Golfer’s elbow and Tennis elbow are common injuries that can be acquired not only by golf or tennis players but by anyone who uses the forearm and wrist repetitively and excessively.
Both conditions involve tendonitis or inflammation of the tendons from overuse. It occurs as a result of repetitive and forceful forearm and wrist movements. Tendons are strong, fibrous tissues that connect the muscles to the bone.
In the case of Golfer’s elbow and Tennis elbow, the inflamed tendons are those attached to the epicondyles or bony protrusions located on the sides of the elbow; thus, both conditions are also called epicondylitis.
Although both Golfer’s elbow and Tennis elbow are injuries that can cause inflammation and microtears in the tendons resulting in pain and swelling on or around the elbow, they are very different and somewhat opposites of each other. The differences between the two (Table 1) are as follows:
Site of inflammation
The pain and swelling in Golfer’s elbow can be felt on the inner side of the elbow up to the inner forearm. Meanwhile, the pain and swelling associated with the Tennis elbow are on the outer side of the elbow and the pain radiates up to the outer forearm.
Golfer’s elbow, also known as medial epicondylitis, affects the tendons that are attached to the medial epicondyle or the bony protrusion on the inside of the elbow. These are the tendons of the wrist flexors or the muscles that bend the palm down with the fingers pointing down at the wrist (like how one grip objects).
In contrast, the injured tendons in the Tennis elbow, also known as lateral epicondylitis, are those that are attached to the lateral epicondyle or the bony protrusion on the outside of the elbow.
These are the tendons of the wrist extensors or the muscles that bring the back of the wrist upward (stretches the wrist backward) and straighten the fingers.
Both Golfer’s elbow and Tennis elbow cause pain, swelling, tenderness on the elbow, and weakness of arm muscles. However, in Golfer’s elbow, the symptoms are felt on the inner side of the elbow and forearm, while in Tennis elbow, these are experienced on the outer side.
In severe inflammation, Golfer’s elbow may also result in numbness and a tingling sensation in the forearm up to the ring and little fingers. This is because a nerve passes along the inside of the elbow, which can be impinged when the tendons become inflamed.
Table 1: Difference between Golfer’s elbow and Tennis elbow
|Parameters||Golfer’s Elbow (Medial epicondylitis)||Tennis Elbow (lateral epicondylitis)|
|Site of inflammation||The inner side of the arm and elbow.||The outside of the elbow and forearm areas|
|Affected tendon||The inside tendon, connected to the medial epicondyle [affects the muscles used for flexing the wrist]||The outside tendon, connected to the lateral epicondyle [affects the muscles used for extending the wrist]|
|Location of symptoms||Inside of the elbow and down the arm||Around the outside of the elbow|
How do you get Golfer’s elbow if you do not play golf?
You may get Golfer’s elbow even if you do not or have not played golf. Any activity that requires repetitive or forceful movements of the wrist flexors may result in Golfer’s elbow.
Weight-lifters who do not perform proper lifting techniques and are not mindful of their elbow and wrist positions during lifting can also acquire Golfer’s elbow. Activities such as gardening, carpentry, and shoveling that require frequent bending and straightening of the elbow, forearm twisting, and strong gripping motions can exert stress on the tendons attached to the medial epicondyle and can also cause Golfer’s elbow.
You may also develop a Golfer’s elbow if you do not follow proper lifting techniques such as when you carry a heavy object with your wrist and fingers flexed because this places large stress on the wrist flexors.
How do you get Tennis elbow if you do not play tennis?
Tennis elbow is not only acquired through playing tennis. Any activity that requires repetitive or forceful wrist extension or backward bending of the wrist can result in Tennis elbow.
Baseball players, especially pitchers who do not follow proper pitching mechanics, may also develop this condition. Other sports linked to Tennis elbow include badminton, football, and javelin because these require repetitive movements of the elbow and wrist.
Also, when the wrist is placed in extreme extension while forcefully manipulating an object such as during plumbing or any manual labor, it places the tendons and the muscles of the wrist under excessive stress and this can result in Tennis elbow. Painters, illustrators, and hairdressers are also prone to Tennis elbow because they need to frequently use their wrists while using their tools.
What happens if Golfer’s elbow or Tennis elbow goes untreated?
A mild Golfer’s elbow or Tennis elbow can heal on its own. However, if left untreated and if movements that cause pain are continued, the injury can become severe and may result in a partial thickness or full-thickness tear of the tendon and/or associated muscles.
This will cause stiffness in the elbow and weakness of the muscles, which can make it difficult to lift, hold, and grip objects and move the wrist and elbow.
Both conditions can be treated conservatively through pain medications and prescribed exercises during physical therapy sessions. If the injury becomes severe, surgery may be needed and will require a longer time for healing and recovery.
What is the fastest way to treat Golfer’s elbow or Tennis elbow?
The best way to treat a Golfer’s elbow or a Tennis elbow is to rest the moment you feel the symptoms and wait for your arm to recover. Resting and refraining from activities that produce pain on the elbow will allow the injured tendons to heal and the inflammation to subside. Aside from rest, the following may be done for quicker recovery:
During the first 24 to 72 hours after the injury or when you first felt the pain, you may apply an ice compress to the painful area to help reduce the pain and swelling. This should be applied several times a day and should not be left for more than 20 minutes.
When the pain and swelling subside, it is best to use a warm compress to increase the blood circulation for faster healing and reduce joint stiffness.
Pain medications such as Ibuprofen may be taken to help lessen pain and swelling.
While resting, you may use a compression bandage or an elbow brace to minimize swelling and to immobilize the joint to keep it from moving. You may still use your elbow and wrist as long as the movements do not cause pain.
If the symptoms do not get better or become worse, consult your doctor immediately to obtain a proper diagnosis and treatment.
For moderate to severe cases of Golfer’s elbow or Tennis elbow, physical therapy and rehabilitation may be prescribed. Your physical therapist will guide you in managing the pain and swelling and will help you return to your normal activities by prescribing exercises to improve the joint’s range of motion and strengthen your arm and wrist muscles and prevent the injury from recurring.
Proper body mechanics and lifting techniques will also be taught to avoid overexertion and to ensure that the correct muscles are being used during forceful arm movements.
You may also need to modify some of your activities once you are allowed by your physician or physical therapist to resume daily tasks. Some modifications include using a thicker handle for shovels during gardening or racket during tennis or badminton for better grip, modifying your arm swing while playing golf or tennis, and using proper movement techniques.
For severe cases involving tendon ruptures or tears, some doctors may prescribe steroid injections for pain relief and to reduce swelling. However, its effects are only temporary and do not have long-term benefits.
Further, if conservative interventions do not improve your symptoms within two to four months of continuous treatment, surgery (that may include tendon repair or removal of bone spurs) may be required.
Dr Aarti is an MBBS (Bachelor of Medicine and Surgery) from Baroda Medical College (The Maharaja Sayajirao University, Baroda). Dr. Aarti has also completed her Masters of Medical Science and Technology from the prestigious Indian Institute of Technology, Kharagpur.