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Tennis elbow

Tennis elbow

Tennis elbow: Strengthening and stretching exercises

Photo of a man doing exercises with weights

Special stretching and strengthening exercises can relieve the symptoms of tennis elbow – but patience and perseverance are needed too. As shown in the following examples, the exercises are easy to do and fit into everyday life.

In most cases, the symptoms of tennis elbow go away within one year without any special treatment. To try to make them go away sooner, people can do stretching and strengthening exercises. The best studied type of exercises are known as eccentric exercises. The aim of these exercises is to stretch and strengthen the extensor muscles in the forearm. These are the muscles that you use when doing things like hitting a tennis ball with a backhand stroke or putting in screws.

Only doing stretching exercises is also often recommended, although it’s not yet clear whether it helps.

You can talk to your or doctor about which exercises are most suitable for you.

What are eccentric exercises?

Muscle-strengthening exercises can generally be divided up into concentric and eccentric exercises. In concentric exercises, the muscle contracts (tightens) – and in eccentric exercises, the muscle relaxes. One example of a concentric exercise is holding a weight in your hand and pulling it up towards your body. Gradually lowering the weight again is an eccentric exercise. Slowly working against gravity like this strengthens the muscles.

Eccentric strengthening exercises: Example 1

  1. Hold a weight in your hand.
  2. Rest the affected arm on a table with your palm facing down, allowing your hand to hang off the edge of the table.
  3. Use your free hand to bend the affected wrist back as far as you can while lifting the weight.
  4. Gradually lower the hand with the weight in it.
  5. Repeat about 10 to 15 times.
  6. After a short break, repeat this set of exercises two more times.
Animation: Strengthening exercise for tennis elbow

It’s important not to use heavy weights. The weight should be about 30% of the maximum weight you can hold. Slight pain is okay, but you shouldn’t put too much strain on the arm.

Eccentric strengthening exercises: Example 2

  1. Rest the elbow of the affected arm on a table, with your forearm upright. Turn your forearm so that the palm of your hand is facing away from you.
  2. Hold a full bottle in the affected hand.
  3. Gradually lower the arm with the bottle, making sure not to bend your wrist.
  4. Allow the bottle to fall into your free hand and move the affected arm back to the upright starting position.
  5. Pass the bottle from the free hand back up to the affected hand.
  6. Repeat about 10 to 15 times.
  7. After a short break, repeat this set of exercises two more times.

It’s best to do strengthening exercises three times a day.

Animation: Strengthening exercise for tennis elbow

Stretching

The aim of stretching exercises is to stretch the wrist extensor muscles in the forearm. These exercises are recommended in order to improve the mobility (range of movement) of the arm and wrist. They can either be done actively or passively. By “actively,” we mean you do them yourself. In passive exercises, a or training partner stretches that part of the body for you.

Example:

  1. Stretch the affected arm out in front of you, with your palm facing downwards.
  2. Relax your wrist, allowing your hand to dangle down.
  3. Using your other hand, push the affected hand down and pull it towards your body.
  4. Hold the stretch for about 30 to 45 seconds.
  5. Have a break (about 30 seconds).
  6. Repeat three times.

People are advised to do these stretching exercises about twice a day.

Illustration: Stretching exercise for tennis elbow – as described in the article

Karanasios S, Korakakis V, Whiteley R et al. Exercise interventions in lateral elbow tendinopathy have better outcomes than passive interventions, but the effects are small: a systematic review and meta-analysis of 2123 subjects in 30 trials. BJSM online 2021; 55(9): 477-485.

Orchard J, Kountouris A. The management of tennis elbow. BMJ 2011; 342: d2687.

Saueressig T. Evidenzbasierte Physiotherapie. Exzentrisches Krafttraining und Tennisarm. 2019.

Stasinopoulos D, Stasinopoulou K, Johnson MI. An exercise programme for the management of lateral elbow tendinopathy. Br J Sports Med 2005; 39(12): 944-947.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Tennis elbow: Strengthening and stretching exercises

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Updated on July 15, 2022

Next planned update: 2025

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Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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