What does golfer’s elbow feel like?

The pain lives on the knob on the inside of the elbow, the side that touches your body when your arms hang. It spreads down the inner forearm. Carrying a bag of groceries with the palm up, wringing a towel, gripping a steering wheel or swinging a club all set it off. Grip strength drops, and you may notice you are dropping things.

The doctor’s name is medial epicondylitis. It is less common than tennis elbow, which sits on the outside of the elbow, and the two can happen together.

Is it my elbow tendon or the nerve?

The ulnar nerve, your funny bone, runs in a groove right next to this tendon. When that nerve is irritated, the ring and little fingers tingle or go numb, and the hand feels clumsy. That is a different problem. The two often show up together in a stubborn case. We test both at the exam, because treating the tendon will not fix a pinched nerve, and a nerve that is squeezed may need its own plan.

How is golfer’s elbow diagnosed?

Pressing on the inner knob of the elbow brings on the pain. So does bending the wrist or squeezing against resistance. Ultrasound shows a thick, worn tendon and lets us check the nerve beside it in the same visit. In people who throw, such as pitchers and some tradesmen who swing overhead, we also test the ligament on the inside of the elbow, because a stretched ligament is a different injury.

Until you are seen, a few steps help. Carry bags with your palm facing down, not up. Use a thicker handle on tools. Avoid resting the inner elbow on a hard armrest or car door, which presses on the nerve.

Why does golfer’s elbow last for months?

Every grip, every lift with the palm up and every twist of the forearm pulls on this small tendon. Across the Metro East that means a lot of jobs: framing and drywall, meat processing, assembly lines, farm work, mechanics. The tendon frays a little each day and repairs a little each night. When the fraying wins, the pain sticks.

Blood sugar shifts that balance. High sugar stiffens the collagen in tendons and slows repair. That is why tendon pain shows up more often, and lasts longer, in people with diabetes or prediabetes. We check that bloodwork, because it changes the plan.

Why does carrying with your palm up hurt so much?

Physics. The tendon that bends your wrist anchors on a knob of bone smaller than a fingertip. Carry a grocery bag with the palm up and the arm away from your body, and the weight hangs off the far end of your forearm like a load on the end of a crowbar. The tendon pays for every inch of that lever. Turn the palm down, hold the bag against your side, and the same bag pulls through different muscles and a shorter lever.

Dr. Padda calls his own attention span bad ADD. At one point he hired contractors to design a ground-based slingshot for throwing payloads into orbit, until the physics killed it. Physics kills a lot of elbow plans too, which is why the first change we make is usually how you hold things, not what we inject.

The body around the elbow matters as much as the lever. In a Finnish population study of 4,783 working-age adults, about 0.4% had definite golfer’s elbow, and smoking, obesity, repetitive movement and forceful work were each tied to it on their own. Smoking starves a poorly supplied tendon of oxygen. Belly fat keeps insulin and inflammatory signals high, which slows the nightly repair the tendon depends on. Neither one shows up on an elbow X-ray, so we look for both, and a plan that drops the smoking and the evening sugar gives the tendon a better night shift to repair in.

Does PRP help golfer’s elbow?

There are far fewer studies on the inner elbow than on the outer elbow, so we tell you exactly what exists. A U.S. study of people with stubborn golfer’s elbow compared PRP with surgery. Success was 80% with PRP and 94% with surgery, a gap the study could not tell apart from chance. The PRP group got full motion back in about 42 days, against 96 days after surgery, and was pain-free sooner. A 2022 review of the comparison studies reached the same conclusion: outcomes were similar.

The tennis elbow research adds one lesson that carries over. In those trials, results rose with the number of platelets in the injection, and low-dose PRP did not beat other treatments. We prepare a high-dose product for every tendon for that reason, and we place it into the worn part of the tendon with ultrasound, away from the nerve.

What does recovery look like?

You are awake, numbed with local anesthetic, and most people drive themselves home. The elbow aches for a couple of days. Then the rehab begins. First a few days of rest for the grip. Then slow wrist curls with a light weight, focusing on the lowering phase, which loads the tendon without overloading it. Grip work follows. We also look at the tools and the motion that wore the tendon down, because a tendon that heals into the same job needs a small change in how the job is done.

How many injections you need depends on your response. Many people need one. Some need a second after we see how the tendon is doing.

Hurt it on the job in Illinois? Illinois generally lets the injured worker choose the treating doctor. Our injured at work page explains how that works.

When does golfer’s elbow need surgery?

When a year of good care has failed, when the tendon has torn from the bone, or when the nerve beside it is badly squeezed, surgery is a fair choice. We say so plainly, and we coordinate the referral.

What inner elbow symptoms need care sooner?

• A fall or a throw followed by a pop, then a swollen elbow you cannot fully straighten.
• Ring and little fingers that are numb all the time, or a hand that is getting weaker or thinner between the thumb and index finger.
• A hot, red, swollen elbow with fever.
• Pain that wakes you every night and is not tied to gripping at all.

Numb fingers that will not come back point to the ulnar nerve, which is time-sensitive. Fever or a deformed elbow belongs in an emergency room; see when it is an emergency.

Frequently asked questions

Do I need a referral to have golfer’s elbow looked at?

No. Golfer’s elbow visits are booked directly, without a referral from another doctor. Some insurance plans still want one on file before they pay, and if yours is one of them we tell you before the drive. Coming over from Illinois for a first visit explains the paperwork.

What is the difference between golfer’s elbow and tennis elbow?

Golfer’s elbow is on the inside of the elbow and comes from gripping and bending the wrist. Tennis elbow is on the outside and comes from lifting the wrist. The treatment ideas are similar, but the tendons and the nearby nerves are different.

Why are my fingers numb with golfer’s elbow?

Numbness in the ring and little fingers points to the ulnar nerve beside the tendon. Tell us about it, because it changes the plan.

Can I play golf after PRP for golfer’s elbow?

Yes, after rehab. Chipping and putting come first, then full swings as the tendon tolerates load, usually over several weeks.

Will a cortisone shot help golfer’s elbow?

It can calm the pain for a while. It does not rebuild the tendon, and steroid placed near the ulnar nerve or into a tendon can cause problems of its own. We talk through when a shot makes sense and when it only delays the real fix.

Does insurance pay for PRP for golfer’s elbow?

Most plans do not. That is a budgeting decision about what the plan funds. HSA and FSA funds can generally be used.

Is golfer’s elbow a work injury in Illinois?

It can be, when the job caused it or made it worse. Report it to your employer and keep a record of the tasks that hurt.

Related reading

• Tennis elbow
• Rotator cuff tendinitis
• Peripheral neuropathy
• Injured at work
• Metabolic health and pain
• How PRP injections work, and which tissue they suit