Golfer’s Elbow Massage and Eccentric Exercises: What Helps at Each Stage

Yes, massage can help golfer’s elbow. It can reduce pain, ease tension and guarding through the wrist-flexor and pronator muscles, improve comfortable movement and make rehabilitation exercises easier to tolerate. The type and intensity of treatment matter, however: a newly irritated elbow should not be treated like a persistent tendon problem that has been present for months.

Eccentric exercise also deserves a central place in golfer’s-elbow rehabilitation. Many people remain reasonably functional when the forearm muscles shorten to produce force, but have poorer control or tolerance when those same muscles must lengthen under load. Slow, controlled eccentric training targets that missing part of the movement.

The practical approach is therefore not massage or exercise. Massage, heat or ice, movement, load modification and eccentric strengthening can work together, with the balance changing according to how reactive the elbow is.

This guide focuses specifically on golfer’s elbow and pain arising from the flexor-pronator side of the forearm. For a broader look at tennis elbow, bursitis, arthritis, nerve-related symptoms and other possible causes, read our guide to when massage therapy may help elbow pain.

Golfer’s elbow is the familiar name for medial epicondylitis or medial elbow tendinopathy. It affects the common tendon where several wrist-flexor and forearm-pronator muscles attach near the bony prominence on the inside of the elbow.

The name is misleading because golf is only one possible trigger. Repetitive or forceful gripping, lifting, throwing, racquet sports, weight training, tool use and other repeated wrist or forearm movements can all overload the same region.

Typical symptoms may include:

• Tenderness on or just below the inside of the elbow
• Pain when gripping, lifting or carrying
• Pain with resisted wrist flexion or turning the palm downward
• Aching that extends into the inner forearm
• Reduced grip tolerance, particularly during repeated activity

These findings may be consistent with golfer’s elbow, but they do not prove that every case of medial elbow pain is a tendon problem. The ulnar nerve, ulnar collateral ligament, flexor-pronator muscles and the elbow joint can produce overlapping symptoms. Mayo Clinic’s diagnostic guidance and the Hospital for Special Surgery overview both emphasize history, physical examination and further investigation when symptoms are severe, atypical or persistent.

An irritated tendon rarely exists in isolation from the muscles that load it. The wrist flexors and pronators may become tight, tender and guarded, particularly when a person continues gripping, lifting or working around the pain. That increased resting tension can make ordinary movement more uncomfortable and reduce tolerance for exercise.

Massage can address that muscular part of the presentation. Depending on the stage and the person’s response, treatment may include broad warming work through the forearm, slower longitudinal techniques along the flexor-pronator muscles, trigger-point compression, movement with pressure and, in persistent cases, carefully dosed cross-fibre or instrument-assisted techniques.

Heat, massage and movement can also increase local circulation and make a stiff forearm feel more mobile. The immediate result is often practical rather than abstract: gripping feels easier, the resting ache decreases and the person can move or perform their exercises with less guarding.

Massage should still be dosed rather than attacked. More pressure is not automatically more effective, and a treatment that leaves the tendon substantially more painful the following day was probably too aggressive for its current level of irritability.

A published case report involving a recreational squash player combined cross-friction massage, instrument-assisted soft-tissue work, trigger-point treatment and daily eccentric exercise, with complete symptom resolution reported at long-term follow-up. Because several interventions were used together, the report cannot isolate the contribution of massage, but it does illustrate how manual treatment and progressive loading can be integrated rather than treated as competing approaches.

A small comparative study also reported greater improvements when massage was combined with therapeutic ultrasound than with massage alone. The study does not establish ultrasound as necessary treatment, but it reinforces a useful point: persistent tendinopathy is often managed more effectively through an appropriate combination of interventions than by relying on one technique in isolation.

Golfer’s elbow does not move through identical stages on an identical schedule. A problem that began last week may already tolerate movement well, while a tendon that has been troublesome for six months can become highly reactive again after one demanding day.

The current presentation matters more than an arbitrary week number.

This stage-sensitive approach follows the same basic principle discussed in our broader guide to choosing massage techniques by the stage of sports-injury recovery, but applies it specifically to the medial elbow.

Heat and ice are not opposing teams, and neither one needs to be used at every stage.

Ice is often most useful when the elbow has been newly aggravated, feels hot or highly reactive, or is painful after activity. It may reduce pain enough to let the arm settle. Mayo Clinic includes short periods of ice or gentle ice massage among its self-care options for golfer’s elbow.

As the acute irritability decreases, heat often becomes more useful. A warm compress, heated treatment or several minutes of comfortable movement before massage and exercise can increase local circulation, reduce the sense of stiffness and make the forearm easier to load. Ice can still be used during a later painful flare if it feels better.

Clinical note from Chantal Milot, RMT: My usual preference is ice during the acute or highly painful stage, followed by heat as the condition settles. For a persistent, stiff forearm, heat combined with movement and massage can help tremendously. Ice remains useful when pain flares. The deciding factor is how the elbow is presenting and how it responds—not a rigid rule that one is always correct and the other is always wrong.

A concentric contraction occurs when a muscle shortens as it produces force. An eccentric contraction occurs when the muscle remains active while lengthening and controlling a load.

For the wrist flexors, lifting the palm toward the forearm is the concentric phase. Slowly lowering the hand back toward wrist extension is the eccentric phase. Someone may still be able to grip, lift or complete a wrist curl, yet lack smooth control or sufficient tolerance during that lowering phase.

This is why eccentric work is more than generic strengthening. It trains the flexor-pronator muscle-tendon unit to absorb and control force while lengthening—the exact demand that is often poorly tolerated in persistent golfer’s elbow.

The clinical research supports this emphasis:

• A prospective study of adults with chronic medial epicondylalgia found that 12 weeks of eccentric training reduced pain and increased grip strength.
• A clinical study involving people whose symptoms had not improved sufficiently with previous treatment reported markedly better outcomes after an eccentric wrist-flexor exercise was added to the rehabilitation program.
• A 2026 systematic review of eccentric exercise for medial epicondylitis concluded that eccentric exercise can reduce pain and improve function, particularly when incorporated into a broader rehabilitation approach.

Eccentric wrist-flexor training can therefore be described as a central component of rehabilitation, while still being adjusted to the person’s irritability, control and activity demands.

This exercise isolates the controlled lowering phase so the affected arm does not need to perform the more comfortable lifting phase repeatedly.

1. Sit beside a table with the affected forearm supported and the palm facing upward. Let the hand extend just beyond the table edge.
2. Hold a very light weight. A small dumbbell, soup can or similarly manageable object is enough at the beginning.

3. Use the unaffected hand to help lift the affected wrist upward.

4. Remove the assisting hand and slowly lower the weight with the affected wrist over approximately three to five seconds.

5. Use the unaffected hand to return the wrist to the starting position. The affected side should perform the controlled lowering rather than repeatedly lifting the weight back up.

A common starting range is two to three sets of 10 to 15 controlled repetitions. The correct starting load may be extremely light. Smooth movement is more important than using a weight that turns the last several repetitions into a wrestling match.

Some mild, familiar tendon discomfort may occur during loading, but the exercise should not cause sharp pain, electrical symptoms or a major increase that persists through the day or into the following morning. If it does, reduce the weight, repetitions or frequency and reassess.

When the exercise becomes easy and remains well tolerated afterward, resistance can be increased gradually. Later rehabilitation may add controlled pronation, grip work, lifting and movements that resemble the person’s job, training or sport. More advanced options, such as a reverse twist with a flexible resistance bar, should still be performed with control rather than speed.

Eccentric training is most useful when it reflects what the person needs to regain. A golfer eventually needs to tolerate gripping and the forces of the swing; a weight-training client needs progressive pulling and lifting capacity; someone whose symptoms developed at work may need changes in tool use, workstation position, task rotation or grip intensity.

The Reverse Tyler Twist uses a flexible resistance bar to load the wrist flexors eccentrically. It was the specific exercise used in the 2014 clinical study of chronic medial epicondylosis discussed above. The setup matters because performing the twist in the opposite direction targets the wrist extensors and is generally used for tennis elbow rather than golfer’s elbow.

1. Hold the flexible bar vertically with the affected hand gripping the lower end. Keep the affected wrist flexed comfortably, with the palm facing inward toward you.
2. Grasp the other end with the unaffected hand. Twist the bar by flexing the

unaffected wrist while keeping the affected wrist flexed and still.

3. Bring both arms straight out in front of the body and extend the elbows while maintaining the twist in the bar.

4. Keep both hands holding the bar. Slowly allow the affected wrist to move from flexion into extension as the bar untwists over approximately three to five seconds. The unaffected hand maintains the setup while the affected wrist controls the release.

5. Reset the bar for the next repetition by using the unaffected wrist to create the twist again. The affected side should perform the controlled unwinding rather than actively creating the twist.

Begin with a lower-resistance bar and concentrate on a smooth, slow release. Three sets of 10 to 15 repetitions once daily is a practical range, with approximately 60 seconds of rest between sets. The published clinical protocol used three sets of 15 and an approximately five-second release, although the appropriate starting resistance and volume should still reflect the condition’s irritability.

Mild, familiar pulling or discomfort may occur, but sharp pain, electrical symptoms or pain that is clearly worsening are reasons to stop and reassess. The slow unwinding phase is the important part: it develops the affected wrist flexors’ control and load tolerance while they lengthen.

For a visual demonstration, watch this Reverse Tyler Twist tutorial. For a broader selection of progressive movements, see NHS Inform’s golfer’s-elbow exercises.

Eccentric training is most useful when it reflects what the person needs to regain. A golfer eventually needs to tolerate gripping and the forces of the swing; a weight-training client needs progressive pulling and lifting capacity; someone whose symptoms developed at work may need changes in tool use, workstation position, task rotation or grip intensity.

Gentle self-massage may help between appointments, particularly through the muscular part of the inner forearm. Support the arm with the palm facing upward and begin with slow strokes along the wrist-flexor muscles rather than immediately pressing as hard as possible into the bony attachment.

If you find a tender muscular band, apply tolerable pressure while slowly opening and closing the hand or moving the wrist. Persistent cases that tolerate pressure well may respond to a short bout of cross-fibre work near the tendon attachment, but this should not create a pronounced flare later that day or the following morning.

Stop self-treatment if pressure causes numbness, tingling, electrical pain into the hand or increasing weakness. Those symptoms may involve the ulnar nerve or another structure and are not a reason to massage more aggressively.

Treatment at Excelsior Integrative is based on how the elbow is presenting now rather than applying the same technique to every tendon complaint. An appointment may include a review of the aggravating activities, assessment of wrist and elbow movement, relevant strength or neurological testing and examination of the wrist-flexor and pronator muscles.

Massage may be directed through the forearm muscles and other areas contributing to the person’s symptoms or workload. Heat, movement and home exercise may be incorporated when appropriate. For a persistent condition that tolerates more focused treatment, Massage Therapy + Heated IASTM may be considered. Massage Therapy + Medical Acupuncture is another option when provided by an appropriately trained RMT and suited to the client’s presentation and treatment goals.

The aim is not to force the elbow through the same protocol at every visit. It is to reduce pain and guarding, improve comfortable movement and progressively restore the eccentric control and load tolerance required for the client’s actual activities.

For general information about appointments and our RMTs, visit our massage therapy service page. If you are booking because of elbow pain, include that information with the appointment so the therapist knows what you would like assessed.

Book an appointment at our Yonge and Eglinton clinic

This article provides general information and does not replace an individualized assessment or medical advice.

• Golfer’s elbow: Diagnosis and treatment — Mayo Clinic
• Golfer’s elbow — Hospital for Special Surgery
• Medial epicondylalgia treated by eccentric exercise
• Clinical outcomes of adding eccentric exercise for chronic medial epicondylosis
• Eccentric exercise therapy for medial epicondylitis: 2026 systematic review
• Conservative management of medial epicondylosis using manual therapy and eccentric exercise: case report
• Massage therapy with and without therapeutic ultrasound in medial epicondylitis
• About Registered Massage Therapists — CMTO