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SATURDAY DEEP DIVE: THE EQUIPMENT
Part 1 recommended the TheraBand FlexBar. Today we cover the full landscape, starting with the item that is not on most people's list and should be at the top of it.
SIM60 receives no commissions or affiliate compensation for any equipment referenced in this issue. All mentions are for illustration purposes only.
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THE ELBOW HEALTH STACK
TOOL 1: YOUR GOLF GRIPS
For golfers, grip size and grip condition affect medial elbow load more than any rehabilitation product you can buy. A grip that is too small forces a tighter squeeze to control the club through impact, and that squeeze is the flexor-pronator group working at elevated tension on every swing of every round.
Worn, hardened, or slick grips produce the same effect as undersized grips, because you compensate by gripping harder
Regripping annually, or every 40 rounds, is a reasonable rule for anyone who plays regularly
Midsize grips reduce required grip force for many players with larger hands or with arthritis in the fingers
A club fitter can measure hand size and glove size and recommend a size directly — most fitters will do this in fifteen minutes
This is the highest-leverage change on this entire list and it costs less than a round of golf.
TOOL 2: THERABAND FLEXBAR
Red is the light tension and the correct starting point for nearly all adults over 60
Green is the next step and is appropriate once the red bar produces no meaningful challenge across 3 sets of 15
Blue and beyond are unnecessary for tendinopathy rehabilitation in this population
Approximately twenty dollars at physical therapy supply retailers and online
The bar is not required. A 1 to 2 pound dumbbell accomplishes Level 2 loading perfectly well. The FlexBar's advantage is that it loads pronation along with flexion, which is why it becomes more useful at Level 3 than at Level 2.
TOOL 3: LIGHT DUMBBELLS
A 1, 2, 3, and 5 pound set covers the entire twelve-week progression
Adjustable wrist weights work as a substitute if you already own them
A can of soup weighs roughly one pound and is a legitimate week-one starting load if you would rather not buy anything yet
TOOL 4: COUNTERFORCE BRACE — PLACEMENT MATTERS
The forearm strap that most people associate with tennis elbow has a medial equivalent, and the placement differs. For medial epicondylitis, the strap sits on the flexor mass on the palm-side of the forearm, roughly one to two inches below the medial epicondyle — not on the extensor side where a tennis elbow strap goes.
The mechanism is load redistribution away from the tendon origin, not support
It is a symptom management tool for activity, not a treatment — it does not remodel tissue
Wear it during golf, tennis, or heavy gripping work, and remove it otherwise
If it produces numbness or tingling in the hand, it is too tight or positioned over the nerve. Loosen or remove it.
A brace worn instead of the loading protocol will keep you comfortable and keep you injured. A brace worn alongside the loading protocol is a reasonable tool for staying active while the tissue changes.
TOOL 5: WHAT TO SKIP
Spring-loaded grip strengtheners. These load the flexor group concentrically at high intensity, which is the opposite of what an irritable medial tendon needs. They have a place in general grip training and no place in acute medial epicondylitis.
Repeated cortisone injection. A single injection to break a pain cycle is a defensible clinical decision. Repeated injection into the same tendon has been associated with poorer long-term outcomes and is a conversation for your physician, not a newsletter.
Extended complete rest. Symptoms fade and return the moment load resumes, because nothing about the tissue changed.
Hitting balls off a mat. Range mats do not give, which sends impact load straight up the shaft into the hands and forearms. If you must practice, practice off grass, or reduce volume substantially.
THE COMPLETE SERIES WRAP
Part 1 — The framework: medial epicondylitis is flexor-pronator tendon degeneration, not inflammation, on a longer timeline than the lateral side, with an ulnar nerve caution that comes first.
Part 2 — The stretches: seated flexor stretch with supination, table-supported reversed-finger stretch, and doorframe pronator teres stretch, with short holds before activity and long holds after.
Part 3 — The loading: isometric holds, eccentric wrist flexion, and combined eccentric flexion with pronation, with advancement criteria for each level.
Part 4 — The toolkit: grip size first, FlexBar and light dumbbells second, counterforce brace as an activity aid, and a short list of things to skip.
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RETURN TO PLAY CRITERIA
The question everyone asks is when they can play again. The honest answer for most people is that you do not have to stop entirely — you have to reduce volume enough that symptoms stay in the mild range while the loading work proceeds.
Reasonable markers for returning to full volume:
No pain with daily gripping tasks for at least two consecutive weeks
Able to complete 3 sets of 15 eccentric wrist flexions with 5 pounds without next-day soreness
Grip strength on the affected side within roughly 90 percent of the unaffected side, if you have access to a dynamometer
Nine holes produces no more than mild symptoms that clear by the next morning before adding the second nine
Build back in increments — range session, nine holes, eighteen holes, back to your normal schedule — with a full week at each stage. Rushing this stage is the most common reason a resolved medial elbow becomes an unresolved one.
A CLOSING NOTE
This series exists because a reader asked a question. Chris wrote one sentence after the tennis elbow issue and it turned into four issues, because it turned out a lot of you were quietly dealing with the same thing on the other side of the joint.
If something we cover leaves out the version of the problem you actually have, say so. That is how this works.
And the reminder that belongs at the end of every issue in this series: the inside of the elbow has a nerve behind it. If your symptoms include numbness, tingling, or weakness in the ring and little fingers, none of the above is your starting point. A clinician is.
Still moving forward,
— The SIM60 Team
simsixty.com · Because slowing down isn't in the plan.
Educational content only. Not medical advice. SIM60 is not a medical provider and does not diagnose or treat any condition. Consult your physician or a licensed physical therapist regarding your specific symptoms before beginning any exercise described here.
SIM60 receives no commissions or affiliate compensation for any equipment referenced. All mentions are for illustration purposes only.
