchor. Do it often enough, or ramp it up faster than the tissue can adapt, and the tendon starts to complain.
Despite the old label "epicondylitis," which implies inflammation, this is really a tendinopathy. The tendon has not simply gotten inflamed and angry for a week. Its structure has changed under repeated load and it has lost some of its capacity to handle work. That distinction matters, because it changes the entire treatment plan. You do not calm a tendinopathy down with rest and a needle. You rebuild it with load.
One detail sets golfer's elbow apart from tennis elbow: the ulnar nerve runs right behind that same inner elbow bump, through a tunnel you know as your "funny bone." Research suggests that up to half of people with golfer's elbow also have some irritation of that nerve. That is why some patients feel tingling or numbness spilling into the ring and little fingers, not just local elbow pain. Sorting out how much is tendon and how much is nerve is a big part of getting the plan right.
What Causes It
Golfer's elbow is a load problem. It shows up when demand on the flexor and pronator tendons outpaces what they are currently built to handle. Common triggers we see at our Burlington physiotherapy clinic include:
A sudden jump in activity. A new gym program, a weekend of gardening in spring, a home renovation, or a big increase in golf or racquet volume once the outdoor courts open.
Repetitive gripping at work. Trades, hairstyling, cooking, assembly work, and anything that keeps your hand clenched for hours.
Heavy or awkward lifting. Deadlifts, rows, farmer carries, and pull-ups load these tendons hard, especially if grip is the weak link.
Technique and equipment. In golf, an over-the-top swing or gripping too tightly loads the trail arm. In racquet sports, a heavy topspin forehand does the same.
Here is a point most people miss: the elbow is often the victim, not the culprit. If the shoulder and grip are not strong enough to absorb force, that load gets dumped further down the chain onto the elbow tendons. We treat plenty of people in Burlington, Waterdown, and Oakville whose elbow pain traces back to a weak shoulder or a grip that fatigues too soon.
Signs and Symptoms
Golfer's elbow usually announces itself with a specific pattern:
Pain and tenderness on the inner side of the elbow, right over that bony bump.
Pain that flares when you grip, twist, or bend your wrist down, especially with the arm straight.
A weaker, more painful grip. Opening jars, shaking hands, or carrying a grocery bag can sting.
Stiffness in the elbow, often worse in the morning or after the arm has been still.
Sometimes tingling or numbness into the ring and little fingers if the ulnar nerve is involved.
When It Might Be Something Else
Not all inner elbow pain is golfer's elbow. Ulnar nerve compression at the elbow, a neck problem referring pain down the arm, or a ligament issue can all mimic it. This is exactly why a proper assessment matters. Chasing the wrong diagnosis with the right exercises still gets you nowhere.
What the Research Actually Says
The most useful long-term study on golfer's elbow followed patients treated with a simple, home-based eccentric loading program, then checked in years later.
In a prospective study of adults with golfer's elbow, a graded eccentric exercise program for the wrist flexors, done mostly at home, produced strong improvements in pain and grip strength. At long-term follow-up averaging 11 years, the large majority remained satisfied and symptom-free, with the authors describing it as a safe, low-cost approach that leaned mainly on the patient doing the work rather than passive treatment. Svernlov B, Hultgren E, Adolfsson L. Medial epicondylalgia (golfer's elbow) treated by eccentric exercise. Shoulder and Elbow, 2012.
Two things stand out. First, progressive loading is the treatment that changes the tendon, not the passive stuff. Second, and this is sobering, the patients in that study had been dealing with symptoms for an average of well over a year before starting. Golfer's elbow left alone can drag on for many months. It does not reliably "just settle." The good news is that when you load it correctly, it responds.
It is also worth naming what the research does not support as a standalone fix. Cortisone injections can take the edge off pain in the short term, but the longer-term studies on elbow tendinopathy tend to show worse outcomes and higher recurrence compared to a proper loading program. A shot might buy you a few good weeks, but it does not rebuild the tendon, and it can leave you worse off down the road.
How We Treat Golfer's Elbow at Pursuit Physiotherapy in Burlington
Our approach is not a hot pack and a sheet of generic exercises. It is built around figuring out why the tendon got overloaded in the first place and then rebuilding its capacity in a way that sticks. Here is what that looks like.
Getting the Diagnosis Right
Your first appointment is a full hour, one-on-one with a physiotherapist in Burlington who does the whole assessment personally. We test grip, wrist and forearm strength, and how your shoulder and neck are contributing. We screen the ulnar nerve, because if it is part of the picture, ignoring it will stall your progress. You leave knowing exactly what is driving your pain.
Calming It Down Without Shutting It Down
Total rest is a trap with tendinopathy. Rest too long and the tendon gets even less tolerant of load. Instead we adjust your activity so the tendon stays working but stops getting flared, and we often start with isometric holds that ease pain while keeping the muscle switched on. Where it helps, Burlington manual therapy and targeted soft tissue work can settle symptoms and improve how the elbow moves so you can load it comfortably.
Rebuilding the Tendon With Progressive Loading
This is the part that does the heavy lifting, literally. We build a guided exercise program that gradually loads the wrist flexors and pronators, adding difficulty as the tendon adapts. We do not stop at the elbow. We strengthen the grip, forearm, and shoulder so the whole arm shares the load instead of dumping it onto one sore spot. For golfers and racquet players, we also look at technique and volume so the problem does not simply come back the moment you return to the course or court.
If you want to see how this plays out for the outer elbow, our write-up on tennis elbow treatment in Burlington covers the same loading principles for the flip side of the joint.
What to Expect at Your First Appointment
Pursuit runs differently than a busy clinic where you get passed between assistants. Your first appointment is a full hour, and you spend it directly with Javier, a registered physiotherapist and a medical acupuncture instructor at McMaster University. No stacked schedules, no handing you off to a tech. We assess thoroughly, explain what we find in plain language, and start you on a plan the same day. Follow-up visits keep you progressing and adjust the loading as you get stronger.
What You Can Do Right Now
While you are waiting to get assessed, a few things genuinely help:
Do not fully rest it, but do dial back the aggravator. Cut the volume of whatever grip-heavy task set it off, rather than stopping all activity.
Try gentle isometrics. Holding a light, pain-tolerable wrist-flexion contraction for 30 to 45 seconds a few times can take the edge off without irritating the tendon.
Check your grip. Loosen your death grip on tools, clubs, and the steering wheel. A softer grip drops the load on those tendons noticeably.
Warm up before loading. A few minutes of easy movement before gardening, lifting, or a round of golf preps the tissue.
Be patient with the timeline. Tendons adapt over weeks, not days. Steady, progressive loading beats aggressive on-off cycles every time.
These help, but they are a starting point, not a full program. The people who recover fully and stay recovered are the ones who load the tendon correctly and address why it got overloaded.
When to See a Physiotherapist
If your inner elbow pain has hung around for more than a couple of weeks, keeps returning when you get back to activity, is weakening your grip, or comes with tingling into the fingers, it is time to get it looked at properly. Golfer's elbow rarely resolves on its own once it is established, and the longer it goes untreated, the more stubborn it tends to become. Whether you are in Burlington, Millcroft, Waterdown, Hamilton, Oakville, or Milton, getting an accurate diagnosis early is the fastest route back to a pain-free grip.
Ready to get to the root of it?
If golfer's elbow is getting in the way of your grip, your gym sessions, or your summer on the course, book a one-on-one assessment at Pursuit Physiotherapy in Burlington. We will find out why the tendon got overloaded and build you a plan that actually rebuilds it.
#201-4125 Upper Middle Road, Burlington, ON | (905) 331-8993
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