Top 5 Exercises for Tennis Elbow

Let’s talk about tennis elbow, and discuss our top five exercises to help recover from tennis elbow. Of course, these exercises are based on our opinion, and clinical experience, but some also have the backing of research. Bare in mind though, with any research, one paper will be released that recommends one protocol, and then another research recommends something completely different. We always need to use our clinical judgement, and exercises are ideally prescribed bespoke to patients as individuals depending on their fitness levels, pain levels and stage of the recovery journey.

Tennis elbow (known as lateral epicondylitis) is a painful condition within the elbow caused from overusing the joint. Playing tennis and other racquet sports can cause this condition to occur, but there are other activities and sports that can place you at risk. Tennis elbow is when the tendons joining the forearm muscles along the outside part of the elbow become inflamed or degenerate. The forearm tendons and muscles respond negatively from overusing the joint. Repeatedly performing the same muscles over and over can irritate the tendon insertions, which leads to tenderness and pain on the outer part of the elbow.

Tennis Elbow Anatomy

The elbow joint is made up of three bones: the upper arm bone (humerus) and the two bones within the forearm (ulna and radius). Bony bumps at the bottom part of the humerus are referred to as the epicondyles. The bony bump along the outside part of the elbow is known as the lateral epicondyle. Ligaments, muscles and tendons all hold the joint together.

Tennis elbow involves injury to the tendons and the muscles in the forearm. The forearm muscles work to extend the fingers and the wrist. The forearm tendons attach the bone and the muscles together. They are attached on the lateral epicondyle. The tendon that is often involved with this condition is the extensor carpi radialis brevis.

Let’s look at our top five exercises for tennis elbow:

1. Ice for Tennis Elbow: Use an ice pack or pack of frozen peas (wrapped in a thin towel) over the outside of your elbow. This can be useful for tennis elbow and repetitive strain injuries, as well as other pathologies of the elbow.

2. Self-Massage for Tennis Elbow: With your arm supported on your thigh, gently massage along the outside of your forearm between your elbow and wrist. This helps reduce tension in the forearm muscles.

3. Tennis Elbow Ball Squeeze to Strengthen the Forearm: Squeeze a small ball in your hand. Use this to strengthen your thumb and fingers. You can also use putty, a small towel, or other small squeezy items.

4. Eccentric Wrist Extensor Strengthening: Rest your arm on a table with your palm facing down, and hold a 1-2kg dumbbell. Lift your hand upwards using your other hand, and then with a controlled movement let the weight pull your hand back down. At the bottom, repeat by lifting your own hand upwards again, and then letting the weight pull your hand back down. Eccentric exercises are a very effective way to rehabilitate the wrist, forearm and elbow, and this can be especially useful for tennis elbow.

5. Forearm Extensor Stretch: Hold your arm out in front of you, straighten it, rotate your arm inwards, and bend your wrist back. Hold this position to create a stretch. This exercise stretches the forearm Extensor muscles, and can help with tennis elbow pain and other repetitive strain injuries.

Tips:

Many people with this condition participate in some type of activity that requires vigorous or repetitive use of the muscles in the forearm. Reduce repetitive movements and reduce loading.
Plumbers, painters and carpenters are prone to developing this condition. Rest, recover, reduce force and repetition going through the elbows.
Poor technique may increase your chance of developing the condition when playing tennis or other racquet sports. Seek support from a coach.
If you are a tennis player, check your string tension and enquire whether multifilament strings may help. Check your grip size – wider grips might help.

There is a great article here for more information on tennis elbow: https://www.rehabmypatient.com/media/rmp_advice_sheet/4475.pdf?v=1522380156

If you are a therapist and like the exercises and information in this document, please go to www.rehabmypatient.com and sign up to this amazing exercise prescription software. If you are a patient and need some advice, treatment or a consultation, please go to www.surreyphysio.co.uk/bookonline. We provide virtual and face-to-face appointments with our expert team.

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