Golfer’s elbow — medial epicondylitis — causes pain on the inner side of the elbow and is less talked about than its more famous counterpart, tennis elbow, but it is just as disruptive. It affects not only golfers but also tradespeople, labourers, climbers, baseball players, and anyone who performs repetitive gripping, wrist flexion, or forearm pronation activities. When it becomes chronic, it can be remarkably resistant to simple treatments.
This guide is for patients in Sydney’s north-west — including Castle Hill, Norwest, and the Hills District — and the Southern Highlands who are struggling with inner elbow pain and want to understand their full range of treatment options.
What Is Golfer’s Elbow?
The medial epicondyle is the bony prominence on the inner side of the elbow, and it is the attachment point for the forearm flexor-pronator muscle group. In golfer’s elbow, these tendons — particularly the flexor carpi radialis and pronator teres — develop degenerative changes at or near their attachment to the medial epicondyle.
Like tennis elbow, golfer’s elbow is a tendinopathy rather than a true inflammatory condition. The pain arises from degenerated, disorganised tendon tissue that has failed to repair itself properly, rather than from acute inflammation. This distinction is clinically important because it means anti-inflammatory treatments alone are often inadequate for chronic cases.
Symptoms
- Pain and tenderness on the inner side of the elbow, at or just below the medial epicondyle
- Pain that may radiate down the inner forearm toward the wrist
- Weakness in grip strength
- Pain with activities involving gripping, wrist flexion, or forearm pronation (turning the palm downward)
- Occasional tingling or numbness in the ring and little fingers (due to proximity of the ulnar nerve)
- Stiffness, particularly in the morning or after periods of rest
An Important Distinction: Ulnar Nerve Involvement
A key difference between medial and lateral epicondylitis is that the ulnar nerve runs very close to the medial epicondyle, and in some cases of golfer’s elbow, ulnar nerve irritation or cubital tunnel syndrome co-exists. This can cause tingling, numbness, and weakness in the ring and little fingers. It is important that this is properly assessed, as it influences the treatment approach.
Conventional Treatment
- Activity modification — reducing or avoiding provocative activities during the acute phase
- Physiotherapy — eccentric and isometric loading exercises for the wrist flexors and forearm pronators are the core rehabilitation approach, along with manual therapy and education
- Medial epicondyle brace / counterforce strap — can offload the tendon attachment during activity
- NSAIDs — for short-term symptom relief
- Cortisone injection — may provide rapid but short-lived relief; carries some risk near the ulnar nerve and is associated with inferior long-term outcomes compared to physiotherapy or PRP
- Surgery — debridement of the degenerated tendon attachment is reserved for refractory cases that have failed 6–12 months of comprehensive conservative management
Why Golfer’s Elbow Becomes Chronic
The flexor-pronator tendons at the medial epicondyle are under load during almost every gripping and hand activity, making true rest difficult in everyday life. The tendon’s poor blood supply slows its capacity to heal. And because the condition is fundamentally degenerative rather than inflammatory, treatments focused purely on reducing inflammation often fail to produce lasting improvement.
Patients who have tried rest, physiotherapy, and cortisone injections without lasting success are not failing treatment — they are hitting the biological limits of these approaches. This is where regenerative medicine becomes relevant.
PRP for Golfer’s Elbow
PRP therapy involves injecting a concentrated preparation of your own platelets directly into the degenerated area of the medial epicondyle tendon attachment, using ultrasound guidance for precision. The growth factors released stimulate fibroblast activity, promote the synthesis of new collagen, and drive the remodelling of the abnormal tendon tissue that is generating your symptoms.
Evidence for PRP in medial epicondylitis mirrors the data for tennis elbow — clinical studies have demonstrated meaningful improvements in pain scores and grip strength following PRP injection, with benefits that are more durable than those achieved with cortisone. The treatment is safe, minimally invasive, and uses your own biology.
Patients typically notice gradual improvement over 6–12 weeks following PRP, during which time physiotherapy-directed loading continues. For most patients with chronic golfer’s elbow, PRP represents a significant step forward — and in many cases, it allows them to avoid surgery altogether.
Seek Expert Assessment in Sydney’s North-West or the Southern Highlands
Inner elbow pain should be properly assessed to distinguish between medial epicondylitis, ulnar nerve entrapment, and other causes of elbow pain. Accurate diagnosis leads to more targeted, effective treatment.
At Dr John PRP, we see patients from across Sydney’s north-west — Castle Hill, Norwest, Kellyville, Baulkham Hills, Pennant Hills — and from the Southern Highlands including Bowral, Mittagong, and Moss Vale.
If inner elbow pain has been limiting your work, your sport, or your daily activities, book a consultation today to find out whether PRP is appropriate for your situation.
For further information on elbow conditions, visit Healthdirect Australia’s guide to elbow pain.