Tennis Elbow Exercises

Tennis elbow exercises

The following Tennis elbow exercises form part of our full Tennis elbow rehabilitation program. Created by elite sports physiotherapist Paul Tanner it takes you step-by-step to full fitness and includes stretching, strengthening and activation exercises.

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The following guidelines are for information purposes only. We recommend seeking professional advice before attempting any rehabilitation.

Tennis elbow stretching exercises

Perform Tennis elbow stretching exercises as soon as pain allows. This is likely to be early on in the rehab program because most people with lateral elbow pain have suffered for some time and have chronic injuries. You should also maintain stretching exercises throughout the rehab program and continue even after your injury has healed and you are pain-free.

Tennis elbow/wrist extensor stretch

Place your arm in front with your hand pointing down. Pull the hand towards your body. You should feel a stretch at the back of the wrist, forearm, and elbow. Rotate your forearm inwards to increase the stretch on the outside of the elbow.

Activation exercises for Tennis elbow

Although not strictly elbow exercises they form part of our rehab program. These exercises improve posture which is important for shoulder rehabilitation.

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Scapula squeeze

Sit in a slightly hunched position with your shoulders rounded forward. Pull your shoulders back and upwards, and squeeze your shoulder blades together at the back. Hold for 3 secs and relax.

Neck retraction

From a slouched position, come up into a good, upright posture. Then pull your head back over your shoulders so you make a ‘double chin’. Hold briefly then relax and repeat.

Tennis elbow strengthening exercises

Strengthening exercises begin in phase 2 of our Tennis elbow rehab program and continue throughout. It may seem counter-intuitive to perform strengthening exercises for what is an overuse injury. However, what we are trying to do here is increase the ability of your tendon to tolerate increased loading. It is a good idea to apply cold/ice after exercises because this mitigates the risk of any flare-ups or inflammation.

Isometric Tennis elbow exercises

In the early stages, we perform isometric or static exercises which involve no movement. Isometric elbow exercises preferentially load the tendon itself as opposed to the forearm muscles. When performing Tennis elbow strengthening exercises you should experience no more than 3/10 pain levels. This means it may be a little uncomfortable but more than 3/10 pain and it is too much. If you find the exercises aggravate your injury then reduce the number of reps or how long you hold the contractions for.

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Later in the program, we use isotonic strengthening exercises involving movement. Finally, we move to eccentric exercises which involve the muscle lengthening as it contracts.

Isometric wrist extension

Your elbow should be bent and your wrist in a neutral position. Use your good hand to resist pushing up against it.

Long lever isometric wrist extension

This is a long lever isometric wrist extension. Push the hand of your injured arm up against the resistance of your good arm.

Short lever wrist extension

Long lever wrist extension

In a seated position and using a weight. This can be a dumbbell or a similar weight. Or use an elastic resistance band. Move your wrist up and down in a slow, controlled manner.

Eccentric wrist extension

The injured arm only takes the weight on the way down. Use your good arm to help raise the weight up each repetition. Eccentric exercises stretch the muscle as it contracts. They are more likely to trigger soreness or discomfort after so do these on alternate days. See how you are the following day before loading up again.

Finger extension with elastic band

Bring all your fingertips together as if making a beak shape. Place a rubber band over your fingers, holding the tips together.

References & further reading

  1. Fairbank SM, Corlett RJ. The role of the extensor digitorum communis muscle in lateral epicondylitis. J Hand Surg Br 2002;27B(5):405–9.
  2. Milz S, Tischer T, Buettner A, et al. Molecular composition and pathology of entheses on the medial and lateral epicondyles of the humerus: a structural basis for epicondylitis. Ann Rheum Dis 2004;63(9):1015–21.
  3. Coombes BK, Bisset L, Vicenzino B. A new integrative model of lateral epicondylalgia. Br J Sports Med 2009;43(4):252–8.
  4. Pienimäki T, Karinen P, Kemilä T et al. Long-term follow-up of conservatively treated chronic tennis elbow patients. A prospective and retrospective analysis. Scand J Rehabil Med 1998;30(3):159–66.
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