Tennis elbow vs golf elbow, what's the difference?

TL;DR. Tennis elbow is pain on the outside of the elbow (lateral epicondyle, wrist extensors, ICD-10 M77.1). Golfer's elbow is pain on the inside of the elbow (medial epicondyle, wrist flexors / pronator teres, ICD-10 M77.0). Tennis elbow is roughly 7–10× more common. Both respond to the same protocol family, heavy slow resistance, strict eccentric tempo, 12–16 week arc, but loaded in opposite directions.

Educational only. Not medical advice. A clinician (GP, physio, or sports medicine specialist) should confirm the diagnosis before you start any rehab, symptom maps overlap with cubital tunnel, radial tunnel, and cervical referred pain.

Side by side

	Tennis elbow	Golf elbow
Medical name	Lateral epicondylitis / lateral elbow tendinopathy	Medial epicondylitis / medial elbow tendinopathy
ICD-10	M77.1	M77.0
Pain location	Outside (lateral) of the elbow	Inside (medial) of the elbow
Affected tendon	Common extensor origin (ECRB primarily)	Common flexor / pronator origin (pronator teres, FCR)
Provoking movement	Resisted wrist extension, gripping with wrist extended	Resisted wrist flexion, forceful pronation, gripping with palm up
Sport triggers	Tennis backhand, padel, squash, repetitive screwdriver use	Golf swing, throwing sports, tennis forehand/serve, hammering
Prevalence	1–3% general population; ~40% lifetime in tennis players	~0.4% general population; common in golfers and throwers
Red flag overlap	Radial tunnel syndrome	Cubital tunnel (ulnar nerve), check for ring/little finger tingling
Primary loading	Eccentric wrist extension HSR	Eccentric wrist flexion + pronation HSR
Typical arc	12–16 weeks	12–16 weeks (often slightly slower)
Mobile Squad app	Tennis Elbow Oracle	Golf Elbow Oracle

How do you tell which one you have?

Press the bony bump on the outside of your elbow with your thumb. Sharp local pain → tennis elbow.
Press the bony bump on the inside of your elbow. Sharp local pain → golfer's elbow.
Hold arm straight, palm down. Make a fist. Resist someone pushing your wrist down. Outer-elbow pain → tennis elbow.
Hold arm straight, palm up. Make a fist. Resist someone pushing your wrist down. Inner-elbow pain → golfer's elbow.
Ring or little finger numbness/tingling = think cubital tunnel (ulnar nerve), not golfer's elbow. See a clinician.

Self-screen tests are a starting point. A clinician confirms with examination and, if warranted, imaging.

Same protocol family, different loading

Both conditions are load-induced tendinopathies sharing the Cook & Purdam continuum (reactive → disrepair → degenerative). The clinical response is the same family: progressive heavy slow resistance with strict eccentric tempo, calibrated daily, over 12–16 weeks. What changes is the direction of loading.

Tennis elbow, Tennis Elbow Oracle

Eccentric wrist extension HSR, isometric grip holds, supination/pronation band work. Sport-Proofing drills: wall volleys, shadow swings, controlled feeds for backhand patterning. Open Tennis Elbow Oracle →

Golf elbow, Golf Elbow Oracle

Eccentric wrist flexion HSR, isometric pronation, hammer curls, towel grip work. 9-Hole tournament progression and a return-to-swing drill stack. Open Golf Elbow Oracle →

Evidence

AAOS OrthoInfo, Tennis Elbow (Lateral Epicondylitis). orthoinfo.aaos.org
AAOS OrthoInfo, Golfer's Elbow (Medial Epicondylitis). orthoinfo.aaos.org
NICE CKS, Tennis elbow. cks.nice.org.uk
Vinod & Ross, Refractory medial epicondylitis. J Shoulder Elbow Surg 2015. PubMed 26143161
Cook & Purdam, Tendon pathology continuum. BJSM 2009. PubMed 19224904

Educational content only. Not medical advice. Please consult a qualified clinician before starting any rehab program.

FAQ

What is the difference between tennis elbow and golf elbow?

Tennis elbow (lateral epicondylitis, ICD-10 M77.1) is a tendinopathy of the wrist extensor origin, specifically the extensor carpi radialis brevis (ECRB), on the outside of the elbow. Golf elbow (medial epicondylitis, ICD-10 M77.0) is a tendinopathy of the wrist flexor and pronator teres origin on the inside of the elbow. Pain location is the key distinguishing feature: tennis elbow causes pain on the outer bump of the elbow; golf elbow causes pain on the inner bump. Tennis elbow is approximately 7–10 times more common in the general population.

Can I have both tennis elbow and golf elbow at the same time?

Yes. Concurrent lateral and medial epicondylitis occurs in approximately 5–10% of patients. It is most common in occupations with high repetitive grip and wrist loading, construction, carpentry, and manual assembly work, and in racket sport players who use significant wrist action. The rehabilitation approach is parallel: load both tendon groups separately with appropriate exercises for each condition, calibrate each side independently, and avoid compressing recovery by trying to combine sessions.

Is the rehab protocol different for tennis elbow vs golf elbow?

The protocol family is identical, heavy slow resistance (HSR) with strict eccentric tempo, morning traffic-light calibration, and a 12–16 week progressive arc, but the specific exercises target different muscle groups. Tennis elbow loads wrist extension: exercises include wrist extensions with eccentric lowering, reverse wrist curls, and Tyler Twist variations. Golf elbow loads wrist flexion and forearm pronation: exercises include wrist curls with eccentric lowering and pronation exercises. Using the wrong exercise set for the wrong diagnosis is a common reason home rehabilitation fails.