If you have tennis elbow, the exercises most likely to make it worse share a common thread: they force your forearm extensor muscles to grip hard, stabilize a heavy load, or work while your elbow is locked straight. The specific tendon involved sits on the outside of your elbow and controls wrist extension, so any movement that loads that tendon under tension or stretch can trigger pain and delay healing.
Knowing which exercises to skip (and why) can help you stay active without setting yourself back. Complete rest isn’t the answer either, since total inactivity can lead to muscle wasting that makes recovery harder. The goal is to cut the movements that are quietly aggravating the tendon while keeping everything else in your routine.
Why Certain Movements Cause Problems
Tennis elbow centers on one muscle-tendon unit: the extensor carpi radialis brevis, which runs along the back of your forearm and attaches at the bony bump on the outside of your elbow. This tendon’s job is to extend and stabilize your wrist. When it’s inflamed or partially torn, any exercise that asks it to grip, stabilize, or absorb force will increase pain and potentially worsen the damage.
The worst combination is when the tendon has to lengthen while under load, a type of contraction called eccentric loading. Think of the lowering phase of a pull-up, the bottom of a push-up, or the moment a tennis ball slams into your racquet strings. These moments send peak stress through the tendon attachment, and that’s exactly when most people feel a sharp jolt of pain on the outside of the elbow.
Seven Gym Exercises to Avoid
Pull-Ups and Chin-Ups
Pull-ups are one of the most aggravating movements for tennis elbow. Your forearm is rotated, your elbow straightens at the bottom, and your extensor tendons are under heavy tension the entire time. The lowering phase is especially problematic because the tendon stretches under your full body weight. If you’re mid-set and feel a spike of pain on the outer elbow, this is why.
Heavy Wrist Curls
Wrist curls with a heavy dumbbell or barbell place direct, concentrated stress on the exact tendons involved in tennis elbow. When those tendons are already irritated, high resistance can trigger flare-ups or cause small tears in the tendon. Bar hangs, where you simply grip a bar and let your body weight pull you down, create the same overload.
Traditional Push-Ups and Bench Press
Push-ups force your wrists into extension and demand constant forearm stability, transferring load straight through the elbow. Heavy barbell bench pressing does the same thing. As you lower your body (or the bar), tension on the extensor tendon spikes, often causing a sharp pain right at the bottom of the movement.
Straight-Arm Cable Exercises
Cable movements like wood chops and straight-arm pulldowns strain the forearm extensors when your elbow is locked. The heavier the resistance, the more force funnels through the tendon attachment at the outer elbow. Any cable exercise where the arm stays rigid while the shoulder moves is a potential irritant.
Lateral and Front Raises
Side raises and front raises are shoulder exercises, but performing them with a straight elbow transfers significant strain down your forearm. The longer you hold the weight at the top of the movement, the more static stress builds on your wrist extensors. Heavier dumbbells make this worse.
Heavy Barbell Curls
Even though bicep curls target the front of your arm, the problem is the grip. Clenching a heavy barbell or dumbbell forces the forearm extensors to co-contract to stabilize the wrist. The heavier the weight, the harder you grip, and the more strain lands on an already compromised tendon.
Stress Balls and Grip Trainers
This one surprises people because squeezing a stress ball feels therapeutic. But repeated squeezing uses the forearm extensor muscles directly. If you’re doing it throughout the day, you’re adding volume to a tendon that needs less, not more, repetitive load.
Racquet Sports and Repetitive Motions
Tennis itself is an obvious trigger, but the specific stroke mechanics matter more than people realize. Research published in the British Journal of Sports Medicine found that players with tennis elbow had significantly greater wrist extensor muscle activity during ball impact and early follow-through compared to unaffected players. Contributing factors included a “leading elbow,” an extended wrist, an open racquet face at impact, and hitting the ball on the lower half of the strings.
Novice players are particularly vulnerable. Instead of hitting with a stabilized wrist, beginners tend to strike with the wrist flexed about 13 degrees from neutral, with it continuing to flex on impact. This means the wrist extensor muscles are forced to contract eccentrically, lengthening under load, throughout the entire stroke. It’s the same damaging mechanism that makes the lowering phase of a pull-up so painful.
Beyond tennis, any activity involving repetitive wrist extension or a sustained grip can delay healing: painting, typing with poor wrist posture, using a screwdriver, or chopping food with a dull knife that forces you to press harder. The common denominator is always repeated or sustained load on the outer forearm.
How to Modify Exercises Instead of Quitting
You don’t need to abandon the gym. Most problematic exercises have safer variations that reduce tendon strain while letting you keep training.
- Switch to a neutral grip. Instead of an overhand or underhand grip, hold dumbbells with your palms facing each other (hammer grip). This shifts load away from the wrist extensors. Hammer curls instead of barbell curls, neutral-grip dumbbell presses instead of barbell bench press.
- Use lifting straps. Straps take the gripping demand off your forearm, reducing how hard the extensor muscles need to work. They’re especially useful for rows, deadlifts, and any pulling movement.
- Wear a tennis elbow strap. A counterforce brace worn just below the elbow redistributes tension away from the tendon attachment point and can reduce pain during activity.
- Bend the elbow during raises. If you want to keep doing lateral or front raises, bending the elbow to 90 degrees shortens the lever arm and dramatically reduces forearm strain.
- Lighten the load on wrist work. The American Academy of Orthopaedic Surgeons recommends starting with just 1 to 3 pounds for wrist exercises during rehabilitation, focusing only on the lowering phase initially, and progressing to full range of motion once acute pain subsides. Controlling the speed matters too: don’t let the weight pull your hand down quickly.
When It’s Safe to Add Exercises Back
Returning to the exercises you’ve been avoiding should be gradual, not based on a calendar. The clearest objective marker is grip strength: when your affected arm measures equal to your unaffected arm on a hand-held dynamometer (a simple squeeze test your physical therapist can perform), your tendon is handling load normally again.
Before that point, you should be tolerating progressive resistance exercises without pain, including isolated forearm work and functional movement patterns that mimic the activities you want to return to. Full, pain-free range of motion at the elbow and wrist is another baseline requirement. For tennis players specifically, shoulder internal rotation on the dominant arm should also be assessed, since restricted shoulder mobility can shift extra stress to the elbow during overhead and swinging motions.
The practical progression looks like this: start with light, controlled wrist exercises using the lowering phase only. Move to full-range wrist curls and extensions with light weight. Progress to compound movements with a neutral grip and reduced load. Then gradually reintroduce the original exercises, one at a time, at lower intensity than where you left off. If pain returns at any stage, drop back a step rather than pushing through.