The term “country club elbow” evokes pleasant images of green lawns, polo shirts and tall glasses of iced tea. Unfortunately, this moniker refers to a far less pleasant condition: the combination of tennis elbowand golfer’s elbow—a chronic, painful syndrome associated with the two sports. The condition can cause a shooting pain down the forearm and a dull, permanent ache in the elbow joint, but with proper care, most patients can be pain free within a year.

These two conditions, both forms of epicondylitis, are differentiated by the location of the pain.

  • Golfer’s elbow (medial epicondylitis): the pain is felt on the inside of the elbow


  • Tennis elbow (lateral epicondylitis): the pain is felt on the outside of the elbow

But it is not uncommon for patients to complain of pain in both regions, suggesting a diagnosis of country club elbow.

These types of elbow pain are categorized as overload or overuse injuries. Previously believed to be caused by tendon inflammation, the conditions are more likely caused by scar tissue formed from repetitive strain or a trauma so small it goes unnoticed.  A combination of the two conditions could be an indicator of muscle imbalances or compensations at the shoulder, trunk and hip region.  This can be especially true of patients with  past orthopedic conditions even if they were not formally treated.

The application of ice, a period of rest and nonsteroidal anti-inflammatory drugs (NSAIDs), if your physician approves, may offer temporary relief. In extreme cases, corticosteroid injections or even surgery may be employed. The best treatment, however, is a rehabilitation program involving elbow manipulation and strengthening the tendons around the elbow joint. We can design a program of stretching and eccentric exercise (a form of weight-bearing resistance training), as well as therapeutic modalities such as massage, to alleviate the pain.

Although steroid injections might offer additional relief in some cases, studies have shown that physical therapy alone is the most effective treatment for both tennis and golfer’s elbow. By following the program we design and adopting better ergonomic techniques for whatever activity caused the problem in the first place, you will return to golf, tennis or sipping iced tea in your polo shirt sooner than you think.

Apex Orthopedic Rehabilitation in Paramus, NJ provides orthopedic and sports physical therapy services for the greater Paramus, Ridgewood, and Bergen County region.  This blog is intended for informational purposes only and should not be used for diagnostic or prescriptive purposes. The views expressed here are the author’s views and should be taken as suggestions. Always consult your physician before engaging in a physical therapy or rehabilitative regimen.