Medial Epicondylitis (golfers elbow)
Shockwave Therapy for Golfers Elbow | Sunbury & Melton
Medial epicondylitis, commonly called golfers elbow, is a painful condition affecting the tendons on the inside of the elbow. Shockwave Therapy is a non-invasive treatment that may assist some people with persistent tendon-related pain by applying mechanical energy to the affected tissues.
Evidence suggests Shockwave Therapy can be useful for certain chronic tendinopathies, particularly when combined with appropriate rehabilitation exercises. However, treatment outcomes vary between individuals. A thorough assessment helps determine whether Shockwave Therapy is suitable for your golfers elbow symptoms.
Health Wise Chiropractic provides evidence-informed care for patients in Sunbury and Melton.
Shockwave Therapy may help some people with golfers elbow (medial epicondylitis) by supporting the management of persistent tendon pain and improving function. Golfers elbow is a condition affecting the tendons that attach the forearm muscles to the inside of the elbow. It commonly develops from repetitive gripping, lifting, throwing, computer work, manual labour, or sporting activities that place repeated stress on these tissues.
Although the name suggests a golf-related injury, many people who develop medial epicondylitis do not play golf. It can affect tradespeople, office workers, gym participants, racquet sport players and anyone performing repeated wrist or forearm movements.
Shockwave Therapy uses focused sound waves to deliver mechanical energy to the affected tendon area. The goal is to stimulate a biological response within the tendon, reduce pain sensitivity and support tendon recovery as part of a broader rehabilitation program.
Research suggests Shockwave Therapy may provide benefits for some people with chronic tendinopathy, although results vary depending on the severity of the condition, duration of symptoms, activity levels and overall treatment approach.
At Health Wise Chiropractic, patients in Sunbury and Melton receive an individual assessment to determine whether Shockwave Therapy is appropriate or whether another approach, such as exercise rehabilitation, manual therapy, or referral to a medical practitioner, may be more suitable.
Medial epicondylitis, commonly called golfers elbow, is a painful condition affecting the tendons on the inside of the elbow. Shockwave Therapy is a non-invasive treatment that may assist some people with persistent tendon-related pain by applying mechanical energy to the affected tissues.
Evidence suggests Shockwave Therapy can be useful for certain chronic tendinopathies, particularly when combined with appropriate rehabilitation exercises. However, treatment outcomes vary between individuals. A thorough assessment helps determine whether Shockwave Therapy is suitable for your golfers elbow symptoms.
Health Wise Chiropractic provides evidence-informed care for patients in Sunbury and Melton.
Understanding Golfers Elbow (Medial Epicondylitis)
Golfers elbow, medically known as medial epicondylitis or medial epicondylalgia, is a condition involving pain and sensitivity around the inner part of the elbow. The problem usually affects the tendons that connect the muscles of the forearm to the medial epicondyle, which is the bony prominence on the inside of the elbow.
Despite the name, golfers elbow is not limited to golfers. The condition commonly affects people who perform repeated gripping, wrist bending, lifting or forearm rotation activities.
Examples include:
Golfers and other athletes
Weightlifters and gym participants
Carpenters, electricians and tradespeople
Hairdressers and massage therapists
Warehouse workers
Office workers using a mouse and keyboard extensively
People performing repetitive household activities
The affected muscles are responsible for movements such as wrist flexion and forearm rotation. When these tissues are repeatedly overloaded, the tendon may become painful and less tolerant to normal activities.
The Anatomy Behind Golfers Elbow
The elbow is a complex joint formed by three bones:
The humerus (upper arm bone)
The radius and ulna (forearm bones)
The medial epicondyle is a small bony area on the inside of the lower humerus. Several forearm muscles attach through a common tendon in this region.
These muscles help with:
Bending the wrist forward
Gripping objects
Rotating the forearm
Stabilising the wrist during activity
The tendon attachment transfers force between the muscles and bones. When repeated loading exceeds the tendon’s ability to adapt, symptoms may develop.
Tendon Overload and Degeneration
Historically, golfers elbow was often described as “inflammation” of the tendon. However, modern research shows that many chronic tendon conditions involve a more complex process.
Instead of simple inflammation, persistent tendinopathy may involve:
Changes in tendon structure
Altered collagen organisation
Reduced tendon capacity to tolerate load
Increased sensitivity of local nerves
Changes in pain processing
This explains why symptoms can continue for months despite rest or anti-inflammatory approaches.
A tendon that has become less tolerant usually requires gradual strengthening and controlled loading rather than complete avoidance of activity.
Acute vs Chronic Golfers Elbow
Acute Golfers Elbow
Acute symptoms often occur after:
A sudden increase in exercise
A new sporting activity
Heavy lifting
Repetitive work performed for longer than usual
Symptoms may include:
Localised pain on the inside of the elbow
Tenderness around the tendon attachment
Pain during gripping or lifting
Early management often focuses on reducing aggravating activities while maintaining appropriate movement.
Chronic Golfers Elbow
Chronic golfers elbow usually refers to symptoms lasting more than three months.
Persistent cases may involve:
Ongoing tendon sensitivity
Reduced grip strength
Difficulty with work tasks
Pain during exercise or sport
Reduced confidence using the arm
Chronic tendinopathy often requires a structured rehabilitation approach focused on gradually improving tendon strength and capacity.
Common Symptoms of Golfers Elbow
People with medial epicondylitis may experience:
Pain on the inside of the elbow
Tenderness when pressing over the tendon attachment
Pain when gripping objects
Discomfort lifting a bag, kettle or tools
Reduced grip strength
Pain with wrist bending movements
Stiffness after periods of inactivity
Symptoms that worsen with repetitive activity
Pain may sometimes extend into the forearm, although symptoms are usually centred around the inner elbow.
Different Types of Elbow Pain
Not all elbow pain is caused by golfers elbow. A proper assessment helps distinguish between different sources.
Tendon Pain
Typical features include:
Localised pain over the tendon
Pain with resisted wrist movements
Symptoms linked to activity or loading
Joint-Related Pain
Elbow joint problems may involve:
Reduced movement
Swelling
Clicking or locking
Pain deeper within the joint
Nerve-Related Pain
The ulnar nerve passes close to the inside of the elbow. Irritation may cause:
Tingling
Numbness
Symptoms into the ring and little fingers
Burning or electrical sensations
Referred Pain
Pain can occasionally originate from other areas, including:
The neck
Shoulder region
Upper arm
A comprehensive assessment helps identify the likely pain source.
Common Causes and Risk Factors
Golfers elbow usually develops when the tendon is exposed to repeated stress without enough recovery.
Common contributing factors include:
Sudden Changes in Activity
Examples:
Increasing gym weights quickly
Starting a new sport
Increasing training volume
Returning to activity after a break
Repetitive Work Tasks
Occupations involving repeated:
Gripping
Tool use
Lifting
Wrist movements
may increase tendon loading.
Reduced Tendon Capacity
Factors that may influence tendon health include:
Age-related changes
Previous injuries
Poor recovery between activities
Reduced strength or conditioning
Repetitive overload
Technique and Movement Factors
Poor lifting technique, unsuitable equipment or inefficient movement patterns may increase stress on the elbow.
Prognosis and Recovery
The outlook for golfers elbow is generally positive, although recovery can take time.
Many people improve with:
Activity modification
Progressive strengthening exercises
Education about tendon loading
Appropriate rehabilitation
Recovery depends on factors including:
How long symptoms have been present
Severity of tendon changes
Work and sporting demands
Overall health
Consistency with rehabilitation
Persistent tendon conditions often improve gradually rather than immediately. A treatment plan should focus on restoring function and improving the tendon’s ability to tolerate normal activities.
Who May Benefit From Shockwave Therapy?
Shockwave Therapy may be considered for people who:
Have persistent golfers elbow symptoms
Have tried activity modification and exercise without sufficient improvement
Have tendon-related pain confirmed through clinical assessment
Want a non-invasive treatment option
It may be particularly considered when symptoms have continued for several months.
Who May Not Be Suitable?
Shockwave Therapy may not be appropriate for everyone.
Additional assessment or alternative care may be needed for people with:
Acute traumatic injuries
Suspected fractures
Significant nerve symptoms
Infection
Certain medical conditions affecting healing
Blood clotting disorders
Certain medication considerations
A healthcare professional can determine whether treatment is suitable.
What Happens During Your Appointment?
At Health Wise Chiropractic, your first appointment for golfers elbow begins with understanding your symptoms, your daily activities and the factors that may have contributed to your condition. Shockwave Therapy is not automatically suitable for every elbow complaint, so an appropriate assessment is important before treatment begins.
1. Health History and Discussion
Your practitioner will discuss:
When your elbow pain started
Whether symptoms developed suddenly or gradually
Activities that aggravate your symptoms
Your work, sport and exercise demands
Previous injuries or treatments
Any symptoms suggesting nerve involvement
Questions may include:
Does gripping increase your pain?
Is lifting objects uncomfortable?
Does the pain improve with rest?
Have symptoms been present for weeks, months or longer?
Understanding your individual situation helps determine the likely source of your pain.
2. Physical Examination
Your practitioner may assess:
Elbow and Forearm Function
This may include checking:
Range of motion
Strength
Grip function
Tenderness around the tendon attachment
Pain during specific movements
Related Areas
Because the body works as a connected system, assessment may also include:
Wrist movement
Shoulder function
Neck and nerve-related symptoms
Posture and movement patterns
This helps distinguish between:
Tendon-related pain
Joint-related pain
Nerve irritation
Referred pain
3. Treatment Assessment
Following your examination, your practitioner will explain:
Whether Shockwave Therapy may be appropriate
What treatment options are available
Expected benefits and limitations
Whether additional investigations or medical referral may be recommended
In some cases, Shockwave Therapy may not be the first choice. A progressive exercise program, manual therapy, activity modification or referral to another healthcare provider may be more appropriate.
4. Shockwave Therapy Treatment
If Shockwave Therapy is considered suitable, treatment generally involves:
Positioning the arm comfortably
Applying ultrasound gel to the treatment area
Delivering controlled shockwave impulses through a handheld applicator
Adjusting intensity according to comfort and clinical response
Most sessions are relatively short and commonly take approximately 10–15 minutes, depending on the treatment plan.
Patients commonly describe the sensation as:
Pulsing
Tapping
Pressure
Mild discomfort over the sensitive tendon area
Treatment intensity is adjusted to remain within an appropriate comfort level.
5. Aftercare Advice
Following Shockwave Therapy, patients may be advised to:
Avoid heavy aggravating activities temporarily
Continue appropriate movement
Follow prescribed rehabilitation exercises
Monitor symptom response
Some people experience temporary:
Tenderness
Mild aching
Increased sensitivity
These effects usually settle within a short period.
Your practitioner will provide guidance based on your condition, activity demands and recovery progress.
Home Care & Exercises
Exercise rehabilitation is an important part of managing golfers elbow. Tendons generally respond best to gradual, progressive loading rather than complete rest.
The following exercises are examples of beginner-friendly movements that may support recovery. Exercise selection should be personalised, especially if symptoms are severe or persistent.
1. Wrist Flexor Stretch
Purpose:
Helps maintain flexibility through the forearm muscles connected to the inner elbow.
Instructions:
Extend the affected arm in front of you with your palm facing upwards.
Use your opposite hand to gently pull the fingers backwards.
Feel a stretch along the inside of your forearm.
Hold comfortably without forcing the movement.
Dosage:
Hold for 20–30 seconds
Repeat 2–3 times
Perform daily
Progression:
Gradually increase stretch duration if comfortable.
2. Isometric Wrist Flexion Hold
Purpose:
Introduces tendon loading without large joint movement.
Instructions:
Rest your forearm on a table with your palm facing upwards.
Use your opposite hand to provide resistance.
Attempt to bend your wrist while preventing movement with your other hand.
Hold the contraction.
Dosage:
Hold for 5–10 seconds
Repeat 8–10 times
Perform once daily
Progression:
Increase resistance gradually as symptoms improve.
3. Eccentric Wrist Flexion Exercise
Purpose:
Builds tendon capacity through controlled strengthening.
Instructions:
Hold a light weight such as a small dumbbell or household object.
Support your forearm on a table.
Use your opposite hand to help lift the weight upwards.
Slowly lower the weight down using the affected arm.
Dosage:
2–3 sets of 10–15 repetitions
Perform 3–4 times per week
Progression:
Increase weight gradually while maintaining good technique.
4. Grip Strength Exercise
Purpose:
Improves tolerance to gripping activities.
Instructions:
Hold a soft ball, towel or therapy putty.
Squeeze gently.
Hold the contraction briefly.
Relax completely between repetitions.
Dosage:
10–15 repetitions
1–2 sets daily
Progression:
Increase resistance gradually.
5. Forearm Pronation and Supination Exercise
Purpose:
Strengthens muscles involved in forearm rotation.
Instructions:
Hold a light object such as a small hammer or dumbbell.
Slowly rotate your palm upwards and downwards.
Keep the movement controlled.
Dosage:
2 sets of 10 repetitions
Perform 3–4 times per week
Progression:
Increase resistance as strength improves.
Exercise Safety
Some discomfort during tendon rehabilitation can be normal, but exercises should not cause significant increases in symptoms that last for days afterwards.
Seek professional advice if:
Pain is severe
Symptoms are worsening
You develop numbness or weakness
Normal daily activities become increasingly difficult
Prevention Tips
Preventing golfers elbow involves improving tendon capacity, managing workload and allowing adequate recovery.
Manage Training and Workload Changes
A common trigger for tendon problems is doing too much too quickly.
Helpful strategies include:
Increase exercise intensity gradually
Avoid sudden increases in lifting volume
Allow recovery between heavy sessions
Alternate demanding tasks with lighter activities
Improve Workstation Setup
For people with desk-based work:
Keep your keyboard and mouse positioned comfortably
Avoid prolonged wrist bending positions
Use regular movement breaks
Adjust chair and desk height appropriately
Long periods of static posture may contribute to muscle fatigue and increased sensitivity.
Use Good Lifting Technique
When lifting:
Keep loads close to your body
Avoid excessive gripping force
Use both hands when appropriate
Avoid repetitive wrist bending under heavy loads
Maintain Forearm Strength
Regular strengthening can improve the ability of tendons to tolerate stress.
Include:
Wrist strengthening
Grip exercises
General upper limb conditioning
Progress gradually rather than increasing resistance suddenly.
Prioritise Recovery
Recovery supports tendon health.
Helpful habits include:
Adequate sleep
Balanced nutrition
Managing stress
Maintaining regular physical activity
Stretch and Move Regularly
Gentle mobility exercises can help maintain comfortable movement, especially for people performing repetitive tasks.
Avoid aggressive stretching that increases pain.
Prevalence and Burden of Golfers Elbow in Australia
Reliable Australian population data specifically measuring medial epicondylitis (golfers elbow) prevalence is limited. Unlike conditions such as low back pain or osteoarthritis, golfers elbow is not routinely tracked as a separate national health condition.
However, available research indicates that elbow tendinopathies represent a meaningful musculoskeletal health issue, particularly among working-age adults, athletes and people involved in repetitive occupational activities.
Research from international populations suggests:
Medial epicondylitis affects approximately 0.3% to 1.1% of adults annually, although rates vary depending on occupation and activity exposure.
It is most common in adults aged approximately 40–60 years.
It is associated with occupations involving repetitive gripping, forceful wrist movements and manual work.
Australian workers in industries involving repetitive upper limb loading may have increased risk, including:
Construction and trades
Manufacturing
Healthcare
Hospitality
Agriculture
Office-based occupations involving prolonged computer use
The Australian Institute of Health and Welfare (AIHW) identifies musculoskeletal conditions as one of Australia’s largest contributors to disability, reduced quality of life and healthcare use.
While golfers elbow is only one small component of musculoskeletal disorders, persistent tendon pain can affect:
Work capacity
Sporting participation
Sleep quality
Daily activities
Physical confidence
Early assessment and appropriate management may help reduce the likelihood of persistent symptoms.
Sources:
Australian Institute of Health and Welfare. Musculoskeletal conditions in Australia.
https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/musculoskeletal-conditionsShiri R, et al. “The prevalence and risk factors of lateral and medial epicondylitis: a systematic review.” American Journal of Epidemiology.
Current Evidence for Shockwave Therapy and Golfers Elbow
Shockwave Therapy, also known as extracorporeal shockwave therapy (ESWT), has been investigated as a treatment option for chronic tendinopathies, including medial epicondylitis.
Current evidence suggests Shockwave Therapy may provide pain reduction and functional improvements for some patients, particularly those with persistent symptoms who have not responded adequately to initial conservative care.
However, evidence quality varies between studies because researchers use different:
Shockwave machines
Treatment protocols
Energy levels
Number of treatment sessions
Comparison treatments
For this reason, Shockwave Therapy is generally considered one component of a broader rehabilitation approach rather than a guaranteed standalone treatment.
Randomised Controlled Trial Evidence
A randomised controlled trial investigating extracorporeal shockwave therapy for chronic medial epicondylitis found improvements in pain and function compared with placebo treatment.
Patients receiving active shockwave treatment demonstrated improvements in:
Pain scores
Functional outcomes
Grip-related symptoms
The authors concluded that ESWT may be a useful option for patients with chronic medial epicondylitis.
Reference:
Note: Much of the highest-quality ESWT evidence has focused on lateral elbow tendinopathy (tennis elbow), with fewer studies specifically examining medial epicondylitis.
Systematic Reviews and Meta-Analyses
A systematic review of shockwave therapy for tendinopathies found that ESWT may provide clinically meaningful improvements in pain and function for several chronic tendon conditions.
Findings included:
Reduced pain compared with baseline measurements
Improvements in functional scores
Better outcomes in some chronic tendinopathy populations
However, authors noted that treatment protocols were inconsistent and further high-quality research was needed.
Reference:
Tendon Rehabilitation Remains Important
Clinical guidelines generally support exercise-based rehabilitation as a key component of tendinopathy management.
Progressive loading exercises aim to:
Improve tendon capacity
Restore strength
Improve tolerance to daily activities
Reduce fear of movement
Shockwave Therapy may be used alongside rehabilitation when clinically appropriate.
Reference:
Frequently Asked Questions
1. What is golfers elbow?
Golfers elbow, also called medial epicondylitis or medial epicondylalgia, is a condition involving pain and sensitivity of the tendons attached to the inside of the elbow. It commonly occurs from repetitive gripping, lifting and wrist movements.
2. Can Shockwave Therapy help golfers elbow?
Shockwave Therapy may help some people with persistent golfers elbow symptoms by reducing pain sensitivity and supporting tendon rehabilitation. Research suggests it can be useful for certain chronic tendon conditions, although results vary between individuals.
3. How many Shockwave Therapy sessions are needed for golfers elbow?
The number of sessions depends on the individual condition and treatment plan. Many Shockwave Therapy programs involve several sessions spaced over multiple weeks, combined with appropriate rehabilitation exercises.
4. Is Shockwave Therapy painful?
Some people experience discomfort during treatment because the shockwaves are applied to a sensitive tendon area. Treatment intensity can usually be adjusted according to comfort.
5. How long does golfers elbow take to heal?
Recovery varies. Mild cases may improve within weeks, while persistent tendon conditions may require several months of rehabilitation. Factors such as symptom duration, workload and exercise consistency influence recovery.
6. Is golfers elbow caused only by playing golf?
No. Despite the name, golfers elbow affects many people who do not play golf. It can develop from repetitive gripping, lifting, manual work, gym exercises and other activities that load the forearm muscles.
7. Should I rest my arm if I have golfers elbow?
Complete rest is usually not recommended long term. Tendons generally respond well to gradual loading and strengthening. Temporary modification of aggravating activities may help during recovery.
8. Can Shockwave Therapy replace exercises for golfers elbow?
No. Shockwave Therapy is generally used as part of a broader management plan. Exercise rehabilitation is important for improving tendon strength and long-term function.
9. When should I see a healthcare professional for elbow pain?
Assessment is recommended if elbow pain persists, affects daily activities, reduces strength, or includes symptoms such as numbness, tingling or weakness.
10. Can Health Wise Chiropractic help with golfers elbow in Sunbury and Melton?
Health Wise Chiropractic provides assessment and evidence-informed treatment options, including Shockwave Therapy where appropriate. A practitioner can assess whether your symptoms are consistent with golfers elbow and recommend a suitable management plan.
Why Choose Health Wise Chiropractic?
Managing golfers elbow effectively often requires more than simply treating the painful area. Understanding the cause of symptoms, improving tendon capacity and restoring comfortable movement are important parts of long-term recovery.
Health Wise Chiropractic provides:
Experienced practitioners with musculoskeletal assessment skills
Individualised treatment recommendations
Evidence-informed care
Rehabilitation guidance tailored to your goals
Shockwave Therapy where clinically appropriate
Support for returning to work, exercise and sport
Patients from Sunbury, Melton and surrounding communities can access personalised care designed around their individual presentation.
Online bookings are available for patients wanting to arrange an assessment and discuss whether Shockwave Therapy may be suitable.
Persistent elbow pain can make work, exercise and everyday activities frustrating. If you are experiencing symptoms consistent with golfers elbow, an individual assessment can help identify the likely cause of your pain and determine whether Shockwave Therapy or another treatment approach may be appropriate.
At Health Wise Chiropractic, our experienced practitioners provide evidence-informed care for patients in Sunbury, Melton and surrounding areas. We focus on understanding your symptoms, creating a personalised management plan and supporting your recovery with appropriate treatment and rehabilitation strategies.
Book an assessment online or contact Health Wise Chiropractic to discuss your golfers elbow symptoms and explore your available options.
Recovery Timeline
Recovery from golfers elbow varies significantly between individuals. The timeline depends on factors such as how long symptoms have been present, tendon health, activity demands and consistency with rehabilitation.
Mild Cases
Mild cases may improve over several weeks with:
Activity modification
Appropriate exercises
Load management
Early intervention often provides the best opportunity to prevent symptoms becoming persistent.
Moderate Cases
Moderate cases may require several months of structured management.
Treatment may involve:
Progressive strengthening
Shockwave Therapy where appropriate
Manual therapy
Workplace or sporting modifications
Improvement is usually gradual as tendon capacity increases.
Persistent or Chronic Cases
Long-standing golfers elbow can take several months to improve.
Chronic cases may require:
A structured rehabilitation plan
Changes to aggravating activities
Multiple treatment approaches
Patience and consistency
Shockwave Therapy may be considered for some persistent cases, particularly when combined with rehabilitation.
Factors That Influence Recovery
Recovery may be slower when there is:
Long symptom duration
High physical work demands
Ongoing tendon overload
Poor sleep or recovery
Inadequate rehabilitation progression
A personalised assessment helps create realistic expectations.
Medial epicondylitis, commonly called golfers elbow, is a painful condition affecting the tendons on the inside of the elbow. Shockwave Therapy is a non-invasive treatment that may assist some people with persistent tendon-related pain by applying mechanical energy to the affected tissues.
Evidence suggests Shockwave Therapy can be useful for certain chronic tendinopathies, particularly when combined with appropriate rehabilitation exercises. However, treatment outcomes vary between individuals. A thorough assessment helps determine whether Shockwave Therapy is suitable for your golfers elbow symptoms.
Health Wise Chiropractic provides evidence-informed care for patients in Sunbury and Melton.
Medial epicondylitis, commonly called golfers elbow, is a painful condition affecting the tendons on the inside of the elbow. Shockwave Therapy is a non-invasive treatment that may assist some people with persistent tendon-related pain by applying mechanical energy to the affected tissues.
Evidence suggests Shockwave Therapy can be useful for certain chronic tendinopathies, particularly when combined with appropriate rehabilitation exercises. However, treatment outcomes vary between individuals. A thorough assessment helps determine whether Shockwave Therapy is suitable for your golfers elbow symptoms.
Health Wise Chiropractic provides evidence-informed care for patients in Sunbury and Melton.