Sporthopedia · Patient Information
Understanding Your Elbow
Clear information about tennis elbow, golfer's elbow, UCL injuries, and treatment options — written for patients.
Anatomy
How Does the Elbow Work?
Joint
A Hinge & a Pivot
The elbow is a compound joint — the humeroulnar joint bends and straightens the arm, while the proximal radioulnar joint allows rotation (pronation/supination) for turning the palm up or down.
Epicondyles
Tendon Attachment Points
The lateral epicondyle (outer bump) is where forearm extensor tendons attach — the site of "tennis elbow." The medial epicondyle (inner bump) anchors flexor tendons — the site of "golfer's elbow."
UCL
Thrower's Ligament
The ulnar collateral ligament (UCL) on the inner elbow provides stability during throwing. Repetitive overhead throwing stresses the UCL, leading to tears — most famously treated with "Tommy John" surgery.
Nerves
The Funny Bone Nerve
The ulnar nerve passes directly behind the medial epicondyle (the "funny bone"). Compression here causes cubital tunnel syndrome — tingling and numbness in the ring and little fingers.
Common conditions
What Could Be Wrong?
Tennis Elbow (Lateral Epicondylitis)
Pain and tenderness over the outer elbow, worsened by gripping and lifting. Despite the name, most cases occur in non-tennis players due to repetitive forearm use. Usually resolves with physiotherapy and load management.
Golfer's Elbow (Medial Epicondylitis)
Pain on the inner elbow, aggravated by wrist flexion and gripping. Common in golfers, climbers, and manual workers. Treatment parallels tennis elbow — physiotherapy, eccentric loading, and activity modification.
UCL Injury (Tommy John)
Overuse or acute injury to the medial elbow ligament — most common in baseball pitchers and overhead throwing athletes. Surgical reconstruction using a tendon graft (Tommy John surgery) allows return to throwing sport.
Cubital Tunnel Syndrome
Compression of the ulnar nerve at the elbow causes tingling, numbness, and weakness in the ring and little fingers. Aggravated by prolonged elbow bending. Treated with nerve gliding exercises, padding, or surgical nerve release.
Treatment
What Happens Next?
Diagnosis
MRI evaluates ligaments and tendons. Ultrasound provides dynamic assessment of tendons and can detect partial tears. Nerve conduction studies diagnose cubital tunnel syndrome. X-rays identify loose bodies, arthritis, and calcifications.
Conservative Treatment
Physiotherapy with eccentric strengthening is first-line for most elbow tendinopathies. Activity modification, counterforce bracing, and shockwave therapy are also effective. PRP injections may help in chronic cases.
Arthroscopic Surgery
Elbow arthroscopy can remove loose bodies, treat arthritis, release contractures, and address tennis elbow. It offers excellent visualization with minimal recovery time compared to open surgery.
UCL Reconstruction (Tommy John Surgery)
A tendon graft (usually palmaris longus or gracilis) replaces the torn UCL. Recovery is 12–18 months before return to competitive throwing. Success rates are high, and many athletes return to sport at the same or higher level.
Rehabilitation
Tennis elbow: 3–6 months with physiotherapy. Cubital tunnel release: 4–6 weeks. UCL reconstruction: 12–18 months structured throwing program. Elbow replacement for arthritis: 3–6 months.
FAQ
Your Questions, Answered
With proper treatment, most cases improve within 3–6 months. However, without addressing the cause (load management, technique), it can become chronic. Patience is key — tendons heal slowly. Avoid steroid injections repeatedly as they weaken tendon tissue long-term.
Modified activity is usually possible and even beneficial. Complete rest can weaken the tendon further. The goal is to find a pain level (below 4/10) that allows continued activity while managing load — guided by your physiotherapist.
Tommy John surgery reconstructs the torn UCL using a tendon graft, restoring medial elbow stability for throwing. It is primarily indicated for competitive overhead athletes (pitchers, javelin throwers, volleyball players) who fail conservative treatment. Non-athletes with UCL tears may often be treated non-surgically.
This is a classic sign of cubital tunnel syndrome — ulnar nerve compression at the elbow. Symptoms typically affect the ring and little fingers. Avoiding prolonged elbow bending, using elbow padding, and nerve gliding exercises often resolve mild cases. Surgery may be needed if symptoms are severe or progressive.
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