Elite golfers and Elite junior golfers spend thousands of hours practicing swings, hitting balls, lifting weights, and competing throughout the year. While this dedication is essential for success, it also places significant stress on the developing body.
One of the most common injuries in young golfers is golfer’s elbow, also known as medial epicondylitis. Despite the name, this condition doesn’t only affect adults. Elite junior golfers can develop pain on the inside of the elbow from repetitive stress, poor mechanics, training overload, and growth-related factors.
Understanding why golfer’s elbow develops and how to treat it effectively can help young athletes stay healthy and continue improving their game.
What Is Golfer’s Elbow?
Golfer’s elbow is an injury involving the tendons that attach the wrist flexor muscles to the medial epicondyle, the bony prominence on the inside of the elbow.
The muscles involved include:
- Flexor carpi radialis
- Flexor carpi ulnaris
- Palmaris longus
- Pronator teres
- Flexor digitorum superficialis
Repeated loading causes microtrauma where these tendons attach to bone. Over time, the tissue becomes irritated and degenerative changes can occur if the stress exceeds the body’s ability to recover.
Unlike acute injuries, golfer’s elbow typically develops gradually. It often starts because of a simple swing that contacts the ground. A sore wrist or elbow after this event has to be treated!
Why Elite Young Golfers Are at Risk
High Swing Volumes
Elite juniors often hit hundreds of balls per day.
Consider a golfer who:
- Hits 300 practice balls daily
- Practices four to six days per week
- Competes on weekends
This athlete may perform more than 90,000 golf swings annually.
Even small biomechanical inefficiencies can become significant when repeated thousands of times.
Earlier Specialization
Many elite golfers specialize in the sport at increasingly younger ages.
Research on youth athletics suggests that early sports specialization increases the risk of injury due to repetitive loading of the same tissues without adequate variation.
Golf may appear low impact, but the repetitive rotational forces place substantial stress on the upper extremity.
These golf athletes benefit from the right types of exercises done pre and post training.
Year-Round Competition
Many junior golfers have little true off-season time.
Once a golfer is in pain, planned recovery periods may be necessary to help tendon tissues adapt and repair.
From a clinic perspective, we do everything we can to keep someone from having to skip a day of practice or play. We want you out on the grass! We are not a rest clinic. We are a compete clinic. We treat elite athletes, every single one has a goal and a deadline.
Strength and Growth Mismatches
Rapid growth can create temporary imbalances between:
- Bone growth
- Muscle length
- Tendon capacity
- Neuromuscular control
During growth spurts, young athletes often experience decreased flexibility and altered movement patterns that increase stress on the elbow. We can often correct these by connecting the brain better to the motion of the swing and the movements of the lower body. Imagine if everytime you reached for something it was 1” closer than you remembered. Young atheltes biomechanics change rapidly and it does take time to retrain the brain to the new positions.
Golf Swing Mechanics That Stress the Medial Elbow
The lead and trail arms experience different forces throughout the golf swing.
During the downswing and impact phases:
- Wrist flexors activate intensely
- Forearm pronators stabilize the club
- Valgus stress develops across the elbow
- Ground reaction forces transfer through the upper extremity
These are all normal and completely fine, but poor mechanics may increase medial elbow loading, including:
Early Release
When a player releases the club too early, greater muscular effort is required through impact.
Excessive Wrist Action
Overactive wrist flexion can increase strain on the flexor-pronator tendon complex.
Casting
Casting reduces efficiency and often increases compensatory muscular tension through the forearm.
Over-Swinging
Junior golfers attempting to maximize clubhead speed often create excessive upper extremity stress.
Symptoms of Golfer’s Elbow in Young Golfers
Common symptoms include:
- Pain on the inside of the elbow
- Tenderness over the medial epicondyle
- Pain when gripping a club
- Pain during impact
- Discomfort with wrist flexion
- Reduced practice tolerance
- Forearm tightness
- Decreased performance
Symptoms often begin subtly before progressing into persistent discomfort.
Many golfers initially notice pain only after practice before eventually experiencing symptoms during swings.
Is It Really Golfer’s Elbow?
In adolescents, medial elbow pain is not always classic tendon pathology.
Several other conditions must be considered.
Medial Epicondyle Apophysitis
Young athletes still have open growth plates.
Repeated traction forces can irritate the growth plate near the medial epicondyle.
This condition is sometimes referred to as “Little League Elbow” in throwing athletes but can also occur in golfers.
Ulnar Nerve Irritation
The ulnar nerve runs behind the medial epicondyle.
Symptoms may include:
- Tingling in the ring finger
- Tingling in the small finger
- Numbness
- Weak grip strength
Ulnar Collateral Ligament Stress
Although less common than in baseball players, repeated valgus stress may contribute to ligament irritation.
Cervical or Shoulder Dysfunction
Neck and shoulder issues can alter arm mechanics and increase elbow loading.
A comprehensive evaluation is important for identifying contributing factors.
Why Rest Alone Often Fails
Many golfers stop playing for a few weeks and expect the problem to disappear. Unfortunately, symptoms frequently return when practice volume increases again.
This occurs because the underlying problems remain:
- Weakness
- Poor load capacity
- Swing mechanics
- Mobility restrictions
- Recovery deficits
Pain reduction is not the same as tissue resilience.
Successful treatment requires improving the capacity of the involved tissues while addressing contributing factors.
Our Approach to Treating Golfer’s Elbow in Elite Young Golfers
Treatment Must Go Beyond Pain Relief
At our clinic, we don’t view golfer’s elbow as simply an irritated tendon. In most elite junior golfers, the painful tendon is often the final link in a chain of biomechanical inefficiencies involving the wrist, shoulder, trunk, hips, and nervous system.
The goal is not just to reduce pain. The goal is to restore the athlete’s ability to repeatedly generate force, control impact, and tolerate the demands of high-level golf without symptoms returning when training volume increases.
Phase 1: Neuromuscular Re-Education with ARPwave
One of the most overlooked contributors to chronic golfer’s elbow is poor neuromuscular control.
When muscles fail to activate efficiently, force is often transferred to passive structures such as tendons, ligaments, and growth plates.
Using ARPwave technology, we work to:
- Improve muscle recruitment patterns
- Reduce protective compensation strategies
- Restore efficient movement patterns
- Improve upper extremity force transfer
- Enhance recovery between training sessions
Rather than simply treating the elbow, we evaluate the entire kinetic chain.
In many golfers, elbow pain is associated with deficiencies in:
- Shoulder stability
- Scapular control
- Trunk rotation
- Hip mobility
- Ground force production
Addressing these dysfunctions often reduces stress on the medial elbow while improving performance.
Phase 2: Progressive Eccentric and Isometric Tendon Loading
Research consistently shows that tendons become stronger when exposed to appropriately dosed loading.
Once symptoms are under control, we begin rebuilding tendon capacity through a progressive loading program.
This often includes:
Isometric Loading
Isometric exercises help decrease pain sensitivity while maintaining force production.
Benefits include:
- Pain reduction
- Improved muscle activation
- Increased tendon loading tolerance
- Early progression back to golf activities
Eccentric Loading
Eccentric training involves lengthening the muscle under load and remains one of the most effective strategies for improving tendon resilience.
Examples include:
- Eccentric wrist flexion exercises
- Controlled pronation loading
- Grip strengthening under tension
- Progressive forearm loading drills
The objective is not simply to strengthen the forearm. The objective is to increase the tendon’s ability to tolerate thousands of swings over the course of a season.
Phase 3: Building Impact Capacity
One concept emphasized by tendon specialists such as Dr. Keith Baar and taught extensively by many modern tendon rehabilitation experts is that tendons must eventually tolerate high-rate loading.
Golf is not a slow-strength sport.
Every swing involves:
- Rapid force generation
- High-speed rotational movement
- Significant impact forces
- Deceleration demands through the upper extremity
If rehabilitation only consists of slow exercises, the tendon may never be adequately prepared for the realities of competitive golf.
As symptoms improve, we could even gradually introduce:
- Medicine ball rotational throws
- Dynamic grip exercises
- Forearm power development
- Plyometric progressions
- Golf-specific speed drills
The tendon must learn not only to tolerate force but also to tolerate velocity.
Phase 4: Treat the Athlete, Not Just the Elbow
One of the biggest mistakes in rehabilitation is focusing only on the site of pain.
Elite golfers create power through the entire kinetic chain.
Deficits elsewhere frequently increase demand on the elbow.
A comprehensive program should address:
Shoulder Complex
- Rotator cuff strength
- Scapular stability
- Posterior shoulder endurance
- Thoracic mobility
Core and Trunk
- Rotational control
- Anti-rotation strength
- Force transfer efficiency
- Segmental sequencing
Hips and Lower Body
- Lead hip mobility
- Pelvic control
- Ground force production
- Single-leg stability
When the body functions as an integrated system, less stress is placed on the tissues around the elbow.
Preventing Recurrence in Elite Junior Golfers
The most successful young golfers are not always those who practice the most. They are often the athletes who manage their health most effectively.
Prevention strategies include:
- Training to tolerate higher swing volume
- Maintaining year-round strength training and rehab as needed
- Prioritizing recovery and sleep
- Addressing mobility restrictions early
- Improving force-production capacity throughout the kinetic chain
- Seeking treatment at the first sign of symptoms
Small elbow issues are much easier to correct than chronic tendon injuries that have been present for months.
Our Philosophy
At our clinic, golfer’s elbow is not viewed as an isolated tendon problem. We see it as a training problem and performance problem involving tissue capacity, movement efficiency, and force transfer throughout the body.
By combining ARPwave, progressive eccentric loading, impact-based tendon rehabilitation, strength training, and biomechanical analysis, our goal is to help young golfers return to competition with a stronger, more resilient system than they had before the injury.
Because the true goal isn’t just getting out of pain. It’s building an athlete who can withstand the demands of elite golf season after season while continuing to improve performance.
Look, we know all the golf gurus that want to to change your swing, that isn’t us. We know all the docotors that want you to take a week or a month off, that isn’t us. We are here to fix your problem as fast as possible. Most medical epicondylitis issues arise from very basic mechanisms. We get you out of pain, get you golfing and leave you with the education/knowledge you need to keep golfing all the time.
Give us a call or text! We are in Mesa, AZ.
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