Thrower’s Elbow (or Golfer’s Elbow)

Thrower’s Elbow, also known as Golfer’s Elbow, is the common name for a condition medically termed medial epicondylitis. It is a type of overuse injury that affects the medial (inner) side of the elbow, where the flexor tendons of the forearm attach to the medial epicondyle — a bony bump on the inside of the elbow.

Despite the name, it doesn’t only affect throwers or golfers. It can occur in anyone who performs repetitive wrist flexion or forearm rotation. Common populations include:

• Athletes: Golfers, baseball pitchers, tennis players (especially with poor backhand technique), javelin throwers
• Manual laborers: Plumbers, carpenters, mechanics
• Office workers: Due to repetitive typing or mouse use
• Weightlifters or CrossFit participants: Due to repetitive gripping and pulling motions.

Medial epicondylitis is caused by repetitive stress and microtrauma to the common flexor tendon at the elbow, often due to:

• Overuse without adequate rest
• Improper technique (especially in sports)
• Weak grip or forearm muscles
• Sudden increase in activity intensity

Over time, this leads to degeneration of the tendon, sometimes accompanied by microtears, chronic inflammation, and pain.

Typical symptoms of Thrower’s Elbow include:

• Pain and tenderness on the inner side of the elbow
• Pain that may radiate down the forearm
• Discomfort during gripping, lifting, or flexing the wrist
• Weak grip strength
• Stiffness in the elbow, especially in the morning
• Worsening symptoms with repetitive motion

Diagnosis is usually clinical, based on:

• Medical history
• Physical examination (tenderness at the medial epicondyle, pain with resisted wrist flexion)

In some cases, imaging may be used to rule out other conditions:

• X-rays: to rule out arthritis or fractures
• Ultrasound: to assess tendon damage or inflammation
• MRI: to evaluate chronic or severe cases

Treatment Options
Conservative Treatment (First Line)

Most cases respond well to non-surgical methods, especially when diagnosed early:

1. Rest and Activity Modification

• Avoid or reduce the activities that aggravate symptoms.

2. Physiotherapy

• Stretching and strengthening of the forearm flexor-pronator group
• Manual therapy and massage
• Eccentric strengthening exercises (proven effective for tendon rehab)

3. Ice and Anti-inflammatory Medications

• NSAIDs for pain and inflammation relief

4. Bracing or Elbow Strap

• Offloads the stress on the tendon during activity

5. Corticosteroid Injections

• Provide temporary pain relief, but may weaken tendons with repeated use

6. Platelet-Rich Plasma (PRP) Injections

• Uses components of the patient’s own blood to promote tendon healing
• Increasingly supported by research as a biologic treatment option

Surgical Treatment (For Chronic or Refractory Cases)

If pain persists for more than 6 months of conservative management, medial epicondylitis of the elbow (Thrower’s elbow – Golfer’s elbow) should be treated surgically. This is rare and reserved for chronic, debilitating cases. The surgical treatment for the Thrower’s (or Golfer’s elbow) is a minimally invasive procedure that is performed through a small incision that is made over the inner elbow. The main goal is the removal of degenerated tendon tissue (tenotomy) to relieve pain and restore function. Surgery usually has good success rates, but recovery can take several weeks to months, followed by rehabilitation.

Recovery and Prognosis

• Most individuals recover with non-surgical treatments, especially if therapy begins early.
• Return to full activity (including sports or heavy labor) often takes several weeks to a few months.
• Proper ergonomics, stretching, and preventive exercisesare important to avoid recurrence.

Prevention Tips

To avoid developing or worsening Thrower’s Elbow:

• Warm up properly before activities
• Use proper technique and equipment in sports
• Strengthen forearm, wrist, and grip muscles
• Avoid sudden increases in training intensity or volume
• Take frequent breaks from repetitive tasks
• Incorporate mobility and stretching exercises