Part of Golfer's elbow

Golfer's elbow or a UCL injury

Golfer's elbow and a UCL injury sit in the same place, the inside of the same elbow, so how much it hurts separates nothing. Golfer's elbow is the tendon where the forearm muscles anchor to the bony lump on the inner elbow. The ulnar collateral ligament lies underneath, holding two bones together: OrthoInfo describes it as connecting the upper arm bone to one of the forearm bones, and names its front band as the most important structure keeping the elbow stable for an overhead thrower. What separates them is the history, what the arm can no longer do, and who tends to get them. OrthoInfo describes UCL pain on the inside of the elbow during throwing and overhead activities, or after a throwing session, with loss of velocity and accuracy, and in some people a pop or a sudden snap with immediate pain. Golfer's elbow usually builds over weeks to months and shows itself on gripping and lifting rather than on the throw. This page gives you what you can genuinely observe and no self-test, because neither condition can be ruled in or out at home. A pop on the inside of the elbow during a throw needs checking the same day.

Warning signs, and when to get help

Golfer's elbow or a UCL injury: what the difference actually is

Two structures, one on top of the other, on the inner side of the same elbow. Golfer's elbow comes from the tendon where the forearm muscles fasten onto the bony lump you can feel there (the medial epicondyle). A tendon fastens muscle to bone, so it is loaded when the muscle pulls, which on this side of the elbow means gripping, bending the wrist and turning the palm down. The golfer's elbow program covers that condition end to end, and where golfer's elbow hurts, and where it spreads maps the pain itself.

The ulnar collateral ligament has a different job. A ligament fastens bone to bone, and OrthoInfo, the patient site of the American Academy of Orthopaedic Surgeons, describes this one as connecting the upper arm bone to one of the forearm bones, with its front band the most important structure providing stability for an overhead throwing athlete.

So the two hurt in the same spot for different reasons. Pulling hard with the forearm muscles loads a tendon. Levering the joint open loads a ligament, and OrthoInfo describes that force in throwing precisely: a repeated valgus force on the elbow, worst during the late cocking phase, and it adds that the kind of bending throwing a baseball, softball or javelin requires is not a natural force for the elbow in the first place.

What does a UCL injury feel like?

Here is what OrthoInfo lists on its own UCL page.

Pain on the inside of the elbow while throwing or reaching overhead, or after a throwing session. It adds that the pain can become noticeable at rest as well.
Not being able to compete at the same level.
Less velocity and less accuracy. It names a drop in velocity during throws separately.
Occasionally, tingling in the little and ring fingers.
In some people, a pop or a sudden snap in the elbow, with immediate pain at that moment.

People arrive at that list by either of two routes, and OrthoInfo names both on the same page: a single injury, or gradual wear from repeated stress. These injuries happen most often in overhead throwing athletes, and although pitchers are the group named most, OrthoInfo also lists track and field athletes, gymnasts, volleyball players and position players in baseball and softball.

Now read that beside golfer's elbow and the overlap is plain. Pain on the inside of the elbow is shared. Tingling in those two fingers is shared. What is not shared is a throw that has lost its speed, or an arm that will not compete, which is a complaint about function rather than about pain, and it is the part of the list a sore tendon does not usually produce.

Does it hurt when you throw, or when you grip?

This is the most useful question you can answer about your own elbow, and it is a question about the task rather than about how much it hurts.

Golfer's elbow shows itself when the hand grips while the wrist works. Konarski and colleagues (2023) name grasping and lifting objects among the provocations, and describe pain on resisted wrist flexion and pronation as the most sensitive examination finding. OrthoInfo describes an onset that is gradual, getting worse over weeks to months. The complaint people arrive with is a bag, a key, a kettle or a handshake.

A UCL complaint is tied to the throw or the overhead action, and it usually arrives with something about performance attached. A player can often say which phase of the motion it bites in, or that the ball is not coming out the same way.

Neither answer settles it, and here is why that is not a cop-out. A thrower loads the ligament and the tendon with the same action, and the person most likely to have one is the person most likely to have both. Treat your answer as the single most useful thing to say at the appointment, not as a result.

Why tingling does not separate them

Because both OrthoInfo pages name the same two fingers. Its golfer's elbow page says some people also develop numbness and tingling in the ring and little fingers, and its UCL page lists occasional tingling in the little and ring fingers. The ulnar nerve runs behind the bony lump both structures sit under, so irritation in that corner can send symptoms into the hand whichever structure started it.

A third condition owns that symptom outright. Cubital tunnel syndrome is pressure on the nerve itself at the elbow, and golfer's elbow or a trapped nerve at the elbow is the page for that comparison. Tingling in those fingers tells you the nerve is involved somehow. It does not tell you which of the three is driving it, and it is on the warning list below with how soon each pattern needs attention.

Can you have both at once?

Yes, and the sources treat that as ordinary rather than unlucky. Konarski and colleagues (2023) list a ligament injury among the things that get confused with golfer's elbow, and OrthoInfo's golfer's elbow page says ultrasound or MRI is sometimes used to exclude conditions that look similar, naming an injury to the ulnar collateral ligament as one of them. A test exists in the pathway precisely because the two are hard to separate in a room.

The practical consequence is about order, not about labels. If you throw and your inner elbow hurts, the ligament is checked before the tendon is loaded. The golfer's elbow program says this of itself: it is written for a tendon managed without surgery, and a sudden ligament injury of the kind throwers get with a pop needs assessing first, with the rehab set by the surgeon or physio.

The pop that needs the same day, and why a young thrower is different

A pop or a snap on the inside of the elbow during a throw is the one piece of history on this page that changes what you do today rather than what you call it. The warning list below carries the full line, including the elbow that feels loose and the throw you could not finish.

In a thrower who is still growing, that same pop has a second explanation. OrthoInfo's page on throwing injuries in the elbow in children explains that the growth plate on the inside of the elbow is weaker than the ligaments and tendons pulling on it, that the pull can tear tiny bone fragments away with the soft tissue, and that it can disrupt normal bone growth and leave a deformity. That page lists what should stop a child throwing then and there: elbow pain or swelling, especially with a drop in throwing velocity, feeling a pop, numbness or tingling in the arm, restricted movement, and locking. It is explicit about the cost of ignoring the pain and playing through it.

That is why the warning line sends a child or teenager somewhere that can X-ray the same day rather than to an appointment, and why the golfer's elbow program is written for adults and says so.

What an examination and a scan add

The tests for this are clinician tests done in context, and this page does not hand you one to try. OrthoInfo describes the UCL examination: tenderness along the inside of the elbow, range of movement, strength, and stress tests that put the elbow in a throwing position, which it names as the moving valgus stress test and the milking maneuver. Hand strength and sensation are checked and the nerve is tapped, for the reason the last section gives.

Imaging has a catch worth knowing before anyone tells you an X-ray was normal. X-rays do not show the collateral ligaments, says OrthoInfo, so they can look clear with a damaged ligament underneath; what they can show is calcium deposits or small bone spurs. An MRI shows the soft tissue, and an MRI arthrogram, done with contrast dye, is used where a small partial tear is the question. On the tendon side, OrthoInfo uses X-rays to exclude a fracture or arthritis, ultrasound or MRI to judge the tendon or exclude look-alikes, and nerve studies where nerve compression is in the picture.

Which of those you need is a decision for the person examining you, and it depends on how clear your pattern is and on what is being planned.

What to do while you wait for it to be looked at

Stop the thing that produced it. For a suspected UCL injury OrthoInfo is blunt about what rest means: stopping all overhead and throwing activities rather than easing off. Do not start a tendon loading program on a suspicion either, for the reason the section on having both sets out.

Four things are worth writing down before the appointment, because they are the parts nobody can reconstruct later. How it started, and whether there was a single moment. Whether you heard a pop or felt a snap. Whether your throwing or serving has lost speed, accuracy or control. And whether anything in the hand has been numb, tingling or weak since.

The NHS puts elbow and arm pain that has lasted more than a few weeks in front of a GP, and sends severe arm pain that is hard to move through, an injury where you heard a snap or the arm changed shape, and an arm that tingles or feels numb to urgent care or an emergency department. If the elbow swelled or bruised after the injury, swelling, lumps and bruising at the elbow covers what that can mean, and if what you have turns out to be a broken bone, elbow fracture rehab is the page for the recovery.

Related exercise programs

Warning signs

Get emergency help now

Emergency: any sign of a stroke, even if it goes away. That means a face that droops on one side, an arm you cannot lift or keep up, slurred or muddled speech, weakness or numbness on one side of your body or face, sudden blurred vision, double vision or loss of sight, trouble swallowing, sudden dizziness with unsteadiness or falling over, a sudden severe headache, or a sudden fall where your legs give way but you do not black out (a drop attack). Call emergency services straight away.
Chest pain or tightness, which may spread to your arm, neck or jaw, or shoulder or arm pain that comes with shortness of breath, sweating or feeling sick. This can be a heart attack. Call emergency services straight away.
Emergency: after a fall or a blow to the elbow, the arm has changed shape or sits at an odd angle, a bone is showing through the skin, a cut is bleeding heavily, or the hand has gone numb or tingly or turns cold, pale or blue. Go to an emergency department or call emergency services straight away, and do not drive yourself.
Your arm, hand or fingers turn cold, pale, blue or gray compared with the other side. Call emergency services or go to an emergency department straight away, and do not drive yourself. The blood supply to the arm may be blocked.
The pain started with a fall or a blow to the elbow, and the pain is severe, you heard a snap, the elbow is swollen or bruised, or you cannot bend or straighten the arm. Go to an urgent care center or emergency department the same day.
A sudden pop or snap at the front of your elbow, sudden sharp pain there, or the muscle at the front of your upper arm bunches up or changes shape. Stop and go to an urgent care center or emergency department the same day, even if you can still bend the elbow, as this can be a torn biceps tendon.

Get help today

Same day: you throw, and you heard a pop or felt a sudden snap on the inside of the elbow, followed by pain, a throw you could not finish, or an elbow that feels loose or unstable. Stop throwing straight away and get the elbow checked the same day, because the ligament on the inner side of the elbow (ulnar collateral ligament) may be injured, and in a thrower who is still growing the same pop can be a piece of bone pulled off the inside of the elbow. If the thrower is a child or teenager, go to an urgent care center or emergency department the same day, because that needs an X-ray.
Pins and needles in your arm or hand that do not go away after you stop, or part of your arm or hand goes numb. Get medical advice the same day. If one side of your face or body suddenly goes numb or weak, or your speech becomes slurred or muddled, call emergency services, even if it goes away.
The elbow is hot, red and swollen, or you have elbow pain with a high temperature or feel hot, cold or shivery. Get medical advice the same day, and go to an emergency department if you feel very unwell. This can be a sign of infection in the joint, which needs treatment quickly.
The pain is there at night or at rest and keeps getting worse. If you are being treated for cancer now, contact your cancer team the same day.

Book an appointment

Your hand is getting weaker, you keep dropping things, your fingers feel clumsy, or the web of muscle between your thumb and index finger, or the little finger side of your palm, looks thinner or hollow compared with your other hand. This can mean the nerve behind the elbow is being squeezed. See a doctor within a few days. If the weakness is getting worse from day to day, get medical advice the same day.
You have numbness, tingling or pins and needles in your hand or fingers, most often the ring and little fingers. Stop any exercise that brings it on and see a physio or doctor. For the ring and little fingers, OrthoInfo advises seeing a doctor if the symptoms are severe, or if milder symptoms have lasted more than 6 weeks.
Pain spreads from your neck down the arm, or turning or tilting your neck brings on the arm pain. See a physio or doctor, because the problem may be in the neck rather than the elbow.
The elbow locks, catches or keeps giving way in everyday use, without a pop from throwing. See a physio or doctor rather than pushing on with the exercises.
The pain is there at night or at rest and keeps getting worse. If you have had cancer, now or in the past, or are losing weight without trying, see your doctor sooner, within a day or two, and mention it. This applies even if the pain is not getting worse.
The pain is there at night or at rest and keeps getting worse. See your doctor within a few days.

Common questions

What is the difference between golfer's elbow and a UCL tear?

The structure, and what it is for. Golfer's elbow is a tendon problem where the forearm muscles anchor to the inner elbow, and a tendon is pulled on by its muscle, so gripping and bending the wrist are what set it off. The ulnar collateral ligament holds two bones together, and OrthoInfo names its front band as the most important structure keeping the elbow stable for an overhead thrower, so the throwing action is what stresses it. A tear in it is a failure of that restraint, which is why the complaints that go with it are about throwing rather than gripping: OrthoInfo lists loss of velocity and accuracy, and an inability to compete at the same level. Neither of those tells you which one you have, and an examination is what settles it.

Can you golf with a torn UCL?

That is a question for the clinician who has examined your elbow, and the honest answer here is that the starting point is not playing. For a UCL injury OrthoInfo says treatment begins with rest, ice and elevation, and is specific about what rest means: stopping all overhead and throwing activities. Whether you play again, when, and in what form depends on how much of the ligament is involved and what was found on examination and imaging, and that decision belongs with the surgeon or physio who made it. Our golfer's elbow program does not cover it, because the program is written for a tendon managed without surgery.

Is golfer's elbow the same as a Tommy John injury?

No. Tommy John is the common name for reconstruction of the ulnar collateral ligament, and OrthoInfo explains the name: the operation was developed by Dr. Frank Jobe and first performed on a major league pitcher called Tommy John. So the phrase describes an operation on the ligament, which is a different structure from the tendon golfer's elbow comes from. Someone with golfer's elbow is not a candidate for that operation, and the two problems overlap only in where they hurt.

Can golfer's elbow get worse?

It can. OrthoInfo describes the symptoms developing gradually and typically growing worse over weeks to months, and says that over time the tendon can fray or tear. What matters more than worse, though, is different: a pop on the inside of the elbow, an elbow that feels loose, numbness or tingling that stays after you stop, or a grip that is weakening rather than sore. Each of those has its own line on the warning list at the foot of this page. For how long this condition usually takes, the golfer's elbow program answers that from the sources it cites.

References

American Academy of Orthopaedic Surgeons. Ulnar collateral ligament (UCL) injury. OrthoInfo. https://www.orthoinfo.org/en/diseases--conditions/ulnar-collateral-ligament-ucl-injury/
American Academy of Orthopaedic Surgeons. Throwing injuries in the elbow in children. OrthoInfo. https://www.orthoinfo.org/en/diseases--conditions/throwing-injuries-in-the-elbow-in-children/
American Academy of Orthopaedic Surgeons. Medial epicondylitis (golfer's elbow). OrthoInfo. https://www.orthoinfo.org/en/diseases--conditions/medial-epicondylitis-golfers-elbow/
Konarski W, Poboży T, Poboży K, Domańska J, Konarska K. Current concepts of natural course and in management of medial epicondylitis: a clinical overview. Orthopedic Reviews. 2023;15. https://doi.org/10.52965/001c.84275
NHS. Elbow and arm pain. Page last reviewed 26 January 2024. https://www.nhs.uk/symptoms/elbow-and-arm-pain/

Written and checked by the PocketPhysio editorial team. Last updated 2026-10-18.

This page is general education, not a diagnosis or a personal treatment plan. See a physiotherapist or doctor for advice about your own situation.