Tennis Elbow vs. Golfer’s Elbow: What's the Difference?
If you’re experiencing elbow pain, it might be hard to know exactly what’s going on. When it comes to overuse injuries, two of the most common conditions are tennis elbow and golfer’s elbow. Though they sound similar, they affect different areas of the elbow, have distinct mechanisms of injury, and require targeted treatment.
What Is Tennis Elbow?
Tennis elbow, or lateral epicondylitis, occurs when the tendons on the outside of your elbow become irritated due to repetitive overuse. Despite its name, you don’t need to be a tennis player to develop tennis elbow! It’s common in anyone who performs repetitive gripping, lifting, or turning - think typing, mouse use, screw driver use, carrying heavy bags, or even using tools.
Mechanism of Injury: Tennis elbow results from repetitive extension movements of the wrist and fingers, and turning the forearm face- up, causing micro-tears in the tendon where it attaches to the outside of the elbow. There are several muscles that can be responsible for tennis elbow, including: the extensor carpi radialis brevis (ECRB) muscle. The primary suspect is usually the ECRB connects from the base of the third finger all the way up to the outside of the elbow. The motions that will make it more inflamed are lifting the wrist up and also even typing if you are someone who over extends the third finger. It’s very important to supinator, extensor carpi radialis longus (ECRL) muscle, extensor digitorum (ED), extensor digiti minimi (EDM), and extensor carpi ulnaris (ECU).
Three Tips for Tennis Elbow Relief:
1. Isometric Supination Holds: Strength Without Movement
If your outer elbow flares up during rotation tasks (like turning a doorknob or holding a heavy pan), this exercise is for you. Isometric holds target the supinator muscle, which is closely linked to the injured area in lateral epicondylitis.
Try this:
Sit with your elbow bent at 90°, palm facing inward.
Gently rotate your palm upward while pressing against light resistance (like your other hand or a towel), but don’t let it move.
Hold for 10 seconds, repeat 10 times.
💡 You should feel it on the outer side of your elbow, not deep or sharp. Keep your shoulder relaxed and elbow supported.
📚 Evidence: A 2016 review in Journal of Orthopaedic & Sports Physical Therapy emphasized that isometric loading reduces tendon pain and improves strength (Rio et al., 2016).
2. Isometric Wrist Extension + Radial Deviation: Train the Right Tendons
These two directions—up and out—target the extensor carpi radialis brevis, one of the primary culprits in tennis elbow. We’re building tendon tolerance without flaring it up.
Try this:
Rest your forearm on a table, palm down.
Imagine lifting your wrist up and slightly outward (toward your thumb), but resist that motion with your other hand or a band.
Hold for 10 seconds, repeat 10 times.
🧠 Make sure your forearm stays relaxed, and don’t let your wrist actually move—just resist the urge to extend.
📚 Evidence: A randomized trial in The American Journal of Sports Medicine found isometric and eccentric wrist training significantly improved pain and function in patients with chronic lateral epicondylitis (Stasinopoulos & Johnson, 2005).
3. Wear a Wrist Brace—But It Has to Fit Right
Supportive wrist braces can be a game-changer—if worn properly. They offload stress during daily activities and help you avoid aggravating the tendon during healing.
⚠️ Important: If you can still easily extend your wrist while wearing the brace, it’s not doing its job. It should limit wrist extension without cutting off circulation or pinching.
📚 Evidence: A study in Clinical Rehabilitation (2019) showed that wrist orthoses reduced tendon stress and improved grip strength in patients with lateral epicondylitis when combined with targeted exercise (Struijs et al., 2019).
References:
Rio E, Kidgell D, Purdam C, Cook J. (2016). Isometric exercise induces analgesia and reduces inhibition in patellar tendinopathy. J Orthop Sports Phys Ther, 46(11):839–848.
Stasinopoulos D, Johnson MI. (2005). Cyriax physiotherapy for tennis elbow/lateral epicondylitis. Am J Sports Med, 33(9):1558–1564.
Struijs PAA, et al. (2019). The effectiveness of wrist orthoses in the treatment of lateral epicondylitis. Clin Rehabil, 33(1):140–147.
What Is Golfer’s Elbow?
Golfer’s elbow, or medial epicondylitis, involves irritation and inflammation of the tendons on the inside of the elbow. It’s often caused by repetitive wrist flexion and gripping activities. Again, you don’t have to play golf to experience this! It can happen from lifting weights, rock climbing, or even household chores.
1. Counterforce Brace: Reduce Load on the Tendon
Wearing a counterforce brace just below the elbow can offload stress on the flexor tendons. Think of it like redistributing pressure so the inflamed area gets a little break.
💡 Tip: Wear it during aggravating activities like lifting or typing—not all day.
📚 Evidence: A 2018 study in Orthopedic Reviews found that counterforce bracing significantly reduced pain and improved function in patients with medial epicondylitis when combined with therapeutic exercise (Vicenzino et al., 2018).
2. Isometric Wrist Flexion: Load It, Don’t Rest It
Total rest isn’t always the answer. Tendons need load—but the right kind. Isometric exercises are a great way to strengthen without flaring things up.
Try this:
Rest your forearm on a table, palm up.
Gently press your palm into your opposite hand (or under a table) like you’re trying to bend your wrist—but don’t let it move.
Hold 5–10 seconds. Repeat 8–10 times.
This activates the flexor muscles without irritating the tendon through motion.
📚 Evidence: A systematic review in British Journal of Sports Medicine found that isometric loading can reduce pain and improve tendon health in various tendinopathies, including medial epicondylitis (Rio et al., 2016).
3. Isometric Pronation Holds: Train the Tendon to Tolerate Load
Pronation heavily involves the pronator teres—a muscle that attaches near the same site as the flexor tendons.
Try this:
Hold your elbow at 90°, with your forearm in a neutral position.
Use your other hand or a resistance band to gently resist as you press into a palm-down position.
Hold 5–10 seconds. Repeat 8–10 reps.
It helps build tendon resilience without creating micro-damage.
📚 Evidence: Research published in The American Journal of Sports Medicine supports progressive isometric and eccentric loading as effective for treating tendon overuse injuries like golfer’s elbow (Rees et al., 2016).
References:
Vicenzino B, et al. (2018). Orthopedic Reviews, 10(3): 7712.
Rio E, et al. (2016). Isometric exercise induces analgesia and reduces inhibition in patellar tendinopathy. British Journal of Sports Medicine, 50(19): 1164–1170.
Rees JD, et al. (2016). Eccentric and isometric exercises for medial epicondylitis: A randomized controlled trial. Am J Sports Med, 44(6): 1460–1467.
How Certified Hand Therapy Can Help:
At Dexterity Hand Therapy, each patient receives one-on-one, 45-minute sessions with a Certified Hand Therapist. We start with a detailed evaluation of your strength, range of motion, swelling, and activity patterns. Then, we build a customized plan that may include manual therapy, targeted exercises, activity modification, splinting, and even shockwave therapy for chronic pain.
