A Helpful Guide to Golfer's Elbow (Inner Elbow Pain)

 Nurudeen Tijani (T.J.) Founder of TitaniumPhysique | Pain Relief Fitness Coach

Written by: Nurudeen Tijani

Updated: May 12, 2024

I've been lifting for ten years, and I've dealt with and overcome many elbow injuries. For gym goers and weight lifters, the primary cause of golfer's elbow (inner elbow pain) is restricted forearm flexor muscles that strain the medial elbow tendon during pull exercises. To prevent elbow discomfort, maintain pliable forearms through self-myofascial release exercises. These exercises can instantly relieve the restrictions in the muscles and minimize the risk of injury, overuse, and inflammation.

An illustration of golfer's elbow and the wrist flexor muscles
YouTube video

Understanding Golfer's Elbow from Lifting Weights


Why does the inside part of my elbow hurt from lifting? How do I fix it?

Inner elbow pain from lifting can occur for several reasons, including

    1. Restricted forearm flexor muscles (shortened, tight, and tense muscles)
    2. Inadequate stretching and warm-up of the forearm muscles before exercising
    3. Excessive resistance (i.e., heavy weight lifting)
    4. Poor lifting form or technique
    5. Overtraining (e.g., a sudden increase in upper body training volume)
    6. Inadequate recovery
    7. Lack of myofascial release

    These factors, individually or in combination, can cause discomfort at the inside part of the elbow. Yet, for most people, the primary cause is restricted forearm flexor muscles that strain the medial elbow tendon during pull movements.

    To prevent this condition, prioritize proper form, gradually increase resistance, allow adequate rest periods, and, most importantly, maintain pliable forearms through self-myofascial release "SMR" exercises.

    SMR involves using tools like foam rollers or massage balls to release tight and tense muscles. Restricted muscles exert tension and strain tendons. When you release these muscles, they become more pliable and elastic, reducing the pulling tension on the tendon and joint. SMR is the fastest way to treat and alleviate muscle and tendon pain.

    Get instant access to my in-depth and highly-rated course for a step-by-step guide to performing SMR exercises effectively. Start eliminating your elbow pain today! Click here to access the TitaniumPhysique Program now.

    What is golfer's elbow?

    Golfer's elbow, also known as medial epicondylitis or inner elbow pain, is an overuse injury causing pain at the inside part of the elbow joint due to inflammation of the medial elbow tendon.

    In weight training, golfer's elbow results from repetitive movements during exercise, leading to strain and discomfort. It can develop gradually over time (chronic) or occur suddenly (acute) from overloading the tendon.

    Signs and symptoms of golfer's elbow from weightlifting include the following:

    • A burning sensation or pain on the inner part of the elbow
    • Tenderness, swelling, and soreness in the elbow
    • Sharp, shooting, sudden, severe, or dull pain on the inside part of the elbow
    • Difficulty bending and straightening the arm
    • Weak grip strength
    • Difficulty performing activities or exercises that require wrist flexion
    • Pain that radiates from the inner elbow down the forearm
    • Increased pain when applying pressure to the affected area
    • Stiffness and limited range of motion in the elbow joint
    • Pain that worsens with repetitive movements or gripping activities
    Illustration of golfer's elbow (inner elbow pain) and the medial elbow tendon

    A 3D illustration shows the forearm flexor muscles and tendon. The "X" indicated on the photo is where trigger points in the forearm flexors tend to occur. Trigger points, known as muscle knots, are small, hyperirritable spots within a muscle. They cause pain and tenderness and can develop due to muscle overuse, stress, or injury.

    Can you get golfer's elbow from lifting weights?

    Yes, you can develop golfer's elbow from lifting weights. For example, "pull" exercises like chin-ups, chest flys, bicep curls, lat pulldowns, and rows can trigger acute golfer's elbow or worsen chronic pain.

    However, it's essential to understand that weight training is not the underlying cause of this condition. The root causes of golfer's elbow from weight lifting include chronic inflammation, magnesium deficiency, and muscle restriction.

    For a deep dive into the root causes of elbow pain, elbow tendonitis injuries, elbow bursitis, chronic versus acute pain, and the fastest way to fix these conditions, you can explore these helpful guides:

    Why do I suddenly feel inner elbow pain without an apparent cause?

    The muscle conditions that lead to inner elbow pain develop gradually and cumulatively.

    Over time, the repetitive use of the forearm flexor muscles can lead to muscle restriction, causing them to become shortened and inelastic. This process of muscle restriction can take months or even years to develop.

    When the forearm flexors are chronically restricted, everyday activities at the gym, working out, picking up weights, and gripping exercise bars or dumbbells can unexpectedly trigger inner elbow pain without an apparent cause.

    Unfortunately, most people are often unaware of the restricted state of their forearm flexors until they experience this sudden onset of elbow pain during these activities.

    YouTube video

    I perform bench presses (while wearing elbow sleeves to manage pain) during a workout (2017).

    YouTube video

    I perform variations of bench presses (without elbow pain) during a chest workout (2021).

    Can muscle tension from lifting contribute to golfer's elbow?

    Yes, muscle tension in the forearm from lifting can contribute to inner elbow pain. Muscle tension is one of the root causes of elbow pain.

    The forearm flexors can become restricted when you lift weights over an extended period. This restriction occurs as the muscles shorten, tighten, and tense up due to muscular contraction, overuse, and a lack of myofascial release. 

    The shortened muscles exert increased tension on the medial elbow tendon (the tendon on the inside part of the elbow), reducing its elasticity. As a result, the tendon becomes strained and inflamed, causing elbow discomfort.

    Further muscle tension in the forearm can contribute to related elbow issues like tennis elbow (outer elbow pain) or triceps tendonitis (posterior elbow pain).

    What's the difference between golfer's elbow and brachialis tendonitis?

    Golfer's elbow and brachialis tendonitis are two different types of elbow tendonitis, but they cause similar symptoms. They both cause pain, discomfort, and swelling on the inside part of the elbow.

    Golfer's elbow is irritation of the medial elbow tendon that attaches the wrist flexor muscles to the forearm bone (ulna). The forearm or wrist flexors are primarily responsible for flexing the wrist towards you.

    Brachialis tendonitis is inflammation or irritation of the brachialis tendon, which connects the upper arm bone (humerus) to the forearm bone (ulna). The brachialis is primarily responsible for flexing the elbow joint. In addition to pain, an injured or restricted brachialis can cause elbow instability in the affected arm.

    A 3d illustration of tendonitis in brachialis tendon of the right arm

    The photo above illustrates tendonitis in the right brachialis tendon.

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    Impact of Golfer's Elbow on Weight Lifting


    Is golfer's elbow typical among weightlifters?

    Yes, golfer's elbow is typical among individuals who lift weights.

    Popular exercises commonly performed by weight lifters, including close-grip bench press, chin-up, pull-up, chest fly, bicep curl, lat pulldown, tricep extension, and cable row, contribute to the development of this condition.

    However, according to the National Health Service, golfer's elbow is less typical than tennis elbow, which accounts for two-thirds of elbow pain cases.

    Back in the days when I experienced persistent elbow issues, I remember having more instances of tennis elbow than golfers elbow.

    YouTube video

    I perform chest flys (without pain) during a chest workout (2023). In contrast to 2014 through 2018, when I struggled with persistent elbow issues.

    YouTube video

    I perform skull crushers (without pain) during an arms workout (2022).

    Will golfer's elbow go away by itself?

    The acute symptoms of most elbow tendonitis injuries, including golfer's elbow, can go away unaided with rest.

    However, the underlying factors contributing to this condition, such as restricted and tense forearm flexor muscles, do not resolve unassisted. In fact, for many athletes and weight lifters, it often worsens over time.

    Here's why: the root causes of golfer's elbow pain include chronic inflammation, magnesium deficiency, and muscle restriction.

    Firstly, once a muscle becomes restricted and dysfunctional, it tends to remain in that state or worsen unless specifically addressed.

    Secondly, muscle dysfunction is often associated with magnesium deficiency. "The Magnesium Miracle," a scientific reference on the health effects of magnesium, highlights that around 40% of magnesium in the body is in the muscles. A significant portion of the population is magnesium deficient.

    Heavy exercise, physical activity, and various factors like caffeine, stimulants, diuretics, stress, and dehydration can deplete magnesium levels in athletes. These factors are one reason why restricted muscles persist and worsen.

    Thirdly, chronically restricted muscles eventually become dysfunctional and stop working correctly. This condition leads to repeated injury and stress on the medial elbow tendon, resulting in chronic tendonitis (i.e., chronic golfer's elbow).

    Generally, when the injury first occurs, the medial elbow tendon experiences micro-tear damage (medically known as tendonitis). As fitness training continues, the tendon condition deteriorates and degenerates (tendinosis).

    What happens if golfer's elbow is left untreated?

    1. Tendon deterioration - If left untreated, golfer's elbow can progress and lead to degeneration of the medial elbow tendon. Collagen in the tendon deteriorates. The tendon weakens over time, resulting in loss of strength, which increases the risk of tendon tears or ruptures. Medically, this condition is known as elbow tendinosis.
    2. Elbow arthritis - untreated golfer's elbow can contribute to autoimmune conditions like elbow arthritis.
    3. Forearm, wrist, and hand issues - When restricted muscles in the forearm flexors are left untreated, they become dysfunctional and cause pain in the wrist, forearm, and hand.

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    Managing Inner Elbow Pain


    Can I still lift weights or work out with a golfer's elbow?

    It depends on the severity of the pain. If it's mild, you can use conventional pain relief medicine or short-term remedies such as sports or kinesiology tape, elbow sleeves, braces, or straps to reduce inner elbow discomfort during exercise.

    However, suppose it's chronic, severe, or causes sharp pain. In that case, it's best to treat the underlying cause of the golfer's elbow before resuming exercise.

    Which exercises should I avoid if I have a golfer's elbow?

    Avoid "pull" exercises. These exercises require an underhand grip and can place excessive load on the forearm flexors and strain the elbow medial tendon. 

    Here's a list of 10 exercises to avoid, along with alternative exercises you can perform (see below):

    1. Chin-Ups
    2. Chest Flys (machine, dumbbell, cable)
    3. Bicep Curls
    4. Triceps Pushdowns
    5. Triceps Extensions
    6. Bar Dips/Chair Dips
    7. Close Grip Lat Pulldown
    8. Cable Rows
    9. Skull crushers
    10. Close-grip bench press
    Nurudeen performs close-grip chin-ups

    I perform close-grip chin-ups (without elbow discomfort) during a back workout at the gym (2022).

    What upper body exercises can I perform with a golfer's elbow?

    If you're lifting while still recovering from a golfer's elbow, there are a few essential things to remember.

    1. Opt for resistance band or cable machine variations of exercises instead of using barbells, dumbbells, and stationary machines.
    2. Consider performing partial reps, where you don't fully bend or extend the arm during the movement. This modification can help reduce strain on the tendon and alleviate pain.
    3. Use less resistance and focus on performing more repetitions.

    Here's a list of 24 upper body exercises you can try if you have golfer's elbow. These exercises put a lighter load on the forearm flexors and elbow tendon while effectively engaging the upper body muscles.

    You can find most of these exercises on the JEFIT exercise database.

    Back Exercises:

    • Lat Pulldown (using Resistance Band)
    • Wide-Grip Lat Pulldown (with Palms Facing In)
    • Rows (using Resistance Band)
    • Machine Assisted Pull-Up (using Hammer Grip)
    • Banded Pull-Up (using Hammer Grip)
    • Full Cobra (Supermans)
    • Back Hyperextensions
    • Machine-Assisted Dead Hang Stretch
    • Back Fly (using Resistance Band)
    • Dumbbell Reverse Fly
    • Band Reverse Flys

    Shoulder and Arm Exercises:

    • Machine Deltoid Raise
    • Dumbbell Shrugs (lower weight, higher reps)
    • Lateral Raises (with a Resistance Band)
    • Front Raises (with a Resistance Band)
    • Machine Tricep Extension
    • Machine Seated Tricep Dip
    • Cable Kneeling Tricep Extension
    • Bicep Curl (partial/half curls)

    Chest Exercises:

    • Cable Lower Chest Raise
    • Chest Fly (using Resistance Band)
    • Wall Push-Up or Kneeling Push-Ups (with Wide-Arm)
    • Machine Inner Chest Press (with Palms Facing In)
    • Machine Fly (using Pec Deck Machine)
    YouTube video

    Check out this 2023 video of me performing the wide-grip cable lat pulldown (with palms facing in).

    Can elbow sleeves help with inner elbow pain?

    Yes, elbow compression sleeves, such as elbow wraps, straps, and support braces, can alleviate inner elbow discomfort from exercise.

    However, it's essential to consider the pros and cons of using elbow sleeves to manage golfer's elbow.

    Pros: Elbow compression sleeves provide compression, which improves blood flow, enhances joint position awareness (proprioception), and offers support to the muscles and tendons surrounding the elbow joint. The compression promotes better circulation, stabilizes the joint, reduces swelling, alleviates pain, and can help prevent further damage during intense workouts.

    Cons: Relying only on sleeves for pain relief can mask the underlying problem, allowing athletes to continue lifting without addressing the root cause of their pain. This masking will further perpetuate the injury and potentially lead to long-term degenerative conditions in the elbow.

    Nurudeen performs a bench press with elbow sleeves (golfer's elbow from weightlifting)

    I'm benching with elbow sleeves during a chest and back workout at the gym (2017).

    Healing and Prevention


    How long does it take to heal a golfer's elbow?

    By combining post-workout treatments such as ICE therapy (to relieve burning pain), magnesium supplementation (to reduce inflammation), and self-myofascial release (to alleviate sharp or dull pain), it is possible to treat and heal a golfer's elbow within 7-10 days.

    It will involve performing self-myofascial release (SMR) on the forearm flexor muscles at least 2-3 times daily. Get step-by-step guidance with my TitaniumPhysique Program to ensure you do these exercises correctly and effectively. Click here to access the program now.

    Remember - resting the elbow (i.e., taking a break from fitness activity) may provide temporary relief, but it will not fix the underlying cause of the pain - restricted forearm flexors that strain the medial elbow tendon, leading to discomfort.

    What options do I have to stop inner elbow pain?

    To stop inner elbow pain when lifting, you have two options: utilizing short-term pain relief methods for temporary relief or addressing the underlying causes of the pain to avoid its recurrence.

    Option #1: Short-term relief remedies. These include:

    • Using joint supplements and vitamins
    • Taking anti-inflammatory painkillers (NSAIDs)
    • Undergoing physical therapy
    • Incorporating stretching exercises
    • Applying ice and resting the affected area
    • Wearing elbow braces or straps
    • Using kinesiology tape
    • Applying topical anti-inflammatory solutions such as oils and creams

    Option #2: Fix the root cause to prevent golfer's elbow from interfering with your workouts. Address muscle restriction by improving pliability in the forearm extensors.

    Learn how my TitaniumPhysique Program can help you quickly eliminate pain at its source. Click here to access the program now.

    References

    • Elbow pain
    https://www.mayoclinic.org/symptoms/elbow-pain/basics/causes/sym-20050874

    • Muscle Stiffness
    https://my.clevelandclinic.org/health/symptoms/25147-muscle-stiffness

    • Tennis elbow
    https://www.nhs.uk/conditions/tennis-elbow/

    • Pain-relief medicines
    https://www.healthdirect.gov.au/pain-relief-medicines

    • The Magnesium Miracle (Second Edition)
    https://books.google.com/books/about/The_Magnesium_Miracle_Second_Edition.html?id=2lBcDAAAQBAJ&source=kp_book_description

    • Elbow sprain - aftercare
    https://www.mountsinai.org/health-library/selfcare-instructions/elbow-sprain-aftercare#:~:text=Ice%20your%20elbow%20for%2015,ice%20can%20damage%20your%20skin

    • Arthritis of the Elbow
    https://www.cedars-sinai.org/health-library/diseases-and-conditions/a/arthritis-of-the-elbow.html

    • Patient education: Elbow tendinopathy (tennis and golf elbow) (Beyond the Basics)
    https://www.uptodate.com/contents/elbow-tendinopathy-tennis-and-golf-elbow-beyond-the-basics

    • Elbow Compression Sleeve
    https://dunbarmedical.com/product-category/compression-wear/compression-sleeve/elbow-compression-sleeve/

    • JEFIT Exercise Database
    https://www.jefit.com/exercises/

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