Medial Epicondylopathy: What Helps Golfer’s Elbow Settle Down?

Medial epicondylopathy is the clinical term many practitioners use for what patients often call “golfer’s elbow.” It usually shows up as pain or tenderness on the inside of the elbow, especially with gripping, lifting, pulling, throwing, or swinging a golf club.

Despite the nickname, you do not need to be a golfer to develop it. I see this pattern in people who lift weights, climb, use tools, do yardwork, type or mouse heavily, or suddenly increase the amount of gripping they are doing. It is often less about one bad movement and more about the tendon being asked to do more than it is ready for.

For a broader golf-related overview, you may also like our article on common golf injuries and chiropractic care.

What is medial epicondylopathy?

Medial epicondylopathy involves the common flexor-pronator tendon near the inside of the elbow. These tissues help with wrist flexion, forearm pronation (moving to a palm down position), and gripping. When the tendon is irritated or not adapting well to load, everyday tasks like carrying groceries, shaking hands, opening jars, doing pull-ups, or hitting balls at the range can become painful.

The older term “tendinitis", often used for this condition suggests inflammation is the main issue. However, many longer-lasting tendon problems, the picture is more complicated. Pain sensitivity, tendon capacity, load tolerance, strength, and recovery habits all matter. That is why rest alone often helps temporarily but does not always solve the problem.

Why exercise is usually the foundation of recovery

Recent tendinopathy literature continues to emphasize progressive loading as a key part of care. That does not mean “push through pain” or jump straight into heavy strengthening. It means finding a starting point the elbow can tolerate, then gradually building the tendon’s capacity over time.

For medial epicondylopathy, this may include wrist flexor strengthening, pronation/supination work, grip training, shoulder and trunk work when relevant, and a gradual return to the specific activity that caused trouble in the first place.

Where isometric exercise may fit

Isometric exercise means contracting a muscle without moving the joint very much. For the elbow, that might look like gently pressing the wrist into resistance and holding for a set amount of time.

Isometrics have been studied in tendinopathy, partly because they may reduce pain for some people in the short term and can be a manageable way to start loading an irritated tendon. They can be useful when gripping or wrist motion is too sore for heavier exercise.

A typical starting point might be a comfortable wrist-flexion hold for 30 seconds, repeated for several sets, while keeping pain in an acceptable range. From there, the plan often progresses toward slow isotonic strengthening, heavier loading, and eventually sport- or work-specific tasks.

IASTM: a helpful tool, not the whole treatment plan

Instrument-assisted soft tissue mobilization, or IASTM, uses a steel tool to apply pressure and movement to soft tissues. Some patients like it because it gives a clear treatment sensation and can reduce local tenderness or stiffness for a period of time.

The research on IASTM is mixed. It may help with short-term pain, range of motion, or perceived tissue sensitivity in some conditions, but it should not replace progressive exercise and load management. For golfer’s elbow, I would usually think of IASTM as an adjunct: something that may help the elbow feel better enough to move and load more comfortably.

If you are interested in soft tissue approaches, our clinic also discusses medical acupuncture as one possible part of musculoskeletal care when appropriate.

Active Release Techniques and hands-on care

Active Release Techniques, often shortened to ART, is a hands-on soft tissue approach that combines pressure with patient movement. Around the medial elbow, treatment may focus on the wrist flexors, pronator teres, forearm muscles, and sometimes the shoulder, neck, or upper back if those areas are relevant to the person’s presentation.

The research base for ART specifically is more limited than the broader research on exercise-based tendinopathy care. That does not mean it cannot be useful, but it does mean it should be framed honestly. In practice, ART may help reduce sensitivity, improve comfort with movement, and allow someone to better tolerate the active parts of rehab.

As with IASTM, the key is not to make the patient dependent on treatment. The goal is to pair hands-on care with a plan that builds capacity and gets the person back to gripping, lifting, golfing, or working with more confidence.

What about acupuncture?

Acupuncture and dry needling approaches have been studied for several elbow pain conditions, with more research available for lateral elbow pain than medial elbow pain. For medial epicondylopathy, acupuncture may be considered as an adjunct for pain modulation, especially when the elbow is irritable and exercise needs to start gently.

I would not describe acupuncture as a stand-alone cure for golfer’s elbow. A better way to think about it is this: if it helps calm pain enough for the person to grip, move, sleep, work, and exercise more comfortably, it may be a useful part of the plan. The long-term plan still needs to address load tolerance and the activities that keep provoking the tendon.

A practical plan for golfer’s elbow

A reasonable care plan often starts with confirming the diagnosis and ruling out other contributors. Not every pain on the inside of the elbow is medial epicondylopathy. Ulnar nerve irritation, neck referral, shoulder mechanics, ligament injury, joint irritation, and other issues can sometimes mimic or contribute to the problem.

From there, the plan usually includes modifying the most irritating loads, starting tolerable exercise, gradually increasing strength demands, and reintroducing sport or work tasks in a graded way. For golfers, that might mean starting with putting and chipping, then half swings, then shorter range sessions, and finally full rounds as symptoms allow.

This same load-management idea comes up in other active-life injuries too. Our post on weekend warrior injury prevention covers a similar principle: your body often does best when activity ramps up gradually instead of all at once.

When to book an assessment

Consider getting assessed if inner elbow pain is limiting your grip, affecting your golf swing, worsening over time, or returning every time you increase activity. You should also get checked if you have numbness or tingling into the ring and little fingers, notable weakness, swelling after trauma, or symptoms that do not behave like a typical tendon issue.

Joint Health provides mobile chiropractic care in Whitby, Brooklin, and surrounding Durham Region communities. For elbow pain, golf injuries, and other activity-related concerns, in-home care can make assessment and follow-through easier.

If medial epicondylopathy is keeping you from gripping, lifting, or playing comfortably, book a chiropractic visit with Dr. Brennan Dynes through Joint Health.

Evidence note

This post is written as a patient-friendly overview, not a full literature review. The overall evidence base is strongest for progressive tendon loading and more limited or mixed for passive adjuncts such as IASTM, ART, and acupuncture. The best plan depends on the patient's goals, activity demands, and assessment findings.