Talk:Golfer's elbow

What are the symptoms?

The article doesn't discuss symptoms. 173.66.211.53 (talk) 13:31, 2 June 2013 (UTC)

Description section paragraph 3 is speculative, likely inaccurate, and reinforces unhealthy mindsets.

Paragraph 3 of the description section: "The injury is not acute inflammation, but rather is a chronic disorder resulting from overuse of a repetitive arm motion.[1][2] Repetitive activity leads to recurrent microtears within the flexor tendon, with remodeling of the collagen fibers and an increase in the amount of mucoid ground substance.[1] As a result, scar tissue formation and thickening of the tendon lead to reduced collagen strength and pain with repetitive use.[1]"

This is speculative, likely inaccurate, and reinforces unhealthy mindsets. Ischyros7 (talk) 10:49, 15 December 2023 (UTC)

The description adheres to the main source under Pathophysiology. Please give your evaluation based on this or another reliable WP:MEDRS source. Zefr (talk) 15:48, 15 December 2023 (UTC)

Hi Zefr. The reference for etiology in that narrative review is another narrative review. There is no evidence of inflammation or damage (trauma) in the pathohpysiology of this condition. There is a systematic review of available evidence that was referenced in the edits. That is a much better and more reliable form of evidence than a narrative review which is just the author's thoughts an opinions.

The study cited reviewed the evidence regarding histological assessment of enthesopathies such as medial and lateral epicondylitis. The evidence is clear and consistent that the pathophysiology is mucoid degeneration. Not inflammation. No damage and repair. I strongly support restoring the edits you deleted. Serio31 (talk) 15:02, 4 July 2026 (UTC)

Treatment

"A counterforce brace or "elbow strap" to reduce strain at the elbow epicondyle, to limit pain provocation and to protect against further damage" has been edited. There is no damage in an enthesopathy. It is idiopathic and the pathophysiology is mucoid degeneration.  It's important not to reinforce the common misconception that painful activities will cause damage. Hadis.Askari (talk) 21:14, 21 April 2024 (UTC)

Please reconcile your interpretation with the description of pathophysiology and pain under History and Physical in the Kiel review. Zefr (talk) 22:24, 21 April 2024 (UTC)

I also support these edits and encourage their restoration. Given that the pathophysiology is mucoid degeneration, the concept of "protection" of any sort is not accurate or healthy. The Kiel review recapitulates unhealthy concepts that are out-of-date regarding the current evidence as outlined by Bruni and colleagues.

It is also out-of-touch with the evidence that the meaning assigned to a symptom can either alleviate that symptom (placebo type meaning effects) or make it worse (nocebo type meaning effects).

Useful review of this evidence here: https://www.nejm.org/doi/full/10.1056/NEJMra1907805 Serio31 (talk) 15:07, 4 July 2026 (UTC)

Occurrence

Proposed to replace the the word medial injury with enthesopathy. This condition is not an injury.  It is an idiopathic enthesopathy of middle age.

Additionally, statistics regarding its prevalence by genders have not been phrased correctly. These are claims data. The evidence from imaging suggests no difference in pathophysiology prevalence by gender.

Last proposed change is rephrasing the sentences that improper techniques for the risk factors. Improper technique is not accurate.  We need to be careful not reinforce catastrophic thinking and kinesophobia.  The evidence is strong that this is an idiopathic enthesopathy of middle age. The pathophysiology is unrelated to activity, but the symptoms may be. Hadis.Askari (talk) 04:04, 4 July 2024 (UTC)

As the Kiel source states, golfer's elbow is similar to ulnar collateral ligament injury of the elbow, also described in discussion topics above and in the article. You provided no sources for your opinion. Any change in the article has to be supported by a WP:MEDRS source. Zefr (talk) 05:14, 4 July 2024 (UTC)

Ulnar collateral ligament injury of the elbow is a completely different pathophysiology. There is zero relation to enthesopathy of the origin of the flexor pronatory mass (medial epicondylitis). Serio31 (talk) 15:09, 4 July 2026 (UTC)

Treatment

Proposed deletion of sub-section of "physical therapy" as part of treatments and adding the associated recommendation of " Exercises for stretching and gradual strengthening of the flexor-pronator muscles" as part of existing treatment recommendation. Physical therapy is a profession, not a treatment. Hadis.Askari (talk) 18:02, 4 July 2024 (UTC)

Disagree. Physical therapy is both a profession and a treatment, as explained in the Wikipedia article lede statement and section called Effectiveness. Three sources support the use of physical therapy during recovery from the injury of golfer's elbow. Zefr (talk) 18:30, 4 July 2024 (UTC)

Physical therapy is definitely a profession and not a treatment. Physical therapists recommend treatments, mostly in the form of exercises. I will suggest edits to the physical therapy page. Serio31 (talk) 15:09, 4 July 2026 (UTC)

Final Sentence of Paragraph 1

The final sentence of the opening paragraph was deleted. There is no evidence that this is the case. The best available evidence is the following: 1. Enthesopathies are mucoid degeneration that is idiopathic, no known cause. 2. The idea that activity is harmful is a common misconception that increases symptom intensity. Awradloff (talk) 20:07, 6 May 2026 (UTC)

How do you distinguish golfer's elbow from tennis elbow and pitcher's elbow seen so commonly among baseball pitchers in age groups from children to professional MLB pitchers?

The syndrome of golfer's or pitcher's elbow injury, ulnar collateral ligament injury of the elbow, is caused by overuse of the arm, particularly in baseball pitching for the elbow-twisting to throw curveballs, an injury requiring Tommy John surgery.

This has been discussed in a StatPearls article, which you deleted. I'm restoring the passage and source until you provide sufficient explanation with a WP:MEDRS review to support your opinion.

This was discussed above 2-3 years ago - see above. Are you affiliated with (or the same person as) Ischyros7 or Hadis.Askari? Zefr (talk) 20:23, 6 May 2026 (UTC)

A 2024 StatPearls review of medial epicondylitis ("golfer's elbow", "pitcher's elbow", "tennis elbow") is here. Zefr (talk) 22:10, 6 May 2026 (UTC)

First, to clarify terminology:

Golfer's elbow - medial epicondylitis involving the common flexor-pronator origin.

Tennis elbow - lateral epicondylitis involving the common extensor tendon at the origin of the extensor carpi radialis brevis.

Pitcher's elbow - typically refers to valgus extension overload syndrome, an arthritic/bony condition that is mechanically distinct from the degenerative tendinosis of the flexor-pronator origin that defines medial epicondylitis. "Pitcher's elbow" is an umbrella term however than can also refer to UCL injury, medial epicondyle apophysitis, and ulnar neuritis.

This Wikipedia page is titled "Golfer's elbow," not "medial epicondylitis." Therefore, the content of this article should only focus on medial epicondylitis involving the common flexor-pronator origin. In summary, just because "medial epicondylitis" can refer to both "golfer's elbow" and "pitcher's elbow," does not mean that golfer's elbow and pitcher's elbow are the same or related conditions. The cited StatPearls review is about medial epicondylitis, not specifically golfers elbow. Therefore, just because something is cited in that article does not mean that it is true about golfer's elbow specifically.

Here is my reasoning for deleting the text:

"...causing an injury similar to ulnar collateral ligament injury" is clinically misleading: UCL injury is ligamentous failure from repetitive valgus load, while golfer's elbow is a degenerative tendinosis of the common flexor origin. Treating them as analogous conditions in the opening paragraph of the Wikipedia article misrepresents both conditions and conflates them for readers.

"The tendinopathy results from overload or repetitive use of the arm..." is also misleading: In the "histopathology" section of the StatPearls review, histological studies show minimal or absent inflammatory infiltrates, meaning it is a degenerative, not inflammatory, process. Evidence shows that this degeneration appears to be driven by intrinsic tendon biology rather than simply mechanical wear and tear. The StatPearls review states factors like age, smoking, diabetes, and obesity as risk factors, backing up this assertion. Further, while overuse and overload are associated with golfer's elbow, the relationship is not straightforwardly causal. Many people with high repetitive load never develop it; many people who develop it have no obvious precipitating activity. The idea that it is a simple "overuse injury" is not well supported histologically. The tissue does not look like mechanically damaged tissue. Awradloff (talk) 20:02, 7 May 2026 (UTC)

Please provide WP:MEDRS sources for these interpretations, which do not agree with the reviews and clinical guidelines used in the article. Thanks. Zefr (talk) 20:26, 7 May 2026 (UTC)

On degenerative vs. inflammatory nature:

StatPearls: "histopathological studies show that classic inflammatory infiltrates are minimal or absent. The condition is therefore best understood as a degenerative tendinosis rather than an acute inflammatory process."

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On systemic/individual risk factors beyond simple overuse:

StatPearls: "Tobacco use and type 2 diabetes have been associated with an increased risk of tendinopathy, including medial epicondylitis" and lists "higher body mass index, smoking, preexisting comorbidities" as risk factors.

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On UCL injury being distinct:

StatPearls: Describes UCL injury and Golfer's elbow as potentially co-occurring but distinct: "degeneration within the flexor-pronator mass can diminish its role in providing dynamic valgus stability to the elbow, potentially coexisting with or exacerbating ulnar collateral ligament pathology."

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The StatPearls review repeatedly frames repetitive overload as the "primary mechanism" — "chronic, repetitive eccentric loading of the flexor-pronator musculotendinous unit...leading to supraphysiologic forces to create microscopic tendon failure." However, please see the following sources for justification on my conflicting assertion.

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Additional support from the broader tendinopathy literature:

A peer-reviewed paper in BMC Sports Science, Medicine and Rehabilitation (Fu et al., 2010), explicitly argues that tendinopathy "is not an 'overuse injury' per se," framing it instead as a failed healing response in which "predisposing intrinsic or extrinsic factors may be involved." This means that mechanical load alone does not determine who develops the condition. nih

Supporting this, a PMC review on epicondylitis treatment notes that "the specific causes of epicondylitis have not been elucidated," and that the degenerative mechanism involves "calcification, fibrosis, vascular proliferation, and hyaline degeneration of the affected muscles without inflammatory infiltration." Again pointing toward intrinsic biology rather than simple mechanical wear. PubMed CentralPubMed Central

That said, it is important not to dismiss mechanical stress entirely. The Fu et al. paper itself acknowledges that overuse and microtrauma "may well be primary triggers of the process." The more defensible and nuanced position, and the one best supported by the literature, is not that mechanical load is irrelevant, but that it is insufficient as a sole explanation. Many individuals with high repetitive loads never develop the condition, and the tissue changes seen histologically resemble a failed healing response more than straightforward mechanical damage. The condition is therefore better characterized as a degenerative tendinosis driven by a combination of mechanical triggers and intrinsic biological vulnerability, rather than a simple overuse injury. nih

This framing is both scientifically accurate. Awradloff (talk) 21:47, 7 May 2026 (UTC)

All of the sources emphasize it primarily as an overuse injury. The Fu article - 16 years out of date - discusses a theory of injury. The Tarpada report - 8 years out of date - addresses current and potential future treatments. I don't see its relevance here.

Overuse and mechanical stress are the main cause, as the sources state clearly. I don't see the common user understanding anything from "intrinsic biological vulnerability". Zefr (talk) 22:20, 7 May 2026 (UTC)

Discussion about mucoid degeneration

Can you identify evidence to support your views? It seems like the weight of evidence is against your views.

Wikipedia is meant to capture the breadth of opinions on the foundation of knowledge and evidence. Can't we find edits that represent the evidence as brought forth in these discussions and the gaps in evidence that allow for debate? Serio31 (talk) 15:12, 4 July 2026 (UTC)

The article has 9 references, the first 8 of which support the description of golfer's elbow as an injury from overuse of the common flexor tendon, similar in overuse to pitcher's elbow and tennis elbow. NIH summarizes these elbow injuries (under the subhead, "Elbow Injuries") as similar, without mentioning "mucoid degeneration". Likewise from the Cleveland Clinic.

From the above discussion, the main dispute vaguely refers to the injury as an enthesis involving mucoid degeneration.

Please make the case using any specific review source defining golfer's elbow resulting from mucoid degeneration. Zefr (talk) 18:20, 4 July 2026 (UTC)

How about this? You add your defense of an injury or damage pathophysiology. I and others can address the evidence in favor of an idiopathic mucoid degeneration. How does that sound? Serio31 (talk) 18:34, 4 July 2026 (UTC)

My defense of the existing description as an overuse injury is the article itself - my edits and sources are 45% of the article. Zefr (talk) 18:45, 4 July 2026 (UTC)

Is it OK if I and others put in a counterpoint without you deleting it? ~2026-38344-69 (talk) 13:21, 5 July 2026 (UTC)

That would be considered as tag-teaming, a form of meatpuppetry. The place to establish consensus is on the talk page using WP:BMI reviews as evidence for a clinical definition - see WP:MEDASSESS, left pyramid, for strength of evidence. Zefr (talk) 20:04, 9 July 2026 (UTC)

Explain that to me. Having a counterpoint that we are discussing in this talk page remain on the acutal page is meatpuppetry? Serio31 (talk) 14:45, 12 July 2026 (UTC)

While trying to be collegial on this topic and consider the concept of mucoid degeneration explaining golfer's elbow pathology, it's unmistakable that Serio31, IP 2026-38344-69, Awradloff, Hadis.Askari, Shriya Swamy, and Ischyros7 are a) all new usernames (since 2023); and b) make edits that are mostly or entirely only on this topic of mucoid degeneration.

It implies an individual user (using multiple account names) or a group of users having a WP:SPA focused on promoting the concept of "mucoid degeneration".

On 6 May 2026 above, I asked Awradloff: "Are you affiliated with (or the same person as) Ischyros7 or Hadis.Askari?" (no reply). Then on 4 July, Serio31 said: "I and others can address the evidence in favor of an idiopathic mucoid degeneration." and the next day, the IP user said: "Is it OK if I and others put in a counterpoint without you deleting it?"

These were the reasons I pointed out possible tag-teaming and meatpuppetry, implying either one user with several usernames or a "team" of editor-colleagues making the same reasoning about mucoid degeneration as the cause of golfer's elbow. Apologies for not being clearer about the implication, but the possibility remains.

In fairness, Serio31 should answer the question: are Serio31, IP 2026-38344-69, Awradloff, Hadis.Askari, Shriya Swamy, and Ischyros7 the same person or a collegial group? Zefr (talk) 18:59, 12 July 2026 (UTC)

I understand. And it's important to make sure that the experimental evidence is accurately represented. Rest assured that all of the people interested in ensuring balance and accuracy on Wikipedia are individual people representing themselves. Let's get to work Zefr! Together, we can all make sure the information on this and other pages is accurate, healthful, and useful. Serio31 (talk) 19:10, 12 July 2026 (UTC)

Are Serio31, IP 2026-38344-69, Awradloff, Hadis.Askari, Shriya Swamy, and Ischyros7 a collegial group discussing and planning edits to this article together offline? Zefr (talk) 19:21, 12 July 2026 (UTC)

1) This study found no evidence of damage/repair or inflammation in any structural soft-tissue disease in the human body:

2) The common misperception that painful activities cause damage is associated with greater symptom intensity: https://pmc.ncbi.nlm.nih.gov/articles/PMC8747479/

3) Statements that stigmatize or demonize use of the body are harmful to health and need careful consideration.

4) Pitcher's elbow is part of valgus extension overload osteoarthritis. There are aspects of pathophysiology at the flexor prontator mass. But this is distinct from idiopathic enthesopathy of the flexor pronator mass origin from the medial epicondyle in middle age. https://pubmed.ncbi.nlm.nih.gov/12860556/

5) The pathophysiology section of this review notes the lack of inflammation. It recapitulates speculation about enthesopathies in general being from "overuse," but it does not provide evidence. The weight of evidence points to idiopathic, transiently symptomatic, mucoid degeneration of middle age. Serio31 (talk) 14:45, 12 July 2026 (UTC)

Note that an editorial review of the Ring study specifies that mucoid degeneration in the elbow is a "story about aging". As golfer's elbow occurs across age groups, it is unlikely that "degeneration" applies in young people. Another letter to the editor concerning the Ring report stated that tendinopathy is a "failed healing response", which would be consistent with an overuse injury.

Attempting to explain a tendinopathy with the alternate explanation of "mucoid degeneration" as done in Serios31's edit Special:Diff/1363802341 is a synthesis from other sources to draw a preferred conclusion, i.e., WP:SYNTH.

No source supporting mucoid degeneration has yet been provided to specifically explain golfer's elbow.

Further, the existing description based on StatPearls and similar reviews describing golfer's elbow as overuse causing medial common flexor tendinopathy and strain of the pronator teres muscle attachment has not been refuted with WP:BMI reviews. Zefr (talk) 19:51, 12 July 2026 (UTC)