In the video above, and the podcast and article below, I offer my perspective on how and why 'Lateral' elbow pain / (Lateral Epicondylopathy) seems to be the greater challenge for golfers.
Podcast: Why Do Golfers Get Tennis Elbow?
Here's the downloadable version of this podcast you can keep by clicking the "download" link under the player below - And please subscribe on your favorite platform:
Table Of Contents Of This Article:
Pitchers get “Pitcher's Elbow” - Swimmers get “Swimmer's Elbow” and rock climbers get “Climber's Elbow” - All of which are the same as Golfer's Elbow.
(Links jump down the page to various sections of this article.)
People who fly fish, do construction for a living, play musical instruments and/or use a computer a lot get injured frequently, too! (Often with Tennis Elbow.)
And let's not forget "Chuck It Elbow!" Another name for the same injury, but instead from throwing the tennis ball to your dog with the Chuck It thing over and over!
So, what's the difference, then?
Well, it's not about which sport you play. Players of both tennis and golf can and do get both types of injuries... (Skip ahead to more interesting parts below, like how golfers get injured, if you already know the difference.)
The short version of the difference is:
- Golfer's Elbow is an injury that happens to the tendons of the muscles that close your wrist and fingers INTO a fist – at their “anchor” / origin tendons at a bony knob at your inner elbow... ( More on Golfers Elbow Treatment ) - And...
- Tennis Elbow is an injury that happens to the tendons of the muscles that open or 'extend' your wrist and fingers FROM a fist – most of which have their “anchor” tendons at a bony knob at your outer elbow... ( More on Tennis Elbow Treatment | More about What Tennis Elbow IS )
(These injuries are technically known as Lateral Epicondylitis / -osis, which is commonly called Tennis Elbow – And Medial Epicondylitis / -osis, which is the medical name for Golfer's Elbow.)
It's a common mistake – even among pros of both sports – to misidentify the injury by referring to the sport played.
Here in the video below (slide 15 of the Storify slideshow or in my mini G+ post under that) two pros discuss how golf can cause Golfer's Elbow – Although what they're actually referring to is technically Tennis Elbow.
Not that it matters that much. The nature of the injuries is exactly the same – And, you know if you have either one that they can hurt like hell and be a real b!#ch to recover from!
In this video two golf pros talk about alignment issues in the golf swing, explaining how common alignment and golf-swing execution mistakes set a golfer up for injury.
I think their last point is the key one: “Hitting Down on the ball,” which I believe refers to hitting down too early resulting in the classic “heavy” or “fat” shot and a big divot!
And the impact shock with the ground travels right up the rigid club and into the wrist and elbow muscles and joints.
Your wrist (whether or not properly “cupped”) will tend to suddenly go into a more flexed position, which the Wrist Extensor Muscles will try to resist (Eccentrically, by the way)...
While the muscle group is already under stretch in an extended (and sometimes HYPER-extended) elbow position.
Stressing those Extensor Muscles and their attachment 'origin' tendons at the outer elbow! (Lateral Epicondyle) – Setting the golfer up for a case of Tennis Elbow!
Yes. Apparently, they do! (According to golf-related websites and medical studies and statistics.)
Common sense suggests that golfers must have historically suffered Medial Epicondylitis more often then the Lateral version that tennis players tend to get – Hence, “Golfer's Elbow.”
It seems times have changed though! And, although tennis players do still develop Tennis Elbow more often than Golfer's Elbow (with the latter apparently on the rise!)…
The interesting thing is that Golfer's seem to be developing Tennis Elbow at a much greater frequency.
Despite having treated a significant number of golfers myself (with both injuries, but clearly more with T.E.) I didn't realize the disparity was that marked.
According to at least two major golf websites, GolfChannel.com, Golf.About.com, golfers are more likely to suffer T. Elbow than G. Elbow.
Brent Kelly writing at Golf.About.com writes that Back Pain And T/G Elbow injuries are #1 and #2, receptively, and that
"Tennis Elbow is actually more common among golfers than Golfer's Elbow."
This is backed up by By Karen Palacios-Jansen, writing for "Golf Fitness Magazine" at: http://www.golfchannel.com/news/golf-fitness-magazine/10-common-golf-injuries/
And John Lindell at "Golf Tips" Golftips.Golfsmith.com - (Although this article doesn't answer the question it poses about "why" the injury is so common among golfers, simply stating that it is very common, I will do my best to explain why below.)
There seems to be plenty of medical data from survey studies and other sources.
A.R. Stockard, writing in The Journal of the American Osteopathic Association, states that:
“Although the term golfer’s elbow has historically described Medial Epicondylitis, the more common problem is actually Lateral Epicondylitis.”
“McCarroll and colleagues found lateral elbow pain to be more common than medial pain by a 5:1 ratio in amateur golfers.”
J Am Osteopath Assoc 2001;101(9):509-516 - Stockard AR
Also from the Physician and Sportsmedicine / PubMed:
"Lead arm elbow pain resulting from Lateral Epicondylosis (Tennis Elbow) is the leading upper extremity injury in amateur golfers."
Upper Extremity Injuries In Golf - Phys Sportsmed. 2009 Apr;37(1):92-6. Doi:
10.3810/psm.2009.04.1687. Bayes MC1, Wadsworth LT.
So, it looks like this injury is especially troublesome for the amateur golfer, whereas the professional golfers seem to have a more widely distributed range of injuries.
When it comes down to pure statistics a lot more people develop Tennis Elbow than Golfer's Elbow as a whole. T.E. is more prevalent in the general population, most occupations AND most sports.
If you want the simplest explanation, although these muscles groups are similar, one is stronger and more adaptable and is thus less likely to be injured than the other.
Winner, Winner, Chicken Dinner! It's the Wrist Flexor Muscle Group. (The Golfer's Elbow side of your wrist/forearm/elbow.)
The Wrist Flexors being stronger, more adaptable and having a higher endurance threshold can better withstand and adapt to both sudden and long-term loads better than their opposing muscle group, the Wrist Extensors.
Let's keep in mind that it's the weaker and less adaptable Wrist Extensors of the “Lead Arm” that are on the front lines, so to speak.
A Right-handed golfer leads with his or her Left shoulder, arm and wrist, with the Left wrist facing the direction of the swing…
Thus, the Left Wrist Extensors (since the Left wrist faces outward or 'Lateral') are positioned right in the line of force.
And those muscles are the first to absorb the impact shocks from simply hitting the ball, or with the ground, in the case of a Fat shot – as they travel up the club and then into the wrist and elbow.
It's a rather unusual way to use those muscles and I don't believe it helps that the elbows (especially the Left in a Right-handed golfer?) are almost, if not completely, straight.
These muscles, (which also cross the elbow joint and assist as 'Synergists' in elbow flexion / bending) are under greater stretch with the elbow straight – so they have less ability to handle stresses – especially a sudden shortening from the lead wrist suddenly flexing from hitting a Fat shot!
It's a recipe for both gradual, chronic mico-trauma leading to tendon fraying and degeneration, if the tendon is unable to adapt – And the ever-present risk of a significant tear in those tendons or their muscles.
It's hard to say objectively which is more painful, but Tennis Elbow seems to take the cake.
It also seems to be more stubbornly resistant to healing.
I don't have the statistics handy, but they are practically worthless anyway, when it comes to the question of: “How long will it take to heal?”
Since the time frames are “all over the map” as I've explained here in my post on the average healing time question.
I think the bottom line is that the muscle group and their tendons, which are injured in Tennis Elbow are less rugged and adaptable. (And seem to have less of a blood supply.)
Whereas the Golfer’s Elbow muscles and tendons seem to be a lot stronger, rugged and more adaptable as I mentioned earlier. (With a better blood supply, which means faster healing potential.)
As a golfer, Tennis Elbow is probably the more limiting condition of the two; more painful and harder to compensate for if you decide to continue playing with it.
Whereas Golfer's Elbow is probably less limiting and easier to compensate for if you keep playing.
Both are treatable – although it's Golfer's Elbow that's somewhat easier to treat yourself.
Ether way, which ever you have, I have a self-help program for it here at Tennis Elbow Classroom:
Learn To Treat And Heal Your Own Tennis Elbow Right Here:
I'll be your personal tutor guiding you through easy-to-follow lessons, where you'll get the therapy techniques, key stretches and essential exercises you need to treat and recover from your injury at home.
Just watch the videos, follow along and start putting an end to your elbow pain today.
Learn more, and get started here: Tennis Elbow Self-Help Program
Golfer's Elbow sufferers, get started here: Golfer's Elbow Classroom