You can do quite a few exercises with tennis elbow, and the right ones will actually speed your recovery. The key is starting with gentle, low-load movements and progressing gradually over a roughly 3-month timeline. Most people notice meaningful pain relief within 4 to 6 weeks of consistent daily exercise.
The exercises fall into three categories: stretches to restore flexibility, isometric holds to reduce pain, and strengthening movements that rebuild the tendon. Here’s how to do each one correctly and in the right order.
Start With Wrist Extensor Stretches
Stretching the muscles along the top of your forearm is the simplest place to begin and something you can do on day one. Extend your affected arm straight out in front of you, palm facing down. Use your other hand to gently bend your wrist downward until you feel a stretch along the top of your forearm. Hold for 30 seconds, then release. Do 4 repetitions, and repeat this 3 times throughout the day.
This stretch targets the exact muscle group that attaches at the painful spot on the outside of your elbow. It won’t feel like much, but it reduces tension on the tendon and prepares the tissue for the strengthening exercises that follow.
Isometric Wrist Extensions for Early Pain Relief
Isometric exercises, where you create tension in the muscle without actually moving the joint, are one of the best tools for reducing tendon pain early on. Rest your forearm on a table with your hand hanging off the edge, palm facing down. Press the back of your affected hand against your other hand (or a fixed surface) as if trying to lift the wrist, but don’t let any movement happen. You’re just pushing against resistance.
Protocols vary, but a common approach backed by clinical research is holding each contraction for up to 60 seconds with strong resistance, repeated 5 times, once a day. Another well-studied option uses shorter holds of 10 seconds for more repetitions. Either way, the goal is the same: load the tendon without aggravating it. If a 60-second hold is too much at first, start with shorter durations and work up. These isometric holds are particularly useful during the first few weeks, when the tendon is most irritable.
Eccentric Wrist Extensions Build Tendon Strength
Eccentric exercises are the backbone of tennis elbow rehab. “Eccentric” means you’re strengthening the muscle as it lengthens, which is the specific type of loading that helps tendons heal and remodel. For tennis elbow, this means slowly lowering your wrist from an extended (bent-back) position to a flexed (bent-down) position against resistance.
Here’s how to do it with a resistance band:
- Setup: Secure a resistance band under your foot and grasp the other end with your affected hand, palm facing down.
- Starting position: Use your other hand to pull your affected wrist back into extension. This is critical: your uninjured hand does the lifting.
- The exercise: Release your uninjured hand and slowly let your affected wrist lower into a bent-down position over 3 to 5 seconds.
- Reset: Use your other hand to bring the wrist back to the starting position. Never use the injured arm to lift back up.
You can also do this with a light dumbbell. The AAOS recommends starting with no weight at all, then progressing to 1 pound, then 2, and finally 3 pounds. The rule for advancing: when you can complete 30 repetitions on 2 consecutive days without any increase in pain, move to the next weight level.
The Tyler Twist With a Flexible Resistance Bar
The Tyler Twist is a well-known exercise designed specifically for tennis elbow using a flexible rubber bar (the most common brand is the FlexBar). It combines twisting and eccentric loading in one movement and has strong clinical evidence behind it.
The sequence has five steps:
- Step 1: Hold the bar vertically in your affected hand with your wrist bent back (extended).
- Step 2: Grab the top end of the bar with your other hand.
- Step 3: Twist the bar with your unaffected hand while keeping your affected wrist locked in extension.
- Step 4: Bring both arms out in front of you, elbows straight, maintaining the twist in the bar.
- Step 5: Slowly let the bar untwist by allowing your affected wrist to move into flexion. This is the eccentric portion, and it’s where the therapeutic benefit happens.
The bars come in different resistance levels (color-coded). Start with the lightest and progress when the exercise feels easy and pain-free. Most protocols call for 3 sets of 15 repetitions, once or twice a day.
How to Progress Without Flaring Up
The biggest mistake people make with tennis elbow exercises is doing too much too soon. Some discomfort during exercise is normal, but actual pain is a signal to back off. If a movement causes sharp pain at the elbow or leaves you more sore the next day, reduce the resistance or the number of repetitions.
A reasonable progression looks like this: spend the first 1 to 2 weeks on stretching and isometric holds only. Once those feel comfortable, add eccentric wrist extensions or the Tyler Twist. Start with bodyweight or the lightest resistance available, and increase load only when you hit 30 pain-free repetitions on 2 consecutive days. Pain typically starts improving around week 4 to 6, but continue the program daily for about 3 months to give the tendon time to fully remodel.
Exercises and Movements to Avoid
While you’re recovering, certain movements will repeatedly aggravate the tendon and stall your progress. Avoid lifting heavy objects with your arm fully straightened. Instead, keep a slight bend at the elbow whenever you carry or grip something heavy, and use both hands when possible.
In the gym, pull-ups, heavy barbell curls, and rows with a pronated (palms-down) grip put significant stress on the outer elbow. Repetitive gripping exercises like heavy deadlifts or farmer’s carries can also be problematic. If you play tennis, switching to a two-handed backhand reduces load on the affected forearm considerably.
More broadly, avoid repetitive hand and wrist motions when you can, and take frequent breaks when you can’t avoid them entirely. The general rule is straightforward: if a particular movement brings the pain back, stop doing it until you’ve progressed further in your rehab program.
Exercises You Can Still Do for General Fitness
Tennis elbow doesn’t have to sideline your entire workout routine. Lower body exercises like squats, lunges, leg presses, and calf raises are generally safe since they don’t load the forearm extensors. Cardio options like walking, cycling, and using an elliptical are fine too.
For upper body work, you can often continue with movements that use a neutral or supinated (palms-up) grip, which shifts stress away from the affected tendons. Think hammer curls instead of reverse curls, or neutral-grip dumbbell presses instead of barbell bench press. Core work like planks, leg raises, and crunches typically poses no issue. Just pay attention to how your elbow responds in the 24 hours after any workout, and adjust from there.