Tennis elbow, clinically known as lateral epicondylitis, is a common painful condition that occurs when the tendons connecting the forearm muscles to the outside of the elbow are repeatedly strained. This overuse injury often happens with repetitive wrist and arm movements, such as those performed by plumbers, painters, carpenters, and, yes, racquet sports players [1].
If left untreated, tennis elbow pain may become chronic. The initial steps in managing this condition focus on reducing pain and inflammation, often involving rest and, in some cases, over-the-counter pain relievers such as Non-steroidal Anti-Inflammatory Drugs (NSAIDs).
However, before starting any medication or exercise program, it is essential to consult with a qualified healthcare professional, such as a Certified Physical Therapist or physician, for a personalised diagnosis and treatment plan [2]. Specific, targeted exercises can be a key component of a successful recovery plan once the initial acute pain has subsided.
10 Exercises for Tennis Elbow: Strengthening & Stretching
Tennis elbow can cause persistent pain and discomfort, but a targeted, progressive exercise program focusing on strengthening and stretching the forearm muscles is crucial for long-term recovery. These exercises can help alleviate strain, improve mobility, and increase the tendon’s load-bearing capacity [3].
Important: Perform all exercises slowly and with control. If any exercise causes sharp, increasing pain, stop immediately and consult your physical therapist. Start with the suggested repetitions and sets, and only increase the resistance or duration as your therapist recommends.
1. Fist Clench (Isometrics/Grip Strength)
This exercise helps improve grip strength, which is often difficult for people with tennis elbow.
- Targeted Muscles: Tendons and muscles of the fingers and thumb.
- Procedure:
- Sit with your forearm supported on a table, palm facing up or sideways.
- Hold a rolled-up towel or small stress ball in your hand.
- Squeeze the towel/ball firmly but comfortably and hold for 5-10 seconds.
- Release the squeeze completely.
- Do 10-15 repetitions for 2-3 sets.
2. Wrist Extension (Eccentric Loading)
Eccentric exercises (lowering a weight slowly) are often highlighted as one of the best treatments for strengthening the affected tendons [2, 3].
- Targeted Muscles: Wrist extensors.
- Materials: Table and a very lightweight dumbbell (e.g., 1-2 pounds or a can of food).
- Procedure:
- Sit in a chair, place your forearm on your thigh or a table with your wrist hanging off the edge, palm facing down.
- Hold the dumbbell.
- Use your non-affected hand to lift the weight up into wrist extension.
- Slowly lower the weight back down using only the affected arm, taking 3-5 seconds to complete the lowering phase (the eccentric portion).
- Repeat 10-15 times for 2-3 sets.
3. Bicep Curls (Band Resistance)
This exercise focuses on general arm strength, which can help support the entire elbow joint. The description for ‘Elbow Bend’ was unclear; it has been replaced with a clear Bicep Curl variation.
- Targeted Muscles: Biceps brachii.
- Materials: A light resistance band or lightweight object.
- Procedure:
- Sit upright. Hold a resistance band with your hand, or a light weight (e.g., 1 lb).
- Keep your elbow tucked close to your side.
- Slowly bend your elbow, bringing your hand towards your shoulder.
- Slowly lower your hand back down.
- Repeat 10-12 times for 2 sets.
4. Forearm Twist (Supination/Pronation)
This exercise is best performed using a specialized weight (like a ‘Thera-Bar’ or a hammer/club) for optimal resistance, a method supported by clinical evidence [3].
- Targeted Muscles: Forearm supinators and pronators.
- Materials: A hammer or a specialized forearm training device (e.g., 2-5 lbs).
- Procedure:
- Sit next to a table and rest your forearm flat on the table, with your hand hanging off the side, holding the end of the hammer head.
- Start with the hammer head vertical.
- Slowly twist your forearm to turn the hammer head toward the ceiling (palm up) and hold briefly.
- Slowly twist your forearm in the opposite direction (palm down).
- Repeat 10 times in each direction for 2-3 sets.
5. Wrist Flexion (Concentric/Dynamic)
This complements the Wrist Extension exercise by strengthening the muscles on the palm side of the forearm.
- Targeted Muscles: Wrist flexors.
- Materials: A very lightweight dumbbell (e.g., 1-2 pounds or a can of food).
- Procedure:
- Sit in a chair, place your forearm on your thigh or a table with your wrist hanging off the edge, palm facing up.
- Hold the dumbbell.
- Slowly bend your wrist upward, bringing your palm toward your body.
- Slowly lower the weight back down with control.
- Repeat 10-15 times for 2-3 sets.
6. Wrist Down (Modified Wrist Extension)
This exercise is similar to the Wrist Extension (Exercise 2) but is typically done without the eccentric focus, making it a good initial strengthening step.
- Targeted Muscles: Wrist extensors.
- Materials: Lightweight object (e.g., a can of beans).
- Procedure:
- Make a 90° bend with your elbow. Hold something lightweight with your palm facing down.
- Keep your forearm supported.
- Slowly bend your wrist downward (palm facing floor), then slowly lift it up.
- Perform three sets of 15 repetitions, focusing on a slow, controlled movement.
7. Finger Extensor Stretch
This stretch targets the overworked extensor muscles, which attach near the lateral epicondyle (the sore spot).
- Targeted Muscles: Forearm extensors.
- Procedure:
- Extend the affected arm straight out in front of you, palm down.
- Bend your wrist downward, pointing your fingers toward the floor.
- Use your opposite hand to gently pull the fingers of the affected hand towards your body until you feel a comfortable stretch in the top of your forearm.
- Hold the stretch for 30 seconds. Repeat 2-3 times.
8. Ball Squeeze (Isometrics)
A simple, effective isometric exercise for improving general grip strength and endurance.
- Targeted Muscles: Forearm and hand muscles.
- Materials: Stress ball or tennis ball.
- Procedure:
- Hold the ball tightly in your hand.
- Squeeze it firmly (not painfully) and hold for 10 seconds.
- Release the pressure completely.
- Repeat this 8 to 10 times a day as a warm-up or throughout the day.
9. Wrist Flexor Stretch
This stretch balances the extensor stretch by targeting the flexor muscles on the inside of the forearm.
- Targeted Muscles: Forearm flexors.
- Procedure:
- Extend the affected arm straight out in front of you, palm up.
- Bend your wrist downward, pointing your fingers toward the floor.
- Use your opposite hand to gently pull the fingers of the affected hand back toward your body until you feel a comfortable stretch in the underside of your forearm.
- Hold the stretch for 30 seconds. Repeat 2-3 times.
10. Towel Twist (Wringing)
This exercise is excellent for integrating wrist rotation with grip strength, a functional movement often impaired by tennis elbow.
- Targeted Muscles: Forearm supinators and pronators.
- Materials: Rolled-up hand towel.
- Procedure:
-
- Hold a rolled-up towel horizontally with both hands.
- Keep your shoulders relaxed.
- Twist the towel as if you were wringing water out of it, moving one hand away from you and the other hand toward you.
- Twist in one direction for 10 repetitions, then twist in the opposite direction for 10 repetitions.
- Perform 2 sets.
Conclusion
While consistent exercise and stretching are vital components of recovery, they are best performed under the guidance of a qualified healthcare professional. If these exercises or stretches fail to alleviate pain, or if your pain worsens, you must consult a physician or Physical Therapist [2]. They can confirm the diagnosis, rule out other conditions, and may prescribe a customised rehabilitation program, including other treatments like dry needling, manual therapy, or corticosteroid injections, to manage the condition effectively.
Frequently Asked Questions (FAQs)
What is the fastest way to cure tennis elbow?
There is no “instant cure” for tennis elbow, as it is a degenerative tendon condition that requires time to heal. The most effective approach involves rest, ice, avoiding aggravating activities, and a supervised, progressive strengthening program, especially eccentric exercises [3]. In some cases, a doctor may recommend corticosteroid injections for faster symptom relief, though the long-term benefit of injections is debated.
What is the best exercise for tennis elbow?
Eccentric wrist extensions (where you lower a lightweight slowly, as described in Exercise 2) are widely supported by clinical research as a highly effective exercise for strengthening the involved tendons and helping to manage tennis elbow [3].
How to relax elbow pain?
Initial relief can come from R.I.C.E. (Rest, Ice, Compression, Elevation). Applying an ice pack for 15 minutes at a time, gently massaging the area, using a specific elbow brace (counterforce brace), or performing light, non-painful stretching can all help manage discomfort.
Is it good to stretch a tennis elbow?
Yes, gentle, non-painful stretching is important to help improve flexibility and reduce stiffness in the forearm muscles. However, stretching alone is not sufficient; it must be paired with progressive strengthening exercises for long-term recovery.
Can elbow stiffness go away?
Yes, elbow stiffness associated with tennis elbow can often be alleviated. Consistent application of heat, stretching, strengthening exercises, and a structured physical therapy plan are typically effective in restoring range of motion.
What to avoid with tennis elbow?
Avoid all activities that cause a sharp increase in pain, particularly repetitive motions, heavy gripping, or forceful twisting actions (like using a screwdriver or wringing heavy rags). Use ergonomic tools or techniques to minimise strain during daily tasks.
Disclaimer:
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider, such as a physical therapist or physician, with any questions you may have regarding a medical condition or before starting any new exercise or treatment regimen.
References
[1] Institute for Quality and Efficiency in Health Care (IQWiG). (2018, May 30). Tennis elbow: Strengthening and stretching exercises. Informed Health. https://www.ncbi.nlm.nih.gov/books/NBK506995/
[2] Page, P. (2010). A new exercise for tennis elbow that works! North American Journal of Sports Physical Therapy: NAJSPT, 5(3), 189–193. https://pmc.ncbi.nlm.nih.gov/articles/PMC2971639/
[3] Finestone, H. M., & Rabinovitch, D. L. (2008). Tennis elbow no more: Practical eccentric and concentric exercises to heal the pain. Canadian Family Physician, 54(8), 1115–1116. https://pmc.ncbi.nlm.nih.gov/articles/PMC2515258/
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