Golfer's Elbow vs. Tennis Elbow: What's the Difference and Why It Matters for Treatment

Elbow pain. Is it on the outside or the inside? Does it hurt when you extend your wrist or when you flex it? The answer tells you a lot — because golfer's elbow and tennis elbow are two different conditions affecting two different tendons, and getting the distinction right matters for treatment.

Frustratingly, neither condition requires you to play the sport it's named after. This post clears up the confusion, explains the key differences, and shows you how to treat each one effectively.

The Key Anatomical Difference

"Simple rule: outer elbow pain is tennis elbow. Inner elbow pain is golfer's elbow. Getting this distinction right means you'll be loading the correct tendon from day one — which is the whole foundation of recovery."

Tennis Elbow (Lateral Epicondylalgia)

Tennis elbow affects the common extensor tendon on the outer (lateral) side of the elbow. The primary tendon involved is the extensor carpi radialis brevis (ECRB), which is responsible for extending the wrist backward. Pain is felt on the outside of the elbow — the bony bump on the lateral side — and often radiates down the outer forearm.

Golfer's Elbow (Medial Epicondylalgia)

Golfer's elbow affects the common flexor tendon on the inner (medial) side of the elbow. The tendons here are responsible for wrist and finger flexion, as well as forearm pronation. Pain is felt on the inside of the elbow — the bony bump on the medial side — and may radiate down the inner forearm toward the wrist.

How to Tell Which One You Have

Tennis Elbow — Outer Elbow

• Pain on the outside of the elbow
• Pain when extending the wrist against resistance (e.g., picking up a heavy bag with palm facing down)
• Weak grip — worse when the arm is extended
• Pain with common tasks: lifting, opening jars, shaking hands, keyboard use

Golfer's Elbow — Inner Elbow

• Pain on the inside of the elbow
• Pain when flexing the wrist or gripping strongly
• Pain with activities requiring forearm pronation: throwing, swinging a club, wrist curling
• Sometimes associated with tingling in the ring and little fingers (ulnar nerve involvement)

Note: some people have both conditions simultaneously — particularly those with heavy manual work demands or repetitive asymmetric loading.

Who Gets Golfer's Elbow?

Like tennis elbow, golfer's elbow rarely comes from golf. It's common in throwing sports (baseball pitchers, javelin throwers, cricket bowlers), racquet sports players with a heavy topspin forehand, manual tradespeople such as plumbers and mechanics, gym-goers who do heavy pulling exercises like rows, pull-ups, and deadlifts, and musicians including pianists and guitarists.

Are the Treatments Different?

The underlying principle is the same for both conditions: progressive loading of the affected tendon. The specific exercises differ because the affected muscles differ.

For Tennis Elbow: wrist extension loading

Eccentric-concentric wrist extension exercises (dumbbell wrist extensions, Tyler Twist) load the forearm extensors. See the tennis elbow exercises article for the full protocol.

For Golfer's Elbow: wrist flexion loading

Eccentric-concentric wrist flexion exercises — the mirror image of the tennis elbow protocol. Hold a light dumbbell with palm up and forearm supported, slowly lower the wrist (let it extend), then slowly curl it back up. 3 x 15 reps at slow tempo (3–4 seconds each direction), progressing load over weeks. Every other day. Also include pronation-supination exercises with a weighted implement and progressive grip strengthening.

One Key Difference: Ulnar Nerve

Golfer's elbow can involve the ulnar nerve, which runs close to the medial epicondyle. If you have tingling, numbness, or weakness in the ring and little fingers alongside your elbow pain, this warrants specific clinical assessment — it may indicate cubital tunnel syndrome (ulnar nerve entrapment) which requires a slightly different management approach.

Frequently Asked Questions

Can I have both tennis elbow and golfer's elbow at the same time?

Yes. It's uncommon but not rare, particularly in people with high manual work demands affecting the whole forearm and elbow. Both conditions are treated simultaneously with appropriate loading for each affected tendon.

Is golfer's elbow harder to treat than tennis elbow?

They respond similarly to appropriate loading. Golfer's elbow has slightly less research volume, but the same progressive loading principles apply. Cases involving the ulnar nerve may be more complex and benefit from clinical input.

I have inner elbow pain that appeared suddenly after lifting. Is that golfer's elbow?

A sudden acute onset with significant pain after a specific lifting incident may indicate a muscle or tendon strain rather than classic tendinopathy. If pain is severe and acute, rest initially and get it assessed before beginning a loading programme.

If you've confirmed you have tennis elbow (outer elbow), how to fix tennis elbow gives you the full evidence-based approach. For a structured programme to guide your recovery, browse the rehab programs or book a virtual session with me to get a plan tailored to your specific situation.