The Simple Anatomy

If you stand with one arm down at your side, and the palm of your hands touching the side of your leg, your medial epicondyle rests along your trunk/ waist. Your  lateral epicondyle is on the outer side of your elbow and aligns with your pinky finger.

Tennis elbow hurts on the outside bump. It involves the tendons that pull your wrist backward. These are called extensor tendons. Every time you lift a cup, shake hands, or turn a doorknob, you use them. If you use them too much, tiny tears happen. That is tennis elbow [1].

Golf elbow hurts on the inside bump. It involves the tendons that flex your wrist. These are called flexor tendons. You use them when you grip something tightly, make a fist, or throw a ball. Excessive gripping can strain these tendons [2].

So remember: outside pain = tennis elbow. Inside pain = golf elbow.

Tennis Elbow

With tennis elbow, you feel pain on the outside of your elbow. The pain may travel down the back of your forearm toward your wrist.

What makes it worse? Here are some examples:

• Lifting a coffee cup or a grocery bag with your palm facing down
• Shaking hands with someone
• Turning a doorknob
• Using a screwdriver or a hammer
• Typing for many hours

You may also feel weak. You might drop things like a glass or a plate. Your grip may not be as strong as before [3].

Here is a simple test. Straighten your arm with your palm down. Use your other hand to push your middle finger downward. If this causes sharp pain on the outside of your elbow, you may have tennis elbow.

Golf Elbow

With golf elbow the pain is on the inside of your elbow. It can travel down the inner side of your forearm to your wrist.

What makes it worse?

• Gripping something hard, like a golf club, rake, or jar lid
• Bending your wrist downward against force
• Throwing a ball
• Doing curls with weights at the gym
• Using a computer mouse for a long time

You may also feel tingling in your pinky and ring fingers. That happens because the nerve near the inside of your elbow can get irritated [2].

Here is a simple test. Make a fist with your palm facing up. Bend your wrist forward. Use your other hand to try to push it back. If this causes pain on the inside of your elbow, you may have golf elbow.

Remember: these self-tests are just clues. A doctor or physical therapist can give you a sure answer.

Treatment Without Surgery (Works for 90% of People)

Here is the best news. More than 9 out of 10 people with tennis elbow or golf elbow get better without surgery [4]. You just need to be patient and follow these steps.

Step 1: Rest and Ice

Stop doing the activity that caused the pain. But do not stop moving your arm completely. Gentle movement stops stiffness. Put an ice pack on the sore spot for 15 minutes, three or four times a day. You can take ibuprofen or naproxen for a few days if the pain is bad. Do not take them for weeks without asking a doctor.

Step 2: Use a Simple Brace

You may have seen athletes wearing a narrow strap just below their elbow. That is a counterforce brace. It takes pressure off the injured tendon. Wear it only when you are doing activities that hurt. Do not wear it all day [1].

Step 3: Do Physical Therapy

This is the most important step. A physical therapist will teach you special exercises called eccentric exercises. These exercises help the tendon heal. For tennis elbow, you will do slow wrist lifts with a very light weight. For golf elbow, you will do slow wrist curls. Most people feel much better after 6 to 8 weeks of therapy.

Step 4: Shots (If needed)

If you still have pain after two months of therapy, your doctor may suggest a shot. Cortisone shots can stop pain quickly, but the pain often comes back after a few months. Another option is PRP (platelet-rich plasma). This uses your own blood to help heal the tendon. Some studies show it works well for tennis elbow [5].

Surgical Option

Surgery is rarely needed. Only about 5 to 10 people out of 100 with these conditions ever need an operation [4]. You might be a candidate for surgery if:

• You have tried all non-surgical treatments for at least 6 to 12 months
• You still have severe pain that stops you from doing normal things

The surgery removes the damaged part of the tendon and reattaches the healthy part to the bone. For tennis elbow, the surgeon works on the outside of the elbow. For golf elbow, the surgeon works on the inside. Success rates are high: 85 to 90% of people feel much better after surgery [3].

After surgery, you will wear a sling for a few days. Then you will start physical therapy for 2 to 4 months. Most people go back to all their normal activities within 4 to 6 months.

How to Prevent These Elbow Pains

The best way to deal with tennis elbow and golf elbow is to never get them. Here is how:

• Strengthen your forearm muscles with light wrist curls and reverse curls
• Stretch your wrists every day
• If you play tennis, try a larger grip size or softer strings
• If you golf, make sure your club grips are not too small
• Take a 5-minute break every 30 minutes when doing repetitive tasks like typing or gardening [2]

Remember, tennis elbow hurts on the outside and golf elbow hurts on the inside. Both are caused by overusing the tendons in your forearm. Both usually heal with rest, ice, a simple brace, and physical therapy. Surgery is rarely needed. Listen to your elbow. Give it time to heal. You will most likely get better and return to all the things you love to do.

Come see us at The Orthopedic and Sports Medicine Institute if you are concerned about persistent pain or suspect an injury. Our goal at the Orthopedic and Sports Medicine Institute (OSMI) is to provide our patients with quality, cutting-edge orthopedic treatments, both surgical and non-surgical. If you would like to book an appointment, please submit an online appointment request or contact our office. We have clinic locations in Fort Worth, Mansfield, Decatur, and Willow Park.

References

1. Coombes BK, Bisset L, Vicenzino B. Management of Lateral Elbow Tendinopathy: One Size Does Not Fit All. J Orthop Sports Phys Ther. 2015 Nov;45(11):938-49. doi: 10.2519/jospt.2015.5841.
2. Amin NH, Kumar NS, Schickendantz MS. Medial epicondylitis: evaluation and management. J Am Acad Orthop Surg. 2015 Jun;23(6):348-55. doi: 10.5435/JAAOS-D-14-00145.
3. Buchanan BK, Varacallo MA. Lateral Epicondylitis (Tennis Elbow) [Updated 2023 Aug 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan. https://www.ncbi.nlm.nih.gov/books/NBK431092/
4. Vangsness CT Jr, Jobe FW. Surgical treatment of medial epicondylitis. Results in 35 elbows. J Bone Joint Surg Br. 1991 May;73(3):409-11. doi: 10.1302/0301-620X.73B3.1670439.
5. Kıvrak A, Ulusoy I. Comparison of the Clinical Results of Platelet-Rich Plasma, Steroid and Autologous Blood Injections in the Treatment of Chronic Lateral Epicondylitis. Healthcare (Basel). 2023 Mar 6;11(5):767. doi: 10.3390/healthcare11050767.