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# Medial epicondylitis (golfer's elbow)

Golfer's elbow (medial epicondylitis) is wear of the tendon that anchors the wrist flexors to the inner elbow; it hurts with gripping and wrist bending.

Updated 2026-10-29

## Structures involved

Tap one to see what it is and open it in 3D.

- [Flexor carpi radialis](https://durgical.com/en/anatomy/flexor-carpi-radialis/)
- [Pronator teres](https://durgical.com/en/anatomy/pronator-teres/)
- [Humerus](https://durgical.com/en/anatomy/humerus/)
- [Palmaris longus](https://durgical.com/en/anatomy/palmaris-longus/)
- [Flexor carpi ulnaris](https://durgical.com/en/anatomy/flexor-carpi-ulnaris/)
- [FDS](https://durgical.com/en/anatomy/flexor-digitorum-superficialis/)
- [UCL (elbow)](https://durgical.com/en/anatomy/ulnar-collateral-ligament-of-the-elbow/)
- [Ulnar nerve](https://durgical.com/en/anatomy/ulnar-nerve/)

## Why it happens

- [Connective tissue proper: cells and fibres](https://durgical.com/en/histology/connective-tissue-proper-cells-and-fibres/)

## What it is

A degenerative tendinopathy of the common flexor-pronator origin at the medial epicondyle of the [humerus](https://durgical.com/en/anatomy/humerus/), caused by repeated wrist flexion and forearm pronation. Known as golfer's elbow.

## Who gets it

Much less common than lateral epicondylitis. Usually affects adults in their 40s and 50s, manual workers and people in throwing, racquet or golf sports.

## Causes

- Repetitive wrist flexion and forearm pronation
- Repeated valgus stress in throwing sports
- Forceful gripping with manual tools or heavy lifting

## Risk factors

- Manual labour with repetitive forceful gripping
- Golf, throwing sports, racquet sports and weight training
- Age between about 40 and 60
- Smoking, obesity and diabetes (reported in some studies)

## Pathophysiology

The common flexor origin gives rise to [pronator teres](https://durgical.com/en/anatomy/pronator-teres/), [flexor carpi radialis](https://durgical.com/en/anatomy/flexor-carpi-radialis/), [palmaris longus](https://durgical.com/en/anatomy/palmaris-longus/), [flexor digitorum superficialis](https://durgical.com/en/anatomy/flexor-digitorum-superficialis/) and [flexor carpi ulnaris](https://durgical.com/en/anatomy/flexor-carpi-ulnaris/); pronator teres and flexor carpi radialis are most often affected. Repeated microtears fail to heal and lead to angiofibroblastic degeneration (tendinosis) rather than true inflammation.

## Symptoms and signs

- Pain and tenderness just distal and anterior to the medial epicondyle
- Pain worse with gripping, wrist flexion and pronation
- Weak grip
- Gradual onset, sometimes after a change in activity

## Red flags

- Numbness or tingling in the ring and little fingers (associated ulnar neuropathy)
- Elbow instability or a pop in a thrower (ulnar collateral ligament injury)
- Fever, warmth or major swelling (infection)

## Diagnosis

**Clinical**
Tenderness over the common flexor origin; pain on resisted wrist flexion and resisted forearm pronation. Clinicians also check the [ulnar nerve](https://durgical.com/en/anatomy/ulnar-nerve/) and the ulnar collateral ligament (valgus stress), which can be injured at the same time.

**Tests**
Not usually needed. Nerve studies if ulnar neuropathy is suspected.

**Imaging**
Diagnosis is clinical. X-ray rules out other bony causes; ultrasound or MRI shows tendon changes and helps in unclear or refractory cases.

## Differential diagnosis

- Ulnar collateral ligament injury
- Cubital tunnel syndrome
- Medial epicondyle avulsion (in adolescents)
- Cervical radiculopathy
- Elbow osteoarthritis

## Goal of treatment

Reduce pain, restore grip strength and return to work or sport while letting the tendon remodel.

## Treatment

**Conservative**
Relative rest, modification of the offending activity, ice and a counterforce strap; most cases improve with time.

**Medical**
Topical or oral NSAIDs for short-term pain relief. Corticosteroid injection gives short-term relief, with care to avoid the ulnar nerve; evidence for longer benefit is limited.

**Rehabilitation**
Physiotherapy with stretching and eccentric strengthening of the wrist flexors and pronators.

**Surgical**
Surgical debridement of the degenerated tendon for symptoms that persist despite months of good conservative care.

## Complications

- Chronic pain and recurrence
- Associated ulnar neuropathy
- Tendon weakening after repeated corticosteroid injections

## Prognosis

Most patients improve with conservative care over months. Surgery is rarely needed and usually gives good results in refractory cases.

## Prevention

- Proper technique and equipment in sport
- Gradual increase in training or work load
- Forearm strengthening and breaks in repetitive tasks

## Test yourself

Think of the answer, then tap the question to see it.

## Which tendons form the common flexor origin affected in medial epicondylitis?

Pronator teres, flexor carpi radialis, palmaris longus, flexor digitorum superficialis and flexor carpi ulnaris; pronator teres and flexor carpi radialis are most often involved.

## Which resisted movements reproduce pain in medial epicondylitis?

Resisted wrist flexion and resisted forearm pronation.

## Which nerve is often affected together with medial epicondylitis?

The ulnar nerve, which runs behind the medial epicondyle in the cubital tunnel.

## Is medial epicondylitis mainly an inflammatory condition?

No. It is mainly a degenerative tendinosis from repeated microtears that fail to heal.

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## Related conditions

- [Lateral epicondylitis (tennis elbow)](https://durgical.com/en/conditions/lateral-epicondylitis/)
- [Cubital tunnel syndrome (ulnar neuropathy at the elbow)](https://durgical.com/en/conditions/cubital-tunnel-syndrome/)
- [Elbow dislocation](https://durgical.com/en/conditions/elbow-dislocation/)
- [Cervical radiculopathy](https://durgical.com/en/conditions/cervical-radiculopathy/)

Educational information, not medical advice. For any symptom, see a health professional.

Sources: [Medial Epicondylitis (Golfer's Elbow)](https://www.ncbi.nlm.nih.gov/books/NBK519000/) (StatPearls (NCBI Bookshelf), 2026).

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Source: https://durgical.com/en/conditions/medial-epicondylitis/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/conditions/medial-epicondylitis/