Golfer’s elbow and tennis elbow feel similar but sit on opposite sides of the joint, and telling them apart changes how you treat the pain and heal it.
Same Joint, Opposite Sides
Both conditions are irritation where forearm tendons anchor to the bony bumps of the elbow. The difference is which side hurts. Golfer’s elbow, known clinically as medial epicondylitis, affects the inner elbow, the side closest to your body when your arm hangs with the palm forward. Tennis elbow, or lateral epicondylitis, affects the outer elbow.
The tendons involved explain the pattern. On the inside, the tendons that flex your wrist and curl your fingers converge. On the outside, the tendons that extend your wrist and straighten your fingers converge. So golfer’s elbow flares when you grip, curl, and pull, while tennis elbow flares when you lift, extend, and twist the wrist upward.
Neither name is very accurate. Plenty of golfers get tennis elbow, and most people we see with either problem have never picked up a racquet. In North Idaho, these show up in framers and finish carpenters, hairstylists, dental hygienists, mechanics, kayakers on Lake Coeur d’Alene, rock climbers, and homeowners who spent a weekend splitting firewood before the snow comes.
How to Tell Which One You Have
You can get a surprisingly good sense at your kitchen table. Sit with your forearm resting on the table, palm down.
Quick Self-Checks
- Press the bony bump on the inner elbow. Sharp local tenderness points toward golfer’s elbow.
- Press the bump on the outer elbow. Tenderness there points toward tennis elbow.
- Have someone resist while you bend your wrist toward your palm. Inner elbow pain suggests the medial side.
- Have them resist while you lift the back of your hand upward. Outer elbow pain suggests the lateral side.
- Lift a full coffee mug palm-down. Outer elbow pain is a classic tennis elbow sign.
- Squeeze a tennis ball or shake hands firmly. Inner elbow pain leans golfer’s elbow.
Both conditions share a general profile: pain that came on gradually rather than from a single injury, an ache that lingers after activity, morning stiffness that loosens with movement, and weakness that feels less like a strength problem and more like the arm refusing to cooperate.
What Is Actually Happening Inside the Tendon
Despite the “-itis” ending, elbow tendonitis in a case that has been building for months is usually not simple inflammation. Under a microscope, the tendon shows disorganized, degenerated fibers, a process better described as tendinopathy. That matters because it changes treatment. Rest and anti-inflammatories may quiet the pain, but the tendon still needs loading to rebuild organized, tolerant tissue. Doing nothing rarely fixes it, and pushing hard through it rarely does either.
What It Is Not
Not every sore elbow is a tendon problem. Arthritis, a loose fragment of cartilage, a stress reaction in the bone, a pinched nerve in the neck, and ulnar nerve irritation at the inner elbow can all produce elbow pain. So can referred pain from a stiff shoulder. If your symptoms include numbness, night pain, or pain that does not track with a specific motion, the diagnosis deserves a second look rather than another brace.
Why Grip Is Almost Always Involved
Grip pain is the common thread. Whenever you squeeze anything, the muscles on both sides of the forearm fire to stabilize your wrist, which pulls on both elbow attachments. That is why a person with tennis elbow struggles to hold a milk jug and a person with golfer’s elbow winces reaching for a suitcase handle, and why both may notice it opening a jar.
Look at what changed before the pain started. A new job task, a new pickleball habit at a local rec center, a heavier chainsaw for fall firewood, a longer paddling season, a fresh set of dumbbells, or hours of trimming and raking in September are all common triggers. Tendons object to sudden changes in volume more than to hard work in general.
In youth athletes, inner elbow pain is a separate concern. A growing thrower with medial elbow pain may have irritation at the growth plate rather than tendinopathy, and that needs evaluation and a throwing-volume conversation before the pain becomes a bigger problem.
Treatment That Actually Works
The good news is that most cases improve without surgery. The bad news is that tendon healing takes patience measured in months, not days.
The First Several Weeks
- Modify, do not fully stop. Reduce the aggravating motion instead of resting the arm completely.
- Change your grip. Thicker handles on tools, rackets, and clubs reduce the load on the tendon.
- Ice after aggravating activity, and use heat before you work to loosen up.
- Try a counterforce brace, positioned on the forearm below the sore spot, not on the bump itself.
- Fix your setup. Keyboard and mouse height, chair position, and steering wheel or club grip all matter.
- Address the shoulder and upper back. A weak shoulder makes the forearm do more work.
The Core of Recovery: Loading the Tendon
Progressive strengthening is the treatment with the best track record. Slow, controlled wrist curls for the medial side or slow wrist extensions for the lateral side, with light weight and an emphasis on the lowering phase, gradually retrain the tendon to accept load. Eccentric and isometric work is often prescribed together, and a hand therapist or physical therapist can dial the dose so you are challenged without flaring.
Some soreness during and after these exercises is expected and acceptable, as long as it settles by the next day. Sharp pain, swelling, or pain that lingers into the following morning means the load was too much. This is the part patients most often get wrong on their own, either doing nothing for months or attacking it too aggressively and restarting the cycle.
When Simple Measures Are Not Enough
If a well-run program stalls, there are further options: a formal therapy course with manual work and dry needling, corticosteroid injection for short-term relief in select cases, platelet-rich plasma or similar biologic injections, and for stubborn cases, a minimally invasive tendon procedure or surgical debridement. Surgery is uncommon and reserved for pain that has resisted months of good conservative care. Imaging is not always necessary, but ultrasound or MRI can help when the diagnosis is unclear or a tear is suspected.
Because the inner elbow sits close to the ulnar nerve and the outer elbow can mimic joint or radial nerve problems, it is worth being examined rather than guessing. The physicians at OSSM evaluate elbow pain for patients across Coeur d’Alene, Hayden, and Post Falls and can sort out which structure is driving your symptoms.
When to See an Orthopedic Specialist
Schedule an evaluation if you notice any of these:
- Elbow pain that has not improved after several weeks of activity changes and home care
- Numbness or tingling in the ring and little fingers, or into the back of the hand
- Weakness that makes you drop objects or lose grip strength unexpectedly
- Pain at rest or at night rather than only with use
- Locking, catching, clicking, or an elbow that will not fully straighten
- Swelling, warmth, or visible deformity around the joint
- A sudden pop or tearing sensation during a lift, swing, or throw
- Symptoms that keep you from working, lifting your kids, or sleeping
Contact OSSM today to request your consultation. The sooner the right tendon gets the right plan, the sooner your grip feels normal again.