Golfer’s Elbow

T

tennisralph4

New User
Hello. I have been having quite a bout with golfer’s elbow this year and came here looking for some help and maybe some tips/exercises that have helped some of you.

I developed it earlier this year back in March and was able to shake it after a cortisone shot and strengthening my forearm muscles.

2 months ago I was practicing my serve with some not great balls (old and dead) and the next day the golfer’s elbow was back and was throbbing.

I have been doing the theraband, Marcy wrist, hammer exercise, heating, icing and have seen little progress. I did receive another cortisone shot about a month ago but that did not do anything this time around.

I am 33 years old and a 5.0 who plays 2-4 times a week. I have noticed I can do just about everything but serve and tolerate the pain but if I serve I can definitely feel it the next day.

I have tried taking a week or so off but have noticed if I take a few days off from tennis or weight lifting it hurts even more than when I’m active.

Any help would be greatly appreciated! Thank you!
 
There continues to be evidence that cortisone shots will eventually degrade soft tissues. It might be something to talk to your doctor about before going that route again. I wish this were known back in the day. I had probably 8-10 cortisone shots in my neck for a nerve impingement caused by a bone spur. I ended up needing a disc fusion but the surgeons did mention that things were not good in there, likely from the shots.

Have you tried either a tight neoprene elbow sleeve or one of those forearm compression devices that prevents you from flexing your lower arm muscles too tightly? Of the two, the neoprene wrap helped me more when I went through a bout of golfer’s elbow many years ago. Something about the tightness seemed to hold everything in place firmly and prevented the localized soreness on the tendon or ligament.
 
tennisralph4 said:
Hello. I have been having quite a bout with golfer’s elbow this year and came here looking for some help and maybe some tips/exercises that have helped some of you.

I developed it earlier this year back in March and was able to shake it after a cortisone shot and strengthening my forearm muscles.

2 months ago I was practicing my serve with some not great balls (old and dead) and the next day the golfer’s elbow was back and was throbbing.

I have been doing the theraband, Marcy wrist, hammer exercise, heating, icing and have seen little progress. I did receive another cortisone shot about a month ago but that did not do anything this time around.

I am 33 years old and a 5.0 who plays 2-4 times a week. I have noticed I can do just about everything but serve and tolerate the pain but if I serve I can definitely feel it the next day.

I have tried taking a week or so off but have noticed if I take a few days off from tennis or weight lifting it hurts even more than when I’m active.

Any help would be greatly appreciated! Thank you!
Click to expand...
GE often occurs in tennis & golf when squeezing the handle too hard. Your grip should be very relaxed most of the time — as if you are holding a baby bird in your hand. Your grip force should be just enuff so that the bird does not fly away. If you squeeze to firmly, you’ll harm the bird.

Consider a scale from 0 to 10. At a grip of 0, the racket falls out of your hand. A grip of 10 is 10 is max grip strength. You should never come close to this.

Most is the time, an ideal grip force would be around 2. Very shortly before contact (about 30-50 ms), your grip force should naturally increase a bit — do not force this. The finder will squeeze a bit just prior to contact. At contact, the grip does not need to be greater than a 5 or 6 for the serve or most other strokes. Immediately after you hear or feel the contact, let the grip relax again (to a grip F of 2).
 
What size grip do you play with? It may be too small, which can make using less grip pressure as suggested difficult. From your description of exercises, it sounds like you are focused on strength only, but no flexibility/mobility exercises. For myself, rolling the forearm on a tennis ball on a table with palm down was helpful as well as stretching the wrist several times a day by holding the arm out palm up and bending the hand down. It’s also possible you need to work on shoulder mobility. You mention theraband - are you definitely using the motion for golfer’s elbow vs the motion for tennis elbow? Another good exercise to balance against constant gripping is to put a rubber band around your fingers and spread them out against the resistance of the rubber band.
 
What's your setup?

I had the same issue, and it took a long time to heal.

My case and the changes I made:

Changed the strings and stopped playing until they broke (especially old strings that get stiff).
Increased the weight of the racquet; more mass helps absorb vibrations.
Used ice and stretches to relieve the pain.
Did hand grip exercises and power ball spinning exercises.
 
Agree with above poster that cortisone shots are generally overused and possibly do more damage than good (just on what i've read i am not a doctor)
could be something with your form but as a 5.0 player maybe not
a week off is literally nothing, serves zero purpose, i'd plan on much longer like 4 months maybe longer
use theraband regularly, continue to use even after return to play
take a look at your equipment, maybe a less stiff racket would help, but if don't want to change rackets at a minimum would consider lowering tension in your strings and assuming you're using poly now, changing strings to a multi or gut until you're recovered then can move back to poly gradually
 
tennisralph4 said:
Hello. I have been having quite a bout with golfer’s elbow this year and came here looking for some help and maybe some tips/exercises that have helped some of you.

I developed it earlier this year back in March and was able to shake it after a cortisone shot and strengthening my forearm muscles.

2 months ago I was practicing my serve with some not great balls (old and dead) and the next day the golfer’s elbow was back and was throbbing.

I have been doing the theraband, Marcy wrist, hammer exercise, heating, icing and have seen little progress. I did receive another cortisone shot about a month ago but that did not do anything this time around.

I am 33 years old and a 5.0 who plays 2-4 times a week. I have noticed I can do just about everything but serve and tolerate the pain but if I serve I can definitely feel it the next day.

I have tried taking a week or so off but have noticed if I take a few days off from tennis or weight lifting it hurts even more than when I’m active.

Any help would be greatly appreciated! Thank you!
Click to expand...
in case it applies to you...

i got golfers elbow (medial epicondylitis) pretty bad from serving (so much so that i thought i'd have to get dropped down a couple levels to 3.5/4.0 as i could only underhand serve and/or roll my serve in as a sitter - my groundies were not impacted). i hurt it when my mental model was to make contact with the ball when my elbow was locked, because i was reaching up as "high as i could" to make contact (took an entire summer off from serving to recover, and also used that time to study up and revamp my serve)

before fixing technique, i also experimented with soft strings ("soft" poly - IMO doesn't exist!!, multi-filament, gut) and low tension... and "soft frames"... to me these were all bandaids to the ultimate need to fix my technique. side note, gut & soft frame & low tension is "comfortable" but not enough when trying to "serve big" with my bad technique.

fast forward a few years i fixed the issue, after watching this vid (and ones similar to it, but can't find):
the sensation i have is making contact lower, in the space between my head and my hand, such that my elbow is never locked at contact (but am violently moving the racquet from supination to pronation up & through contact - which also feells much whippier than my old motion)

side note, after fixing, i practiced with old/dead balls all the time, and was practicing serve daily for 30-40m... no more elbow issues... then again i'm not a 5.0 and typically not breaking 100 throughout a match (but can hit flat, slice, kick, etc...).

my $.02

other:
* i did massage, icing, etc... but once i started serving again, it came back
* strengthening, just made it worst IMO
* avoided cortisone/pain killers for reasons mentioned above..
* originally i thought i was doing what the video above showed, but videos like this, helped point out the errs of my old serve, and show/feel me the path to my current serve:
 
Last edited:
tennisralph4 said:
Hello. I have been having quite a bout with golfer’s elbow this year and came here looking for some help and maybe some tips/exercises that have helped some of you.

I developed it earlier this year back in March and was able to shake it after a cortisone shot and strengthening my forearm muscles.

2 months ago I was practicing my serve with some not great balls (old and dead) and the next day the golfer’s elbow was back and was throbbing.

I have been doing the theraband, Marcy wrist, hammer exercise, heating, icing and have seen little progress. I did receive another cortisone shot about a month ago but that did not do anything this time around.

I am 33 years old and a 5.0 who plays 2-4 times a week. I have noticed I can do just about everything but serve and tolerate the pain but if I serve I can definitely feel it the next day.

I have tried taking a week or so off but have noticed if I take a few days off from tennis or weight lifting it hurts even more than when I’m active.

Any help would be greatly appreciated! Thank you!
Click to expand...
I've had luck with reversing a couple cases of golfer's elbow among the high school sluggers I coach by switching those players out of a stiff string - poly was the culprit in each case - to a multifiber for at least a few weeks. I generally like to keep Prince Premier Control 16 on hand for anybody needing a full bed of multifiber, but two kids who were very strong hitters could eat that string up in only about 5-7 days. They got much better service life from their string beds along with plenty of comfort when they tried the heavier gauge PPC 15L.

If you currently have a stiffer string setup - even a poly hybrid at relatively low tension - I'd say don't be subtle. Go to a much softer alternative string type for at least a month or two while you're doing whatever else in terms of therapy and exercise for cooling out that elbow.
 
tennisralph4 said:
Hello. I have been having quite a bout with golfer’s elbow this year and came here looking for some help and maybe some tips/exercises that have helped some of you.

I developed it earlier this year back in March and was able to shake it after a cortisone shot and strengthening my forearm muscles.

2 months ago I was practicing my serve with some not great balls (old and dead) and the next day the golfer’s elbow was back and was throbbing.

I have been doing the theraband, Marcy wrist, hammer exercise, heating, icing and have seen little progress. I did receive another cortisone shot about a month ago but that did not do anything this time around.

I am 33 years old and a 5.0 who plays 2-4 times a week. I have noticed I can do just about everything but serve and tolerate the pain but if I serve I can definitely feel it the next day.

I have tried taking a week or so off but have noticed if I take a few days off from tennis or weight lifting it hurts even more than when I’m active.

Any help would be greatly appreciated! Thank you!
Click to expand...
Do nothing athletic until you are absolutely pain free. Slowly add activities and observe closely for any recurrence of pain and immediately back off for any pain. Your goal is to identify if there's any activity you need to permanently avoid.
 
I had GE last year which forced me to stop. I went for shock therapy which really accelerated the healing, so I would highly recommend it.

I'd also suggest you use a heavier racquet with a relatively high flex, so avoid the Babolats. Something like a Blade with a multi setup or similar.
 
Get a TENS machine, i just got one, I've had awful golfers elbow for over 12 months to the point i couldn't hardly serve or hold a racket if i hit for longer than an hour, been using the TENS for a fortnight now and huge improvement, pain nearly completely gone on serve and can hit for nearly 2 hours with only minor pain. Have also been stretching and doing some forearm weights to increase strength.
 
Thank you all for the help and advice. Went to see an elbow specialist two weeks ago who actually played D2 tennis and had struggled with elbow pain in the past. He suggested I take the lead tape off of my racquet (I have added weight at 10 & 2 and also in the handle). I had previously been taking Meloxicam from my PCP, but he switched me from that to diclofenac sodium.

I continued hitting as usual last week and took the lead tape off. Everything felt fine until I served a little too much one day so I took a few days off. Went for a hit last night (no serving) and my right elbow was still in pain but now I am having pain in my right wrist as well as pain in the top of my left (non-dominant) elbow. What in the world is going on? Is taking the weight off of the racquet causing more stress on the rest of my body without the added stability? Was the meloxicam more effective than the diclofenac?

I have been using the Pure Aero 98 2023 for about 18 months now with the added weight and strung with Solinco Confidential at 48 lbs. I have ordered some softer poly as well as some nrg2 to try a hybrid. Do I need to start considering a more arm friendly racquet? Just seems odd that after a year of using it that is when the arm problems would start to appear. I stay in pretty good shape and get to the gym once a week so it's hard for me to believe my arms can't handle the stiffness of the racquet.

Feel like I am running out of options here. The specialist did mention I could do a PRP injection but that would require a 6 week shut down. If nothing changes in the next few weeks I am afraid that is my best hope but I will likely have to sit out this spring and summer season.

Does anyone have any experience with the above options? Thanks again for all of the help.
 
tennisralph4 said:
Thank you all for the help and advice. Went to see an elbow specialist two weeks ago who actually played D2 tennis and had struggled with elbow pain in the past. He suggested I take the lead tape off of my racquet (I have added weight at 10 & 2 and also in the handle). I had previously been taking Meloxicam from my PCP, but he switched me from that to diclofenac sodium.

I continued hitting as usual last week and took the lead tape off. Everything felt fine until I served a little too much one day so I took a few days off. Went for a hit last night (no serving) and my right elbow was still in pain but now I am having pain in my right wrist as well as pain in the top of my left (non-dominant) elbow. What in the world is going on? Is taking the weight off of the racquet causing more stress on the rest of my body without the added stability? Was the meloxicam more effective than the diclofenac?

I have been using the Pure Aero 98 2023 for about 18 months now with the added weight and strung with Solinco Confidential at 48 lbs. I have ordered some softer poly as well as some nrg2 to try a hybrid. Do I need to start considering a more arm friendly racquet? Just seems odd that after a year of using it that is when the arm problems would start to appear. I stay in pretty good shape and get to the gym once a week so it's hard for me to believe my arms can't handle the stiffness of the racquet.

Feel like I am running out of options here. The specialist did mention I could do a PRP injection but that would require a 6 week shut down. If nothing changes in the next few weeks I am afraid that is my best hope but I will likely have to sit out this spring and summer season.

Does anyone have any experience with the above options? Thanks again for all of the help.
Click to expand...
I would move away from Confidential yesterday. I doubt the lead had anything to do with it. I’d get something like Velocity at 52lbs strung up for now.

As for the elbow, various things that have helped me with golfers and tennis elbow:

-be mindful how and how often you hold your cell phone. Change how you hold it if you are constantly holding it in the palm of you hand.
-be mindful of how you use a mouse or keyboard if you work at a computer
-Dry needling - I saw a physio locally that is tennis oriented. They have a lot of different procedures they use but dry needling was the most effective to me.
-Massage - using your other hand, you really need to get in and massage against the fibers/tendons in your fore arm. If your fore arm was a long rectangle, you’d be massaging north & south on the shorter side
-There band exercises
-Strengthening - keep your arm bent at 90 degrees, hold a 3-5lb weight in your hand and curl your wrist up. Hold this position for 30 secs. Then release. Do multiple sets.
 
Worth having a coach take a look at your service motion. Or post a video here.

socallefty said:
If you have shoulder issues and golfer’s elbow, that seems to be an indication for your serve technique possibly causing the issue. When your racquet is extended above before you contact the ball, do you take it vertically up so that the Racquet tip is pointed straight up or do you initially have the racquet tip pointed slightly inwards towards your head before you swing up/out. If it is the first case, it causes injuries. If it is the second case, it is the right technique where you are using ISR to generate power and not just your arm.

This freeze frame shows the internal tilt I am talking about.
maxresdefault.jpg
Click to expand...
 
tennisralph4 said:
Thank you all for the help and advice. Went to see an elbow specialist two weeks ago who actually played D2 tennis and had struggled with elbow pain in the past. He suggested I take the lead tape off of my racquet (I have added weight at 10 & 2 and also in the handle). I had previously been taking Meloxicam from my PCP, but he switched me from that to diclofenac sodium.

I continued hitting as usual last week and took the lead tape off. Everything felt fine until I served a little too much one day so I took a few days off. Went for a hit last night (no serving) and my right elbow was still in pain but now I am having pain in my right wrist as well as pain in the top of my left (non-dominant) elbow. What in the world is going on? Is taking the weight off of the racquet causing more stress on the rest of my body without the added stability? Was the meloxicam more effective than the diclofenac?

I have been using the Pure Aero 98 2023 for about 18 months now with the added weight and strung with Solinco Confidential at 48 lbs. I have ordered some softer poly as well as some nrg2 to try a hybrid. Do I need to start considering a more arm friendly racquet? Just seems odd that after a year of using it that is when the arm problems would start to appear. I stay in pretty good shape and get to the gym once a week so it's hard for me to believe my arms can't handle the stiffness of the racquet.

Feel like I am running out of options here. The specialist did mention I could do a PRP injection but that would require a 6 week shut down. If nothing changes in the next few weeks I am afraid that is my best hope but I will likely have to sit out this spring and summer season.

Does anyone have any experience with the above options? Thanks again for all of the help.
Click to expand...
re-posting what i wrote in December

Agree with above poster that cortisone shots are generally overused and possibly do more damage than good (just on what i've read i am not a doctor)
could be something with your form but as a 5.0 player maybe not
a week off is literally nothing, serves zero purpose, i'd plan on much longer like 4 months maybe longer
use theraband regularly, continue to use even after return to play
take a look at your equipment, maybe a less stiff racket would help, but if don't want to change rackets at a minimum would consider lowering tension in your strings and assuming you're using poly now, changing strings to a multi or gut until you're recovered then can move back to poly gradually
 
EggSalad said:
I would move away from Confidential yesterday. I doubt the lead had anything to do with it. I’d get something like Velocity at 52lbs strung up for now.

As for the elbow, various things that have helped me with golfers and tennis elbow:

-be mindful how and how often you hold your cell phone. Change how you hold it if you are constantly holding it in the palm of you hand.
-be mindful of how you use a mouse or keyboard if you work at a computer
-Dry needling - I saw a physio locally that is tennis oriented. They have a lot of different procedures they use but dry needling was the most effective to me.
-Massage - using your other hand, you really need to get in and massage against the fibers/tendons in your fore arm. If your fore arm was a long rectangle, you’d be massaging north & south on the shorter side
-There band exercises
-Strengthening - keep your arm bent at 90 degrees, hold a 3-5lb weight in your hand and curl your wrist up. Hold this position for 30 secs. Then release. Do multiple sets.
Click to expand...
I was thinking the same about the lead tape. Thought it even might help making the racquet more stable upon contact.

It's funny you say that because I have in the last few months tried to exclusively use my phone with my left hand as opposed to my right.

I do work at a computer for the majority of the day. Is there anything to do or not do that would help?

How often are you dry needling? Once a week?
 
tennisralph4 said:
I was thinking the same about the lead tape. Thought it even might help making the racquet more stable upon contact.

It's funny you say that because I have in the last few months tried to exclusively use my phone with my left hand as opposed to my right.

I do work at a computer for the majority of the day. Is there anything to do or not do that would help?

How often are you dry needling? Once a week?
Click to expand...
I alternate the locations of my mouse and keyboard. Have my mouse to the left of the keyboard so that I’m reaching across my body. Then after a couple weeks, move it back to the right of the keyboard.

I’m not sure if that will help golfers elbow, it may apply more to tennis elbow.

I am a believer in holding your phone in the other hand and changing up how you hold it.

When I was starting to get tennis elbow, I went to rhat physio once a week for 3 weeks. They did dry needling each session; so once a week for three weeks is what got me over the hump.

The dry needling is really interesting. They are sticking a needle into muscle fibers to get the muscle to respond with a spasm. When the muscle spasms, it breaks up the junk that is keeping it stuck in place. Then you can do massage. And once you are on the track to healing, start doing some light strength work.

In My experience, it’s all about loosening those muscles up and getting them to move free, then do some strength work to build them up and help heal.
 
SystemicAnomaly said:
GE often occurs in tennis & golf when squeezing the handle too hard. Your grip should be very relaxed most of the time — as if you are holding a baby bird in your hand. Your grip force should be just enuff so that the bird does not fly away. If you squeeze to firmly, you’ll harm the bird.

Consider a scale from 0 to 10. At a grip of 0, the racket falls out of your hand. A grip of 10 is 10 is max grip strength. You should never come close to this.

Most is the time, an ideal grip force would be around 2. Very shortly before contact (about 30-50 ms), your grip force should naturally increase a bit — do not force this. The finder will squeeze a bit just prior to contact. At contact, the grip does not need to be greater than a 5 or 6 for the serve or most other strokes. Immediately after you hear or feel the contact, let the grip relax again (to a grip F of 2).
Click to expand...
What about volleys?
 
EggSalad said:
I alternate the locations of my mouse and keyboard. Have my mouse to the left of the keyboard so that I’m reaching across my body. Then after a couple weeks, move it back to the right of the keyboard.

I’m not sure if that will help golfers elbow, it may apply more to tennis elbow.

I am a believer in holding your phone in the other hand and changing up how you hold it.

When I was starting to get tennis elbow, I went to rhat physio once a week for 3 weeks. They did dry needling each session; so once a week for three weeks is what got me over the hump.

The dry needling is really interesting. They are sticking a needle into muscle fibers to get the muscle to respond with a spasm. When the muscle spasms, it breaks up the junk that is keeping it stuck in place. Then you can do massage. And once you are on the track to healing, start doing some light strength work.

In My experience, it’s all about loosening those muscles up and getting them to move free, then do some strength work to build them up and help heal.
Click to expand...
Interesting experience, but sounds like you had a muscle issue. TE is tendonitis.
 
Last edited:
LuckyR said:
Interesting experience, but sounds like you had a muscle issue. TE is tendinitis.
Click to expand...
It’s probably my inability to articulate what they were actually doing.

GE/TE is basically caused by overuse/damage to those muscles and tendons and the pain localizes at that spot where the tendon attaches to the muscle as it gets inflamed. But ultimately, you have to treat the root cause which is in the forearm itself as opposed to the elbow. At least that has been my experience.
 
EggSalad said:
It’s probably my inability to articulate what they were actually doing.

GE/TE is basically caused by overuse/damage to those muscles and tendons and the pain localizes at that spot where the tendon attaches to the muscle as it gets inflamed. But ultimately, you have to treat the root cause which is in the forearm itself as opposed to the elbow. At least that has been my experience.
Click to expand...
I accept your description of your experience as accurate, though in my own experience relieving then preventing TE/GE is more about avoiding causes than true "treatments".
 
EggSalad said:
I would move away from Confidential yesterday. I doubt the lead had anything to do with it. I’d get something like Velocity at 52lbs strung up for now.

As for the elbow, various things that have helped me with golfers and tennis elbow:

-be mindful how and how often you hold your cell phone. Change how you hold it if you are constantly holding it in the palm of you hand.
-be mindful of how you use a mouse or keyboard if you work at a computer
-Dry needling - I saw a physio locally that is tennis oriented. They have a lot of different procedures they use but dry needling was the most effective to me.
-Massage - using your other hand, you really need to get in and massage against the fibers/tendons in your fore arm. If your fore arm was a long rectangle, you’d be massaging north & south on the shorter side
-There band exercises
-Strengthening - keep your arm bent at 90 degrees, hold a 3-5lb weight in your hand and curl your wrist up. Hold this position for 30 secs. Then release. Do multiple sets.
Click to expand...
Yes don't do anything with your dominant arm if you got TE, switch hands for the mouse, etc.
 
Have tried the Babolat RPM Rough 17 in the mains and the Tecnifibre NRG2 in the crosses this week; both at 48 pounds. Definitely gives the stringbed a softer feel which I like. Have hit for 2 hours on it and the NRG2 is already very frayed and about to break. Any other crosses recommendations? Have read good things about IsoSpeed Cream as a cross string even though it is a poly. Head Velocity MLT also getting some good feedback.
 
tennisralph4 said:
Have tried the Babolat RPM Rough 17 in the mains and the Tecnifibre NRG2 in the crosses this week; both at 48 pounds. Definitely gives the stringbed a softer feel which I like. Have hit for 2 hours on it and the NRG2 is already very frayed and about to break. Any other crosses recommendations? Have read good things about IsoSpeed Cream as a cross string even though it is a poly. Head Velocity MLT also getting some good feedback.
Click to expand...
Replace the poly cross after 15h or so, with any poly. I use Mayami Tour Hex or Hit Pro.
You can do it 2-3 times before the gut mains break if you are not a string breaker.

I also wax the gut mains to remove the clay chips and the poly crosses to improve snap back.

Have you tried straight arm lifting 20LBs? The twinge in my TE is gone and I am now back of playing with full bed poly. Isospeed atm, 3-6 months old from Germany( came strung with it).
 
For TE, what helped me, was an exercise I've read about here: straight arm lifts (of 20 LBS in my case, sets of 5, both laterally and in front, with both arms). The twinge is gone and going back to full bed poly for gut/poly hybrid.
It could also be that my technique improved due to taking two lessons per week, so for example I am hitting harder and having the ball more to my right on the FH.
 
6 days into the PRP injection and within the last 48 hours my elbow has become very stiff/inflamed and in a lot of pain. Apparently this is part of the healing process?
 
tennisralph4 said:
6 days into the PRP injection and within the last 48 hours my elbow has become very stiff/inflamed and in a lot of pain. Apparently this is part of the healing process?
Click to expand...
I have read that is the case.

I’m keen to see whether the PRP works for you, I’ve got chronic GE and I’m considering PRP myself.
 
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