Tennis elbow vs golfer's elbow

Outside is tennis, inside is golf

Both injuries are tendinopathies at the elbow, and both come from the same mechanism: repetitive load on a tendon where it attaches to bone, which frays the fibers faster than the body rebuilds them. What separates them is which side of the joint, which tendon, and therefore which movement hurts.

Tennis elbow - lateral epicondylitis - sits on the outer side. OrthoInfo describes it as usually involving the extensor carpi radialis brevis tendon, which attaches the muscle that extends your wrist and fingers to the lateral epicondyle, the bony bump on the outside of the elbow. The pain is on that outer side, sometimes burning, sometimes present at night, and grip strength is commonly weak.

Golfer's elbow - medial epicondylitis - sits on the inner side. OrthoInfo names the pronator teres as the muscle most often injured, alongside the flexor carpi radialis, palmaris longus, flexor digitorum superficialis and flexor carpi ulnaris, all of which attach at the medial epicondyle. Because the ulnar nerve runs behind that bump, some people also get pain shooting toward the hand, or numbness and tingling in the ring and little fingers.

The two-minute self-check

This is not a diagnosis - it is a way of knowing which page to read and which question to take to a clinician. Do it on the painful arm, gently, and stop if anything is sharp.

1. 01Find the two bony bumps. Bend your elbow to about 90 degrees with the palm up. The bump on the outer side is the lateral epicondyle; the one on the inner side is the medial epicondyle. Press each one firmly. One of them will be noticeably more tender.
2. 02Test wrist extension. Straighten the arm, make a fist, and try to lift the back of the hand upward against the resistance of your other hand. Pain on the outside of the elbow points to tennis elbow.
3. 03Test wrist flexion and pronation. With the arm straight and the palm up, resist as you try to curl the wrist toward you, then try to turn the palm downward against resistance. Pain on the inside points to golfer's elbow.
4. 04Check the grip. Both conditions weaken grip strength, so a weak grip tells you there is a tendon problem - not which one.
5. 05Check the fingers. Numbness or tingling in the ring and little fingers is a medial-side sign, because the ulnar nerve can be irritated where it passes the inner bump. Take that one to a clinician rather than to a gear page.

One more thing worth knowing: both can arrive without any single recognizable injury. OrthoInfo says tennis elbow most often affects people between 30 and 50 and that some cases are idiopathic, with no identifiable repetitive cause, while golfer's elbow usually turns up between 40 and 60. If you cannot point to the session that did it, that is normal and does not mean you are imagining it.

Why the gear answer is different for each

On the outside of the elbow, the tendon that hurts is the one that extends the wrist, and in tennis the load that stresses it is the backhand - particularly a late, wristy, one-handed backhand where the ball pushes the racket head back against a wrist that is trying to hold it firm. A frame that transmits more shock, strung tight with a stiff string, is the setup most associated with making that worse.

On the inside, the tendons that hurt are the ones that flex the wrist and turn the palm down - which is precisely what a modern forehand and a serve do. So medial pain tends to come from the serving and forehand side of the game, and the gear lever that matters most is not the backhand setup but grip size, swingweight and how violently the wrist is asked to pronate.

That is why the same two changes are not the answer to both. For lateral pain, reduce impact shock: a lower-stiffness frame, a softer string, a lower tension. For medial pain, reduce the demand on the wrist: a lighter swingweight so the head is not lagging behind the hand, and a grip size that lets you hold the handle without clenching. Our racket weight and grip size guides cover how to measure both.

What the orthopedic guidance actually says about equipment

It is worth being straight about this, because it is one of the few places where mainstream medical advice and racquet-industry advice do not line up neatly. OrthoInfo's equipment note for tennis elbow says to have your equipment checked for fit, that stiffer or looser-strung racquets can reduce stress on the forearm, and that moving from an oversized racquet to a smaller head may help.

The stringing half of that is uncontroversial and it is the change we would make first: a looser bed deflects more on impact, so less of the shock reaches your arm, and it costs nothing beyond a restring. On frame stiffness our own pages take the more common racquet-industry line - that a lower RA frame transmits less shock, which is why the frames on our tennis elbow roundup measure in the fifties rather than the high sixties, while the two popular frames compared on Pure Aero 98 vs Pure Drive sit at 66 and 69. We flag the disagreement rather than hide it, and we would put the string change ahead of a new frame either way.

The rest of the nonsurgical list is not gear at all, and it is the part that does the work: rest from the painful movement, ice, a counterforce brace worn over the forearm, and a physical therapy program. For medial epicondylitis, OrthoInfo singles out eccentric strengthening as particularly beneficial, and it cautions that steroid injections may give early relief while lengthening rehabilitation. No racket fixes a tendon. A different racket stops you re-injuring it while it heals.

The order to change things in

Spend from the cheap end. The sequence below is ordered by cost per unit of likely benefit, not by what a shop would rather sell you.

1. 01Change the string first, then the tension. Moving out of a full polyester bed into a multifilament, at a few pounds lower, is the single cheapest meaningful change available - and if you are a string breaker, a multifilament in the crosses only is a reasonable compromise.
2. 02Fix the grip size. Too small is the common error, because it makes you clench to stop the handle twisting. An overgrip adds roughly half a size if you are between two.
3. 03Restring more often. A dead polyester bed goes stiff and stays stiff, so an old string is harder on the arm than a fresh one of the same type.
4. 04Then look at the frame. A lower-stiffness frame is a real change, not a marginal one, but it costs twenty times what a set of string does - so it belongs here rather than at the top.
5. 05Last, look at the swingweight, especially for medial pain. If the head is arriving late, the wrist is absorbing the difference.

The gear that helps, and what each one gives up

Four picks, in the order we would actually spend the money, and all four are already in our registry with a cited source. The first two are strings, because the strings are the first change. The frames follow, with the honest caveat that a new frame is the expensive answer to a problem a restring sometimes solves.

How this guide was put together

We do not run a test lab and nothing here is written as though we did. The clinical side of this page is summarized from OrthoInfo, the American Academy of Orthopaedic Surgeons' patient-information site, and both articles we used are linked at the foot of the page. The gear side is built from published specification sheets and retailer listings, plus the physical reasoning that connects them.

This is a gear page written by a gear site. It is not medical advice, it cannot diagnose you, and persistent elbow pain is worth a real appointment - OrthoInfo notes that most cases of lateral epicondylitis respond to nonsurgical treatment, which is a good reason to start that treatment early rather than to self-manage for a year. The picks come from our product registry, so each one carries a cited source. Our full selection criteria set out the method.