Tennis elbow exercise program

Tennis elbow is very common.  Patients generally get pain on the outside of their elbow.1  The following exercise program should help improve your symptoms gradually over time.  It should be done once daily.

Stretching:1

Straighten your elbow completely. Palm facing the ground.  Bend your wrist towards the ground slightly.  Then fully bend your wrist to the pinky side.  Stretch for 45 seconds and rest for 45 seconds.  Hold the stretch steady; do not bounce. Complete 3 repetitions before and after the strengthening routine.

Strengthening:1

Lie on your bed on your stomach with your elbows on the edge of the bed and fully straightened.  Your palms should be facing the ground off the edge of the bed.  Use your good arm to bend your wrist towards your body completely.  Very slowly lower until you are bending your wrist completely forward.  Use your good arm to raise your wrist back up and repeat.  Start with 1 pound worth of weights.  Do 3 sets of 10 to start and increase velocity of movement daily.  Next, when this is comfortable, increase the weight by 1 pound intervals.  Perform these exercises 3-4 times per week.

Perform these exercises even if you experience some discomfort, but stop if you have pain.  You likely will not get to 3 sets of 10 initially, so do not get discouraged.  Just do as many as you can. Do these exercises once daily.

Follow up:

Please see your doctor again 6 weeks after starting this program.  At that appointment they can check your progress. If you have had no improvement, your family doctor may decide you have more widespread dysfunction of the elbow than a simple home exercise program can correct and may want to refer you to physiotherapy. They may also want to consider referring you to a sports medicine specialist if the diagnosis is unclear. 

You may see people who wear an elbow brace for tennis elbow.  The brace helps to prevent attacks when symptoms have settled down.  It does not help with acute attacks. 2

1.  Stasinopoulos D, Stasinopoulou K,  Johnson MI. An exercise programme for the management of lateral elbow tendinopathy. Br J Sports Med. 2005;39:944–47.

2. Hijmans JM, Postema K, Geertzen JHB. Elbow orthoses: a review of literature. Prosthetic and Orthotics International. 2004;28:263-72.