Golfer’s Elbow: What It Is, Why It Happens, and How to Treat It

In this post, we're going to take a deep dive into what exactly Golfer’s Elbow is, what causes it, and how to get relief. We’ll also touch on an often-overlooked contributor to this condition: trigger points—those painful little knots in your muscles that can make an already painful condition even worse. And don’t worry, we’ll cover how to treat those too.

Whether you're a physical therapist, a sports enthusiast, or someone just dealing with stubborn elbow pain, this guide will break it all down for you. Let’s get started!

1. Anatomy of the Elbow and Muscles Involved

Before we dive into why Golfer’s Elbow happens, it helps to understand the anatomy of your elbow. The elbow is more than just a simple hinge—it’s a complex joint that allows for the bending and straightening of your arm, as well as rotation of the forearm.

The area we’re focusing on with Golfer’s Elbow is the medial epicondyle—a bony bump on the inside of your elbow. This is where the tendons of several forearm muscles attach. These muscles are responsible for wrist flexion (bending your wrist down) and forearm pronation (rotating your forearm so your palm faces downward).

The main players here are:

• Flexor carpi radialis: This muscle helps flex the wrist and can be strained during repetitive movements like swinging a golf club or typing.
• Pronator teres: This muscle is involved in pronating (rotating) your forearm, another motion that can be overworked in sports or daily tasks.
• Flexor carpi ulnaris: Also a wrist flexor, this muscle plays a role in movements that require gripping and pulling.

All of these muscles are linked by tendons that attach to the medial epicondyle, and when they’re overused or strained, you get inflammation and microtears in the tendons, leading to that familiar elbow pain.

2. Causes of Golfer’s Elbow

So, what exactly triggers Golfer’s Elbow? The answer boils down to one word: overuse.

Any repetitive motion that puts stress on the tendons attached to your medial epicondyle can lead to the condition. Think about activities like:

• Swinging a golf club (hence the name).
• Lifting weights with poor technique.
• Even repetitive tasks like typing on a keyboard or using hand tools can contribute.

It’s not just athletes who deal with this—people in jobs that require a lot of gripping or wrist movement, like plumbers or carpenters, are also at risk. The repetitive strain causes tiny tears in the tendon fibers, and over time, this damage builds up, leading to inflammation, pain, and stiffness.

And while it’s called Golfer’s Elbow, it’s important to note that this condition is the cousin of Tennis Elbow, which affects the outside (lateral) part of the elbow. The difference? Golfer’s Elbow affects the inner part of the elbow and is more related to wrist flexion and forearm pronation, while Tennis Elbow is linked to wrist extension and supination (turning the palm up).

3. Symptoms and Diagnosis

Golfer’s Elbow can sneak up on you gradually. At first, you might notice a dull ache on the inside of your elbow, especially after repetitive activities. Over time, though, this pain can become more severe and even radiate down your forearm.

Here are the key symptoms to watch out for:

• Pain and tenderness on the inside of the elbow (this is the big one!).
• Stiffness: You might find it difficult to fully extend your arm.
• Weakness: Your grip strength may decrease, making it harder to hold objects or perform daily tasks.
• Numbness or tingling: This is less common, but some people experience a tingling sensation in the fingers, especially in the ring and little fingers.

If you notice these symptoms, a visit to your healthcare provider or physical therapist is a good idea. They’ll perform a clinical exam to confirm the diagnosis, often by pressing on the medial epicondyle and testing your range of motion. In some cases, they might recommend imaging, like an X-ray or MRI, to rule out other conditions, such as arthritis or a pinched nerve.

4. The Role of Trigger Points in Golfer’s Elbow

Now, here’s where things get interesting. You might be wondering, “What do trigger points have to do with Golfer’s Elbow?” A lot, actually!

Trigger points are tight knots or bands in your muscles that can refer pain to other areas of the body. In the case of Golfer’s Elbow, trigger points in your forearm flexors (like the Flexor Carpi Radialis or Pronator Teres) can cause pain that feels like it's coming from the elbow, even though the problem might be deeper in the muscle.

Think of trigger points as little landmines in your muscles—if you press on one, it can send pain shooting up to your elbow or down your forearm. That’s why they can make an already painful condition like Golfer’s Elbow feel even worse.

These trigger points can form as a result of the same overuse and repetitive strain that causes Golfer’s Elbow in the first place. When the muscles are constantly overworked, they tighten up, and these tight spots restrict blood flow, creating pain and dysfunction in the surrounding area.

In some cases, trigger points in muscles further up the kinetic chain, like the shoulder or upper back, can even contribute to Golfer’s Elbow. This is why a holistic approach to treatment is so important.

5. Trigger Point Therapy for Golfer’s Elbow

So, how do we treat these pesky trigger points? Enter trigger point therapy.

Trigger point therapy involves applying direct pressure to the trigger points in the muscle to help them release. It can be done by a physical therapist, massage therapist, or even by yourself with the right tools (hello, foam rollers and massage balls).

Let’s break it down:

• Manual Trigger Point Release: A therapist will find the trigger point in the affected muscle (let’s say the Flexor Carpi Radialis) and apply firm pressure. This can feel uncomfortable, but after holding the pressure for 30-60 seconds, the muscle will start to relax, and the pain should decrease. This process can be repeated multiple times on different muscles around the elbow and forearm.

• Self-Treatment: If you’re at home and don’t have a therapist on hand, don’t worry—you can do this yourself! Using a tennis ball or massage ball, press the ball into the tight spots on your forearm, hold the pressure, and slowly release. Stretching the muscles afterward can help keep them relaxed.

• Stretching and Strengthening: Once the trigger points are released, it’s important to stretch the muscles to maintain flexibility. Gentle stretches for the forearm flexors and extensors will keep the muscles from tightening back up. And don’t forget strengthening exercises to help build resilience and prevent future injuries.

Trigger point therapy is a great addition to your treatment plan for Golfer’s Elbow, and it’s something you can integrate with other therapies, like massage or physical therapy.

6. Other Treatment Approaches for Golfer's Elbow

While trigger point therapy is a fantastic tool for managing the muscle tension and referred pain associated with Golfer's Elbow, it’s not the only option. In fact, a well-rounded treatment plan that includes various approaches is often the most effective.

Here are some other key treatment strategies:

Rest and Activity Modification

This might seem obvious, but it’s often the hardest advice to follow. The best way to heal from Golfer’s Elbow is to rest the affected muscles and tendons. This doesn’t mean you have to stop all physical activity—just the ones that are causing the pain.

For example, if gripping or repetitive wrist movements are part of your daily routine, see if you can modify how you perform those tasks. You could:

• Use tools or braces that reduce strain on your forearm.
• Take frequent breaks during repetitive activities (like typing or working with hand tools).
• Switch up your golf technique or adjust your grip to minimize strain.

Physical Therapy

Working with a physical therapist is one of the most effective ways to treat Golfer’s Elbow. Physical therapy focuses on improving strength, flexibility, and endurance in the muscles and tendons around your elbow, forearm, and wrist.

Typical physical therapy exercises include:

• Wrist Flexor Stretch: This stretch helps elongate the muscles that contribute to Golfer's Elbow.
• Eccentric Strengthening Exercises: These are exercises where you slowly lower a weight with the affected muscles. They are particularly effective in treating tendon injuries, as they help strengthen the tendon without overloading it.
• Forearm and Wrist Strengthening: Using light weights or resistance bands, you can build strength in your forearm muscles, reducing the strain on your medial epicondyle.

Medications

For short-term relief of pain and inflammation, nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen or naproxen, are commonly recommended. While these medications can help reduce inflammation and relieve pain, they don’t treat the underlying cause—so they're best used in conjunction with other treatments like physical therapy or trigger point therapy.

Corticosteroid Injections

If your symptoms are severe and other treatments aren’t providing relief, your doctor may suggest a corticosteroid injection. This injection targets the inflamed area around the medial epicondyle, reducing pain and swelling. However, there are risks, including weakening of the tendon or delayed healing, so these injections are typically reserved for more serious cases.

Shockwave Therapy

An emerging treatment for Golfer’s Elbow is shockwave therapy (or extracorporeal shockwave therapy (ESWT)). This non-invasive treatment involves sending high-energy sound waves into the affected area to stimulate healing and reduce pain.

Some studies suggest that shockwave therapy can be particularly useful for chronic cases of Golfer’s Elbow that have been resistant to other treatments.

Surgery

Surgery for Golfer’s Elbow is rare but can be necessary in severe cases where the tendon is significantly damaged or if other treatments have failed. The procedure involves removing damaged tissue from the tendon and reattaching the healthy part to the bone. Surgery is usually a last resort and comes with a longer recovery period.

7. Preventing Golfer’s Elbow

As with many overuse injuries, prevention is often the best medicine. Whether you’re an athlete or someone who works with your hands, here are some simple strategies to help prevent Golfer’s Elbow from developing in the first place.

(1). Proper Technique

Using the correct technique while playing sports or performing repetitive tasks can significantly reduce your risk of developing Golfer’s Elbow. In golf, for example, a poor swing or incorrect grip can put excess strain on your elbow tendons. Consider getting professional instruction to ensure you’re using the right technique for your body.

For those in manual labor, focus on proper body mechanics, such as lifting with your legs instead of your arms and avoiding overexertion.

(2). Strengthening Exercises

One of the best ways to prevent Golfer’s Elbow is by strengthening the muscles that support your elbow joint, particularly the forearm flexors and extensors. Strengthening these muscles helps reduce the strain on your tendons, making them less prone to injury.

Here are a few simple exercises:

• Wrist Flexion and Extension: Using a light dumbbell, slowly raise and lower your wrist to strengthen the muscles on both sides of your forearm.
• Forearm Pronation and Supination: Hold a lightweight or a resistance band in front of you, and rotate your forearm palm-down (pronation) and then palm-up (supination) to build strength and flexibility.

(3). Ergonomic Adjustments

For those of us who spend hours at a desk or work with tools, making ergonomic adjustments can make all the difference. Try using an ergonomic keyboard or mouse to reduce strain on your forearms and wrists. In the workplace, ensure that your tools and workstations are positioned correctly to prevent overextension and repetitive strain.

(4). Stretching and Warm-ups

Before engaging in physical activity, make sure to properly warm up and stretch your muscles. Stretching the forearm flexors and extensors can help improve muscle flexibility and reduce the risk of strain. Incorporate dynamic stretches, like wrist rotations, to get your muscles warmed up before you jump into action.

8. The Role of Massage Therapy in Managing Golfer’s Elbow

Massage therapy can be an excellent complement to other treatments for Golfer’s Elbow, providing relief from pain, reducing muscle tension, and improving circulation.

1. Benefits of Massage Therapy

• Pain Relief: Massage therapy helps to reduce the tension in the muscles surrounding the medial epicondyle, which can significantly reduce pain. Techniques like trigger point massage can target those tight, painful areas in the forearm muscles and help relieve discomfort.
• Improved Circulation: By promoting better blood flow to the affected area, massage therapy can help speed up the healing process. More oxygen and nutrients reach the injured tissues, which can aid recovery.
• Muscle Relaxation: Massage therapy also helps release tightness in the muscles around the elbow and forearm, making it easier to move without pain.

2. Massage Techniques for Golfer’s Elbow

Massage therapists will often use a combination of techniques to address the specific needs of a patient with Golfer’s Elbow. These include:

• Myofascial Release: This technique targets the fascia (the connective tissue surrounding muscles) to release tension and improve flexibility.
• Cross-Fiber Friction Massage: This involves applying deep pressure to the muscle fibers at a 90-degree angle, helping to break down adhesions and promote mobility in the affected muscles.
• Trigger Point Therapy: As we discussed earlier, this focuses on releasing tight knots in the muscle that can refer pain to the elbow.

3. Self-Massage Techniques

If you can’t get to a massage therapist regularly, there are a few self-massage techniques you can try at home. Using a massage ball or foam roller, you can apply pressure to your forearm muscles to release tension and improve blood flow. Regular self-massage, combined with stretching, can be an effective way to manage your symptoms between appointments.

9. Case Studies and Research on Golfer’s Elbow and Trigger Point Therapy

While there is a growing body of research on treating Golfer’s Elbow, studies specifically focusing on trigger point therapy and its role in managing the condition have shown promising results.

In a study published in the Journal of Bodywork and Movement Therapies, researchers found that patients who received trigger point therapy in addition to traditional treatment methods experienced greater reductions in pain and improved range of motion than those who only received standard treatments.

Another study in the American Journal of Physical Medicine & Rehabilitation highlighted the effectiveness of myofascial trigger point therapy in reducing symptoms of both Golfer’s Elbow and Tennis Elbow. Patients in this study reported significant improvements in pain after a series of trigger point release treatments.

While more research is needed to fully understand the long-term effects of trigger point therapy for Golfer’s Elbow, these studies suggest that it can be a valuable addition to a comprehensive treatment plan.

10. Conclusion

Golfer’s Elbow might start as a nagging pain, but without proper treatment, it can turn into a long-term issue that impacts your ability to work, exercise, or even carry out daily tasks. The good news? With the right combination of treatments—including trigger point therapy, physical therapy, rest, and massage—most people can make a full recovery.

Understanding the role of trigger points in this condition is key to unlocking a more effective treatment plan. By releasing tight knots in the muscles, improving flexibility, and strengthening the forearm, you can reduce pain, restore function, and prevent Golfer’s Elbow from recurring.

If you’re experiencing elbow pain, don’t hesitate to seek help from a healthcare professional or therapist. Early intervention can make all the difference in your recovery and overall quality of life.

References

1. Simons, D. G., Travell, J. G., & Simons, L. S. (1999). Myofascial Pain and Dysfunction: The Trigger Point Manual. Lippincott Williams & Wilkins.
2. Alvarez, D. J., & Rockwell, P. G. (2002). Trigger points: Diagnosis and management. American Family Physician, 65(4), 653-660.
3. Lee, S. J., et al. (2018). Effect of Trigger Point Therapy in Tennis

Disclaimer

This blog is for informational and educational purposes only. It is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider regarding any questions or concerns about your specific condition or treatment options. The techniques and therapies mentioned should only be performed under the guidance of a licensed professional. If you are experiencing persistent pain or symptoms, seek medical attention from a healthcare provider.