Golfer’s Elbow: Occupational Therapy Treatment

If you’re seeking treatment for golfer’s elbow (especially occupational therapy), we want you to be as informed as possible—so we can truly partner to create the best course of treatment for YOU.

In occupational therapy, we tend to work from “menus” of evidence-based assessments and treatments. This gives us the flexibility to meet the specific needs of each patient. Below, you’ll see the assessment and treatment options your therapist may use, along with the evidence that supports them.

If your golfer’s elbow symptoms are new (i.e., they began within the last 2 weeks) and mild, you may want to first try some of the recommended exercises/stretches at home. (We’ve also included self-assessments to help you determine how golfer’s elbow is impacting your quality of life—and thus, decide whether it’s time to seek out therapy.)

Please note that this page is for educational purposes and should not substitute advice from your medical provider. At the bottom of this page, you’ll find therapists near you who can support you in your golfer’s elbow treatment. 

A quick note on why to pursue therapy first

This post focuses on therapy treatment for golfer’s elbow. As with many conditions, conservative treatment like therapy is typically the first course of care. That is because therapy is safer and much more cost-effective than invasive options like surgery (which come with a host of risks and potential complications—not to mention long recovery times). 

Surgery for golfer’s elbow costs around $6,000–$7,000, whereas therapy typically costs $75–$150 per session. 

The number of therapy sessions needed will vary based on your initial evaluation. In general, the higher your initial disability score, the more frequent your sessions. Ultimately, our goal as therapists is to get you to a point where you can self-manage your condition with a personalized prescribed program. (Read more about this in the discharge section below.)

Therapist-recommended assessments for tennis elbow

As you can see below, evaluating a case of golfer’s elbow involves much more than assessing the elbow itself. Often, other parts of the arm are involved—even when the pain seems localized to the elbow. The other benefit of a thorough examination is that it can help discern whether other diagnoses are involved. 

Assessments also serve as a point of comparison to track your progress and response to treatment. (Without an accurate and thorough baseline, it can be hard to tell how much the interventions are helping!) Your therapist may perform certain assessments at various intervals over the course of therapy.

Core Occupational Therapy Outcome Measures

Here are two metrics that many OTs collect with every patient. You’ll see that our top assessment focuses on your quality of life. At the end of the day, this is the most important outcome for us. We want our treatments to have a noticeable impact on your day-to-day life. 

• Quality of Life Patient Reported Outcome Measure – The PROMIS Global 10
• Grip Strength

Golfer’s Elbow Specific Assessments

• Patient Specific Functional Scale (PSFS)¹
• QuickDASH ²
• Upper Quarter Screen
  • Dermatomes, Myotomes and Reflexes
• Neurological Assessment → Bilateral Ulnar Nerve Tension Tests (ULTT3)
• Elbow Flexion Test for Cubital Tunnel
• Range of Motion (ROM)
  • Cervical ROM ³
  • Shoulder ROM all planes
  • Elbow ROM all planes
  • Forearm ROM all planes
  • Wrist ROM all planes
• Strength Testing
  • Grip Strength bilaterally ^4,5
    • Grip Dynamometer costs roughly $280 on Amazon.
  • Manual Muscle Testing (MMT) bilaterally
    • Shoulder all planes ^6,7
    • Elbow all planes
    • Forearm all planes
    • Wrist all planes
    • Finger flexion
• Special Tests → Note that these all have poor sensitivity and specificity, or no information on diagnostic accuracy at all.^8,9
  • Polk’s Test ¹⁰
  • Medial Epicondylalgia Test 
  • Resisted testing ^12,13
• Differential Diagnoses
  • C8–T1 nerve root compression
  • Radiculopathy Cluster – Cubital Tunnel Syndrome
  • Ulnar collateral ligament of the elbow
  • Posterolateral Rotary Instability (PLRI) → Usually the result of a FOOSH (fall on outstretched hand)
  • Arthritis

Setting goals for golfer’s elbow therapy

Therapy only works when there is buy-in from the patient. It is important that you work with your therapist to set treatment goals that truly reflect what’s important to you. 

Therapy treatment interventions for golfer’s elbow

After a thorough evaluation and goal-setting process, it is time to start making progress. Below are treatment interventions that can be implemented as part of a holistic therapy program. 

• Aerobic Warm Up for endorphin release
• Dynamic Flexibility using Mill’s Stretch for the elbow and shoulder
• Manual Therapy
  • Instrument Assisted Soft Tissue Mobilization (IASTM) ¹⁶
    • Recommended Multi-Tool from HawkGrips can be used on full body
      • Cost: $595
  • Joint Mobilization with movement of the Elbow
  • Dry Needling ¹⁷
  • Myofascial Decompression (cupping)²⁶
• Conditioning, Aerobic, and Strengthening Exercises → According to the ACOEM Practice Guidelines for Elbow Disorders, strength and conditioning exercises are superior to static stretching in the absence of major range of motion deficits.¹⁸
  • Eccentric Exercises for involved muscles, including wrist flexion, ulnar deviation, pronation, and elbow flexion^18,19
  • Modified Tyler Twist Exercise ²⁰
  • Scapular stabilization
  • Rotator Cuff strengthening
  • Core Exercises
• Self-Care Home Management and Activity Modification
  • Lifting mechanics
  • Ergonomic positioning and setup
• Incorporation of Functional Tasks based on patient goals and affected ADLs
• Ulnar Nerve Glides/Flossing (if indicated)¹³
• Orthosis Use (may be appropriate in more severe cases)¹⁸
• Additional Pain Management Tools
  • Kinesio Tape ²¹
  • Rigid taping ²²
  • Modalities (heat, ice, ultrasound, iontophoresis)
  • Biofreeze
  • Salonpas topical patches
• Patient Education on Disease Pathology ^{23, 24}
• Home Program

Discharge suggestions

Every individual is unique, and your response to therapy will also be unique. For some, it is not appropriate to continue therapy until the condition completely resolves. For others, pain may resolve before the entire rehabilitation program is established. In the latter case, it is important to remember that pain is a symptom—not a diagnosis—and that strength and endurance deficits must be addressed to prevent recurrence.

Thus, we recommend that you: 

• Follow your therapist’s discharge recommendations to maintain progress made in therapy. 
• Continue to use self-management and empowerment strategies to control any remaining symptoms.
• Follow a home exercise program with a proximal posture component for an additional 3 months to help establish good habits for body mechanics, even if you feel like you are back to 100%.
• Consult your therapist immediately if your condition worsens, or if you continue to have difficulty with your daily activities after 3 months.

Choosing a therapist for golfer’s elbow

Both occupational therapists and physical therapists can treat golfer’s elbow. In less severe cases, a generalist therapist from either discipline should be able to help you. 

It is also important to note that both OTs and PTs can pursue advanced certification as a Certified Hand Therapist. To achieve this rigorous specialization of the hand, wrist, elbow, and shoulder, therapists must log 4,000 hours of experience treating the upper extremity and pass a formal examination. They also must complete various recertification requirements every 5 years. 

Below, you can find occupational therapy professionals who have tagged “hand therapy” as a focus area. The ones with a “CHT” in their credentials are Certified Hand Therapists.

Conclusion

Hopefully, this article has helped you understand what therapy for golfer’s elbow entails, and whether you are a good candidate! 

This article is updated once per month based on new research. If you have any research you would like us to consider for our next update, please drop it in the comments! 

Therapists who would like more fleshed-out information on golfer’s elbow treatment can join us as members of the OT Potential Club. 

References

Here’s the science that backs the assessment and treatment outlined above. 

1. Stratford, P., Gill, C., Westaway, M., & Binkley, J. Assessing disability and change on individual patients: a report of a patient specific measure. Physiotherapy Canada. 1995.
2. Polson K, Reid D, McNair PJ, Larmer P. Responsiveness, minimal importance difference and minimal detectable change scores of the shortened disability arm shoulder hand (QuickDASH) questionnaire. Man Ther. 2010. 
3. Sukari AAA, Singh S, Bohari MH, Idris Z, Ghani ARI, Abdullah JM. Examining the Range of Motion of the Cervical Spine: Utilising Different Bedside Instruments. Malays J Med Sci. 2021. 
4. Mathiowetz V, Kashman N, Volland G, Weber K, Dowe M, Rogers S. Grip and pinch strength: normative data for adults. Arch Phys Med Rehabil. 1985.
5. Taylor SA, Hannafin JA. Evaluation and Management of Elbow Tendinopathy. Sports Health. 2012.  
6. Ellenbecker TS, Pieczynski TE, Davies GJ. Rehabilitation of the Elbow Following Sports Injury. Clinics in Sports Medicine. 2010
7. Morrey, BF. The Elbow and its Disorders. 2nd ed. Philadelphia, PA: Saunders; 1993.
8. Valdes K, LaStay P. The value of provocative tests for the wrist and elbow: A literature review.  Journal of Hand Therapy. 2013. 
9. MacDermid JC, Michlovitz SL. Examination of the Elbow: Linking Diagnosis, Prognosis, and Outcomes as a Framework for Maximizing Therapy Interventions. Journal of Hand Therapy. 2006.
10. Polkinghorn BS. A novel method for assessing elbow pain resulting from epicondylitis. Journal of Chiropractic Medicine. 2002;1:117-121.
11. Zwerus EL, Somford MP, Maissan F, Heisen J, Eygendaal D, Van Den Bekerom MP. Physical examination of the elbow, what is the evidence? A systematic literature review. British journal of sports medicine. 2018 Oct 1;52(19):1253-60.
12. 1Myers BA, Hanks J. Positive clinical tests for medial epicondylalgia are more common than tests for lateral epicondylalgia in recreational pickleball players: A cross-sectional study. Journal of Hand Therapy. 2025.
13. Gabel, G T; Morrey, B F. Operative treatment of medical epicondylitis. Influence of concomitant ulnar neuropathy at the elbow. The Journal of Bone & Joint Surgery. 1995. 
14. Gehlsen GM, Ganion LR, Helfst R. Fibroblast responses to variation in soft tissue mobilization pressure. Med Sci Sports Exerc. 1999. 
15. Davidson CJ, Ganion LR, Gehlsen GM, Verhoestra B, Roepke JE, Sevier TL. Rat tendon morphologic and functional changes resulting from soft tissue mobilization. Med Sci Sports Exerc. 1997. 
16. Loghmani MT, Warden SJ. Instrument-assisted cross-fiber massage accelerates knee ligament healing. J Orthop Sports Phys Ther. 2009. 
17. Shariat A, Noormohammadpour P, Memari AH, Ansari NN, Cleland JA, Kordi R. Acute effects of one session dry needling on a chronic golfer’s elbow disability. J Exerc Rehabil. 2018.
18. Hegmann KT, Hoffman HE, Belcourt RM, et al. ACOEM practice guidelines: elbow disorders. J Occup Environ Med. 2013. 
19. Andres BM, Murrell GAC. Treatment of Tendinopathy: What Works, What Does Not, and What is on the Horizon. Clinical Orthopaedics and Related Research®. 2008.
20. Tyler TF, Nicholas SJ, Schmitt BM, Mullaney M, Hogan DE. Clinical outcomes of the addition of eccentrics for rehabilitation of previously failed treatments of golfers elbow. Int J Sports Phys Ther. 2014
21.  Zhong Y, Zheng C, Zheng J, Xu S. Kinesio tape reduces pain in patients with lateral epicondylitis: A meta-analysis of randomized controlled trials. International Journal of Surgery. 2020. 
22. Luco AM, Day JM, Vincent JI, Macdermid JC, Fedorczyk J, Grewal R, Martin RL. Lateral Elbow Pain and Muscle Function Impairments. J Orthop Sports Phys Ther. 2022.
23. Moseley L. Combined physiotherapy and education is efficacious for chronic low back pain. Aust J Physiother. 2002;48(4):297-302. doi: 10.1016/s0004-9514(14)60169-0. PMID: 12443524. 
24. Louw, Adriaan & Zimney, Kory & Puentedura, Emilio & Diener, Ina. (2016). The efficacy of pain neuroscience education on musculoskeletal pain: A systematic review of the literature. Physiotherapy Theory and Practice. 32. 1-24. 10.1080/09593985.2016.1194646.  
25. Goodman CC. Screening for Medical Problems in Patients with Upper Extremity Signs and Symptoms. Journal of Hand Therapy. 2010. 
26. Rozenfeld E, Kalichman L. New is the well-forgotten old: The use of dry cupping in musculoskeletal medicine. J Bodyw Mov Ther. 2016 Jan;20(1):173-178. doi: 10.1016/j.jbmt.2015.11.009. Epub 2015 Dec 1. PMID: 26891653.

Additional References:

Mohammadian M, CHOOBINEH A, HAGHDOOST A, HASHEMINEJAD N. Normative Data of Grip and Pinch Strengths in Healthy Adults of Iranian Population. Iran J Public Health. 2014.

OT Potential does not endorse any treatments, procedures, products, or therapists referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking medical advice should consult their medical provider.