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Tennis elbow vs. golfer’s elbow: what most people don’t know


by Reggie Ronning, MS, LAT, ATC

There are many common misconceptions when it comes to tennis elbow and golfer’s elbow. Some people think tennis and golfer’s elbow are the same thing. Some people have heard of one, but not the other. Still others believe you can only get tennis elbow from tennis and golfer’s elbow from golf.

The truth is, these are two different conditions with similar causes and symptoms. Both are caused by repetition and overuse. Many people who experience tennis or golfer’s elbow are not tennis players or golfers at all.

Tennis elbow and golfer’s elbow are actually somewhat opposite. They are similar conditions, both involving pain along the forearm and elbow. However, a patient with tennis elbow has pain on the outside of their elbow while a patient with golfer’s elbow has pain on the inside of their elbow.

As an athletic trainer working at TRIA, I see many patients with pain in their forearm. Patients often do not know if they are experiencing tennis or golfer’s elbow. I begin by sharing some of the similarities and differences.

Tennis elbow
Tennis elbow is an injury caused by overuse of the wrist extensors. Wrist extensors are muscles on the back of your forearm that act on your wrist. While many tennis players experience tennis elbow, only about 5% of people diagnosed with tennis elbow are tennis players. Tennis elbow can be caused by any sort of activity that uses the wrist extensor muscles regularly. I have seen patients with tennis elbow from all sorts of activities:

• Gardening
• Baseball
• Working with tools
• Activities that involve gripping

The most common age range for tennis elbow is 30-50 years old. I often work with high school-aged athletes. This population doesn’t tend to get tennis elbow quite as often. This could be due to the rise of the two-handed backhand with younger generations of tennis players. A two-handed backhand helps decrease the force placed on the dominant arm.

When a patient comes to see me with pain on the outside of their forearm, which is called the lateral elbow, I often ask questions to look for other symptoms. Other symptoms can include grip weakness and numbness in the fingers and hand.

I also discuss the patient’s lifestyle. My goal is to determine if their work, sports or other hobbies could be causing the pain. Next I work with my patient to create a treatment plan.

Golfer’s elbow
Golfer’s elbow is the opposite of tennis elbow. It is also caused by repetition and overuse, but golfer’s elbow is caused by overuse of the wrist flexors. Wrist flexors are muscles on the front and medial aspect of your forearm that act on the wrist. Overuse of these wrist flexors can cause pain on the inside of the elbow.

Much like tennis elbow, golfer’s elbow doesn’t only come from golf. It can be caused by any repetitive activity that flexes the wrist:

• Shoveling
• Painting
• Activities that involve gripping
• Working on an assembly line

If a patient comes to see me with pain on the inside of the elbow, I look for many of the same symptoms as tennis elbow. Grip weakness and numbness in the hand or fingers can be signs of either condition. The location of the pain is always a good indicator of the type of condition.

Asking a few questions about the patient’s work and lifestyle usually helps to quickly determine if they are experiencing golfer’s elbow. Once we determine the cause, we can work together to formulate a treatment plan and begin the road to recovery.

Treatment for tennis elbow and golfer’s elbow
Treatment is very similar for tennis elbow and golfer’s elbow. Rest is very important. I nearly always advise patients to take time off from the activity causing the pain.

If the condition was caused by a sport, I work with the athlete to minimize pain as much as possible. This means they may need to modify their golf swing or tennis backhand. Grip size of the tennis racquet or the golf club can also make a difference. A bigger grip size prevents a player from over-squeezing and overusing their muscles. Racquets with larger head sizes and regular use of a shock absorber help to reduce vibration. This can reduce the force on the elbow. Elbow straps can help reduce and prevent pain as well.

I often recommend physical therapy to help reduce the pain. Both tennis and golfer’s elbow usually resolve on their own. About 80-85% of cases improve significantly within 12 months without surgery. Stretching, light strengthening exercises and proper ergonomics can help with recovery.

Prevention
While tennis elbow and golfer’s elbow are relatively easy to treat, these conditions are also preventable. Light strengthening, stretching and massage are helpful for elbow maintenance and prevention. Specifically for athletes, biomechanics play a big role and it’s very beneficial to have an expert take a further look at how you move.

Most of all, limiting any repetitive activity is helpful. While not all gripping or flexing activities can be avoided, be aware of any activity that might cause repetitive strain on your wrist or arm. With proper care, golfer’s elbow and tennis elbow don’t need to stand in the way of your sports, work or hobbies.

If you’re experiencing tennis elbow or golfer’s elbow, my colleagues at TRIA and I would be happy to take a look. Call 952-831-8742 to schedule an appointment, or walk into one of our orthopedic urgent cares, open seven days a week from 8 a.m. to 8 p.m.

About Reggie Ronning
Reggie Ronning is an athletic trainer at TRIA and Washburn High School. He has expertise in injury prevention through proper biomechanics and maintenance of stability and mobility. Reggie is passionate about treating soft tissue injuries and helping people improve their overall health and well-being.

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