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Exercise for tennis elbow

Musculoskeletal
        1. Exercise for tennis elbow

First published: 5 May 2021

The RACGP gratefully acknowledge the following contributor:

  • Zoe Michaleff, Institute for Evidence-Based Healthcare, Bond University

Related GP HANDI entry Physiotherapy for tennis elbow


 

Your doctor has recommended forearm exercises for your tennis elbow (the pain on the outer side of your elbow).

Key points

  • Tennis elbow usually gets better on its own but this can take up to 6–12 months.
  • Some exercises can help to reduce pain more quickly and improve the use of your arm.
  • Keep being active but try to avoid activities that increase pain.

How can forearm exercises help with tennis elbow?

  • Tennis elbow can be caused by repeated movements of your wrist or arm, usually from activities such as gardening, playing tennis, or using a screwdriver. The muscles around the elbow become overused.
  • Some exercises can help these muscles become stronger and cope better with the movements and gripping activities. This can help to reduce pain and improve the use of your arm.

How do I get started?

Begin with exercise 1 and over time progress to exercise 2.

Important: These exercises may cause a slight discomfort but should not be painful. If your pain level is more than 2 on a scale where 10 is the worst pain imaginable and 0 is no pain, make the exercise easier. You can do this by not holding the exercise for long or not doing the exercise many times. You can also use a lighter weight or less resistance. As you get stronger, you can make the exercises harder.

Exercise 1: Static (or isometric) wrist exercise

Figure 1

Figure 1

Static (or isometric) wrist exercise

Start position: Place your affected arm on a table so that your elbow is bent and your forearm is supported by the table but your wrist is unsupported over the edge. Your wrist should be slightly lifted towards the ceiling and your fingers relaxed or curled (do not force your fingers to be straight). This position is least likely to make your pain worse.

Exercise:  Holding your wrist straight, use your opposite hand to gently apply a downward pressure (See red arrow in picture). Apply enough pressure so that you can hold your wrist straight for 10 seconds without pain, and then release the pressure. (Watch video 1)

Repetitions: Do the exercise 12 times with a 10-second rest in between – this is the first set. Rest for a minute, and then do two more sets of 12 exercises with a minute’s rest between each set. Do this exercise every day for 2 weeks.

How to make the exercise harder: Increase how long you hold your wrist still for or apply more pressure with your other hand.

Exercise 2: Strengthening through full wrist range of movement

Start position: Place your affected arm on a table so that your elbow is bent and your forearm is supported by the table but your wrist is unsupported over the edge. Your wrist should be slightly lifted towards the ceiling and your fingers relaxed or curled (do not force your fingers to be straight).

Exercise: Keeping your forearm on the table, move your wrist  all the way up over 4 seconds and then slowly back towards the floor over 4 seconds. (Watch video 2)

Repetitions: Do this movement 8 times – this is the first set. Rest for a minute, and then do two more sets of 8 exercises with a minute’s rest between each set. You should also do this exercise using your unaffected arm as it can help the affected arm. Do this exercise once a day until you feel that your affected arm is getting as strong as your other arm.

How to make the exercise harder: Just like exercise 1, you can gently resist your wrist movement using your unaffected hand. You can also hold a light weight (e.g. full drink bottle) or use a resistance band (Pictured; also see video 3).

Figure 2a

Figure 2a

Strengthening through full wrist range of movement

Figure 2b

Figure 2b

Strengthening through full wrist range of movement

What to look out for

  • Feeling some discomfort is normal as long as the pain goes away within an hour after exercise and does not get worse the next day.
  • Keep using your arm for everyday activities but avoid activities that worsen your pain. Do not put your arm in a sling or rest it fully because that weakens the muscles further.
  • If you have had tennis elbow for a long time, you may have weak muscles in the area from your shoulder to fingers. You may benefit from an exercise program from your doctor or physiotherapist.

 

Find a physiotherapist through the Australian Physiotherapy Association
Speak with a nurse on Musculoskeletal Australia’s free Help Line 1800 263 265 (weekdays,  9 am – 5 pm).
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