Eccentric Exercises for Tennis Elbow
Rachel Clarke & Phin Robinson (edited by A Watts)
Your therapist or doctor will show you how to use a resistance band safely for these exercises. Alternatively you can use a 500ml water bottle, but start with only 250ml water in it.
Fix the band firmly under your foot and hold the other end in your hand. Place your elbows straight as possible over your knee and let your wrist bend towards the floor.
Use your free hand to pull your wrist back towards you stretching the band with it.
Your free hand must do all the work to bring your wrist back.
Gently let go with the supporting hand. Slowly let the band pull your wrist down towards the floor over about 5 seconds. You have now done one exercise. You will need to do this exercise fifteen times, rest for a minute, do fifteen more exercises, rest for a minute, do a final fifteen exercises.
You will have now finished one full exercise session. For this programme you will need to do three exercise sessions each day for twelve weeks. Your therapist or doctor will tell you how to progress your exercises but here are some important notes to remember:
Stop the exercises very slowly with the band quite loose.
You should feel moderate pain in your elbow towards the end of the exercise session.
Shorten the band or use a stiffer band to make the exercise harder as the pain reduces.
Start to work a little more quickly once you can do a whole session with a stiff band with no pain.
It may take seven to ten weeks for you to feel a lot less pain and a better grip so it is important to keep going with the programme for at least this long. More than seven out of ten people with tennis elbow have no pain and an improved grip after completing this exercise programme.
Svernlv B, Adolfsson L. Non-operative treatment regime including eccentric training for lateral humeral epicondylalgia.
Scand J Med Sci Sports. 2001 Dec;11(6):328-34.
Rabin A. Is there evidence to support the use of eccentric strengthening exercises to decrease pain and increase function in patients with patellar tendinopathy? Phys Ther. 2006 Mar;86(3):450-6. Review. No abstract available.
Pienimki T, Tarvainen T, Siira P, Malmivaara A, Vanharanta H. Associations between pain, grip strength, and manual tests in the treatment evaluation of chronic tennis elbow. Clin J Pain. 2002 May-Jun;18(3):164-70.
Vicenzino B. lateral epicondylalgia: a musculoskeletal physiotherapy perspective. Man Ther. 2003 May;8(2):66-79. Review.
Hart LE. Corticosteroid injections, physiotherapy, or a wait-and-see policy for lateral epicondylitis? Clin J Sport Med. 2002 Nov;12(6):403-4. No abstract available.
Pienimki T, Karinen P, Kemil T, Koivukangas P, Vanharanta H. Long-term follow-up of conservatively treated chronic tennis elbow patients. A prospective and retrospective analysis. Scand J Rehabil Med. 1998 Sep;30(3):159-66.
Wasielewski NJ, Kotsko KM. Does eccentric exercise reduce pain and improve strength in physically active adults with symptomatic lower extremity tendinosis? A systematic review. J Athl Train. 2007 Jul-Sep;42(3):409-21. Review.
Stasinopoulos D, Stasinopoulou K, Johnson MI. An exercise programme for the management of lateral elbow tendinopathy. Br J Sports Med. 2005 Dec;39(12):944-7. Review.
Croisier JL, Foidart-Dessalle M, Tinant F, Crielaard JM, Forthomme B. An isokinetic eccentric programme for the management of chronic lateral epicondylar tendinopathy. Br J Sports Med. 2007 Apr;41(4):269-75. Epub 2007 Jan 15.
Martinez-Silvestrini JA, Newcomer KL, Gay RE, Schaefer MP, Kortebein P, Arendt KW. Chronic lateral epicondylitis: comparative effectiveness of a home exercise program including stretching alone versus stretching supplemented with eccentric or concentric strengthening. J Hand Ther. 2005 Oct-Dec;18(4):411-9, quiz 420.
Finestone HM, Rabinovitch DL. Tennis elbow no more: practical eccentric and concentric exercises to heal the
pain. Can Fam Physician. 2008 Aug;54(8):1115-6.