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Golfer’s Elbow vs. Tennis Elbow: How to Tell What’s Causing Elbow Pain

Princeton Sports and Family Medicine, P.C. Blog Golfer’s Elbow vs. Tennis Elbow: How to Tell What’s Causing Elbow Pain

Elbow pain can be surprisingly limiting.

It may hurt to grip a coffee mug, shake hands, lift groceries, open a jar, swing a racquet, throw a ball, type, garden, lift weights, or carry a bag. For some people, the pain is on the outside of the elbow. For others, it is on the inside. Sometimes the pain travels into the forearm or feels connected to the wrist, shoulder, or neck.

Two of the most common causes are tennis elbow and golfer’s elbow.

The names are familiar, but they can be misleading. You do not need to play tennis to have tennis elbow. You do not need to play golf to have golfer’s elbow.

Both are usually tendon-related overuse problems. The main difference is location, tendon group, and the activities that trigger symptoms.

For patients in Princeton, Lawrenceville, West Windsor, Plainsboro, Hopewell, Pennington, Robbinsville, and Mercer County, the goal is not just to name the elbow pain. The goal is to understand what is overloaded, what activities keep irritating it, and what plan will help you return to work, lifting, sport, or daily life.

Quick Takeaways

What Is Tennis Elbow?

Tennis elbow is pain on the outside of the elbow, near the bony area called the lateral epicondyle.

It usually involves the wrist extensor tendons. These tendons help extend the wrist and assist with gripping, lifting, and controlling the hand during activity.

Tennis elbow may also be called:

The term “epicondylitis” suggests inflammation, but many persistent cases behave more like tendinopathy: a tendon capacity and overload problem rather than a simple inflammation problem.

Tennis elbow can affect:

The common theme is repeated stress on the tendon.

What Is Golfer’s Elbow?

Golfer’s elbow is pain on the inside of the elbow, near the bony area called the medial epicondyle.

It usually involves the wrist flexor and pronator tendons. These tendons help flex the wrist, rotate the forearm, and support gripping.

Golfer’s elbow may also be called:

Like tennis elbow, golfer’s elbow is often not a short-term inflammation problem. It is commonly related to tendon overload, repetitive gripping, poor load progression, or sport-specific stress.

Golfer’s elbow can affect:

The name is only a clue. The pain pattern matters more.

The Simplest Difference: Inside vs. Outside

The easiest way to begin separating the two is pain location.

Tennis elbow usually hurts on the outside of the elbow.

Golfer’s elbow usually hurts on the inside of the elbow.

That distinction is helpful, but not perfect. Pain can spread into the forearm. Some people have symptoms on both sides. Others have nerve irritation or neck referral that makes the pattern less clear.

Still, location is the first clue.

Ask yourself:

The answers help guide the next step.

Tennis Elbow Symptoms

Tennis elbow often causes pain on the outside of the elbow and upper forearm.

Common symptoms include:

Many patients feel fine at rest but have sharp pain during gripping or lifting.

A classic example is pain when lifting a coffee mug or picking up a bag with the palm facing down.

Golfer’s Elbow Symptoms

Golfer’s elbow usually causes pain on the inside of the elbow and forearm.

Common symptoms include:

A key concern with inner elbow pain is the ulnar nerve, which runs near the inside of the elbow.

If inner elbow pain comes with numbness or tingling into the ring and small fingers, nerve involvement should be considered.

What Activities Trigger Tennis Elbow?

Tennis elbow is often irritated by activities that load the wrist extensors.

Common triggers include:

Sometimes the problem starts after a change: new racquet, new paddle, different grip, more matches, heavier lifting, more yard work, or a new job task.

The tendon was tolerating one workload, then the demand changed.

What Activities Trigger Golfer’s Elbow?

Golfer’s elbow is often irritated by activities that load the wrist flexors and forearm pronators.

Common triggers include:

For throwing athletes, medial elbow pain deserves careful evaluation. Not all inner elbow pain is golfer’s elbow. Ligament stress, growth-plate issues in younger athletes, and nerve symptoms may need to be considered.

Why Both Problems Become Persistent

Both tennis elbow and golfer’s elbow can become chronic when tendon load repeatedly exceeds current capacity.

This may happen because:

A common pattern is rest, temporary improvement, return to activity, and then pain returns.

That cycle usually means the tendon needs a better loading plan, not just more rest.

Is It Really Tendon Pain?

Not always.

Elbow pain can come from several sources.

Possible causes include:

This is why evaluation matters if symptoms persist, worsen, or do not fit a typical pattern.

Tendon pain is usually activity-related and localized. Nerve pain may involve numbness, tingling, burning, or symptoms traveling into the hand. Joint pain may involve swelling, stiffness, catching, or loss of motion.

When Nerve Symptoms Matter

Numbness and tingling should not be ignored.

Golfer’s elbow can overlap with ulnar nerve irritation because the ulnar nerve runs near the inside of the elbow. Symptoms may travel into the ring and small fingers.

Possible nerve-related symptoms include:

If nerve symptoms are present, the plan may need to include nerve evaluation, neck screening, and different activity modifications.

Not every elbow pain problem should be treated as simple tendon pain.

Do You Need Imaging?

Not always.

Many cases of tennis elbow or golfer’s elbow can be diagnosed with a history and physical exam. Imaging may be considered when symptoms are persistent, severe, traumatic, unclear, or associated with weakness, swelling, or nerve symptoms.

Imaging may help evaluate:

X-rays may be useful after trauma or if arthritis is suspected. Ultrasound or MRI may be considered when tendon structure or other soft-tissue concerns need to be clarified.

The best imaging decision depends on whether the results will change the plan.

What Helps Both Tennis Elbow and Golfer’s Elbow?

The foundations are similar.

Treatment usually includes:

The goal is not to avoid all pain forever. The goal is to build enough capacity that the tendon can tolerate the activities that matter.

For some people, that means returning to pickleball or golf. For others, it means lifting weights, working with tools, typing, or carrying a child without pain.

Why Complete Rest Often Fails

Complete rest may reduce symptoms temporarily, but it does not rebuild tendon capacity.

That is why many people feel better while resting, then flare as soon as they return to normal activity.

A better approach is usually relative rest.

That means reducing the most irritating loads while keeping safe activity in place. The patient may need to modify gripping, lifting, racquet volume, throwing, pulling, or tool use for a period of time.

Then the tendon needs progressive loading.

Tendons usually adapt to the right amount of load, applied at the right pace.

Physical Therapy and Progressive Loading

Physical therapy can help build a structured plan instead of random exercises.

A rehab plan may include:

The exact plan differs for tennis elbow and golfer’s elbow because the involved tendon groups are different.

But the principle is the same: reduce irritability, rebuild capacity, and gradually return to real-life loads.

Do Braces Help?

A counterforce strap may help some patients with tennis elbow or golfer’s elbow by reducing symptoms during activity.

A wrist brace may help in selected cases by reducing tendon demand during certain tasks.

Braces can be useful tools, but they are not cures.

If a brace helps you function while the tendon is being rehabilitated, that may be reasonable. But relying on the brace without strengthening often leads to recurrence.

The brace should support the plan, not replace it.

What About Shockwave Therapy?

Shockwave therapy may be considered for selected chronic tendon-related elbow pain.

It may be most relevant when:

Shockwave is not a stand-alone cure. It should be paired with load management and progressive strengthening.

The first step is making sure the diagnosis is right.

What About Injections or PRP?

Injections may be considered in some persistent cases, but the choice depends on the diagnosis and goals.

Cortisone injections may reduce short-term pain in some patients, but they may not address tendon capacity. PRP is sometimes discussed for chronic tendon pain. Other treatments may also be considered depending on the case.

The right option depends on:

A sports medicine evaluation can help compare options and decide what makes sense.

Sport-Specific Considerations

Tennis and Pickleball

Tennis elbow may be related to backhand mechanics, grip size, racquet or paddle changes, string tension, poor recovery, or sudden increase in play volume. Golfer’s elbow can also happen in racquet athletes, especially with serves, forehands, or gripping-heavy play.

Golf

Golfer’s elbow can be related to swing mechanics, grip pressure, ground impact, practice volume, or returning too quickly after time off. Tennis elbow can also occur in golfers.

Throwing Sports

Inner elbow pain in throwers deserves careful evaluation. Golfer’s elbow is possible, but ulnar collateral ligament stress, ulnar nerve symptoms, or growth-related issues in younger athletes may also need consideration.

Weight Training

Both conditions can affect lifters. Rows, pull-ups, curls, deadlifts, presses, kettlebells, and heavy carries may all aggravate symptoms depending on grip and wrist position.

When to Get Evaluated

Schedule an evaluation if elbow pain:

Earlier evaluation can reduce trial and error and help you keep more safe activity in your routine.

Golfer’s Elbow vs. Tennis Elbow Near Princeton, NJ

Patients in Princeton, Lawrenceville, West Windsor, Plainsboro, Hopewell, Pennington, Robbinsville, and Mercer County often come in asking:

Those questions deserve a diagnosis-specific answer.

How PSFM Can Help

At Princeton Sports and Family Medicine, elbow pain care starts with identifying the source of symptoms.

Sports Medicine Services can help evaluate whether symptoms are coming from tennis elbow, golfer’s elbow, tendon pain, nerve irritation, joint pain, or another condition.

Physical Therapy can help restore tendon capacity, grip tolerance, forearm strength, shoulder mechanics, and return-to-activity confidence.

Shockwave Therapy may be considered for selected chronic tendon-related cases when it fits the diagnosis and recovery plan.

For condition-specific education, PSFM provides pages on Tennis Elbow, Golfers Elbow, Elbow Pain Causes Treatments and Prevention, Tendinopathy, and Training Around Tendinopathy.

PSFM Wellness can support exercise consistency and long-term wellness habits. Fuse Sports Performance can help athletes and active adults build strength, durability, and performance capacity after symptoms are controlled.

The goal is not just to calm the elbow down. The goal is to restore the ability to grip, lift, work, train, and play without repeatedly flaring symptoms.

Related Pages

FAQs

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

Tennis elbow usually causes pain on the outside of the elbow. Golfer’s elbow usually causes pain on the inside of the elbow.

Can I have tennis elbow if I do not play tennis?

Yes. Tennis elbow can happen from repetitive gripping, lifting, tool use, weight training, pickleball, yard work, or computer work. The name does not require the sport.

Can I have golfer’s elbow if I do not play golf?

Yes. Golfer’s elbow can happen from gripping, wrist flexion, throwing, lifting, pulling, tool use, racquet sports, or repetitive forearm loading.

Which is worse, golfer’s elbow or tennis elbow?

Neither is automatically worse. Severity depends on symptom duration, irritability, nerve involvement, activity demands, and how well the tendon responds to load management and rehab.

What if my elbow pain includes numbness or tingling?

Numbness or tingling may suggest nerve involvement, especially if symptoms travel into the hand. Inner elbow pain with tingling into the ring and small fingers should be evaluated.

Can physical therapy help tennis elbow or golfer’s elbow?

Yes. Physical therapy can help rebuild tendon capacity, improve grip tolerance, strengthen the forearm and shoulder, and guide return to sport or work.

Is shockwave therapy helpful for elbow pain?

Shockwave therapy may help selected chronic tendon-related elbow pain, but it should be part of a broader plan that includes diagnosis, load management, and progressive strengthening.

Where can I get elbow pain evaluated near Princeton, NJ?

Princeton Sports and Family Medicine evaluates elbow pain, tennis elbow, golfer’s elbow, tendon problems, and nerve-related symptoms in Lawrenceville for patients in Princeton and surrounding Mercer County communities.

The Bottom Line

Golfer’s elbow and tennis elbow are both common tendon-related causes of elbow pain, but they are not the same.

Tennis elbow usually affects the outside of the elbow. Golfer’s elbow usually affects the inside. Both can be caused by repetitive gripping, lifting, sport, work, or training load that exceeds the tendon’s current capacity.

If elbow pain is limiting your grip, lifting, work, tennis, pickleball, golf, throwing, or training, request an appointment with Princeton Sports and Family Medicine.

This content is educational only and is not a substitute for individualized medical advice. If you have severe pain, rapidly worsening symptoms, new weakness, numbness, tingling, fever, redness, warmth, major trauma, inability to use the arm, significant swelling, chest pain, fainting, or other concerning symptoms, seek medical evaluation.

Author
Peter Wenger, MD Peter C. Wenger, MD, is an orthopedic and non-operative sports injury specialist at Princeton Sports and Family Medicine, P.C., in Lawrenceville, New Jersey. He is board certified in both family medicine and sports medicine. Dr. Wenger brings a unique approach to sports medicine care with his comprehensive understanding of family medicine, sports medicine, and surgery. As a multisport athlete himself, he understands a patient’s desire to safely return to their sport.

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