3 Best Lateral Epicondylitis Exercises

Try these 3 unique exercises to banish tennis elbow

By Coach E

3 effective lateral epicondylitis exercises tennis elbow

A lot of the advice you’ll find online for tennis elbow pain is a swing and a miss. Don’t waste time overstretching, which could cause more damage. Instead, try these 3 lateral epicondylitis exercises.

Tennis Elbow Time Out

Tennis elbow, or lateral epicondylitis, is a repetitive stress injury that causes painful symptoms. It can keep you from your favorite sports and activities – not just tennis but things like hockey, weightlifting, and even jobs or hobbies like fixing up that old clunker.

lateral epicondylitis exercises - repetitive stress injury

Tennis elbow doesn’t just keep people from these activities, it is usually caused by them. Overuse and overdoing it on the court (or on the ice or with repetitive motions at work) can cause the condition to arise.

But not to worry, the pain doesn’t have to be permanent. I’ve got 3 exercises that will help get at the root of the condition to wipe it out.

But before we can get there, we’ve got to understand that root cause and why these approaches work.

Understanding the Pain

Tennis elbow is also called lateral epicondylitis because the issue is centered around your lateral epicondyle – a bony bump on the outside of the upper arm bone called the humerus.

Supinate your forearm so your palm is up. Using your other hand, feel around the outside of your elbow to locate this area – it’s easy to find.

If you have tennis elbow, it will be REALLY easy – this is likely the center point of your symptoms. Most folks with tennis elbow feel a lot of tenderness at this point [1].

The symptoms may also travel down your forearm, and it’s very common to feel weakness with gripping or lifting.

As a side note, if you’re feeling pain along the INSIDE of your elbow, you’re probably dealing with medial epicondylitis, or golfer’s elbow. Check my article on golfer’s elbow treatment to get started.

Your lateral epicondyle serves as the attachment point for most of your wrist and forearm extensor muscles. These muscles work to extend both the wrist and the fingers. Some muscles that aid in supination also attach at this point.

lateral epicondylitis exercises - anatomy

When you repetitively make motions that use these muscles, excess force and tension can travel up the muscles and tendons and cause damage, including microtears, to the tissues [2].

Tennis movements like forehands, serves and backhands demand a great deal from your extensors, often while overstretching your supinators. Because of this, they can all contribute to the pain and damage in the area.

If you aren’t sure that tennis elbow is what you’re dealing with, you can perform a quick lateral epicondylitis test [3].

how to treat tennis elbow - maudsley's test

Just reach your forearm out in front of you, palm face down. Spread your fingers apart and using your other hand, press down on your middle finger. Resist the pressure.

If doing this causes main on the outside of your elbow, lateral epicondylitis is likely.

Chronic or Acute?

It’s important that you consider whether you are dealing with acute tennis elbow or a chronic form of the condition.

Let’s say you typically smash out a tennis match once a week, but when you go on vacation, your resort has a court. They’ve got the court and you’ve got the time, so you find yourself playing every day for a week.

tennis elbow symptoms - doubles game

When you get back home, your overworked swinging arm is weak and aching right around that lateral epicondyle. You’ve never felt the symptoms before and you know you overdid it.

This is acute tennis elbow. At this point, your tissues around your lateral epicondyle are in fact inflamed (hence the “itis” suffix in lateral epicondyle-ITIS).

What you need to do now is chill out and relax. Ice your elbow, and follow the steps I cover in my article on lateral epicondylitis treatment.

If you do so, you should be feeling fine and back to business soon.

But, let’s say you DON’T follow these steps. Let’s say you instead brush it off and jump back into your typical tennis routine.

You keep playing through the pain, meeting your buddies for matches without backing off, and digging deep to come out ahead in some 7-6 tiebreakers. The pain lingers, but you continue to ignore it and hope it will go away on its own.

In this case, you are likely dealing with chronic tennis elbow pain that has been bugging you for some time – probably 4 weeks or longer.

In the case of chronic tennis elbow, the name lateral epicondylitis is no longer such a good fit. What was once mostly inflammation has progressed into tissue degeneration and damage.

What is the Best Treatment for Tennis Elbow?

This brings us to our 3 lateral epicondylitis exercises and what they are not. If you do a little searching online for tennis elbow treatment, you’ll probably find a whole lot of one thing – static stretches.

tennis elbow exercises - lateral epicondylitis exercises

And yeah, working on flexibility might be helpful in the short term, but to effectively heal lateral epicondylitis, we can’t just train flexibility because more than just tightness contributes to the issue.

For one, we’ve got to get blood flow pumping to the area to help restore tissue quality and heal some of that damage caused by repetitive forces and static stretching doesn’t help much with this.

We’ve also got to build strength in the muscles in the area because – especially in the case of chronic pain – the muscles have likely atrophied and weakened.

Finally, we’ve also got to restore mobility (not flexibility) to the wrist and elbow joint. But we don’t want to haphazardly increase range of motion however we can.

For example, in the first mobilization exercise I’m about to introduce, you’ll want to focus on staying active and engaged throughout the motion.

The reason that this is better than just passively moving back and forth is that activating the muscles works to build strength in the extension range of motion.

I have name for this this active range of motion – Range of CONTROL (ROC).

If you’re doing too much passive or static stretching and your range of motion increases without an increase in your range of control, you create a range where you have flexibility but no strength.

When this happens, your neuromuscular system will reflexively cause your body to tighten up again to help protect yourself, meaning you just wasted your time.

And even worse, these zero-strength flexibility zones put you at a big risk for injury.

Think about it – it’s probably not safe for your body to be moving passively in ways it has no active control over, no joint stability, and no muscle protection. It is just setting yourself up for an increased risk of injury.

So let’s avoid thoughtless stretching while working instead to improve active mobility, strength, and control.

3 Best Lateral Epicondylitis Exercises

Reminder: These exercises are not meant for you if you’re dealing with acute tennis elbow. Be patient and give yourself time to heal.

If you have been chilling out and are now in the post-acute phase, OR if you have chronic lateral epicondylitis, then it’s time to dive in.

Active Wrist Extension Mobilization

This move is good for any kind of elbow pain associated with gripping (like a tennis racquet or even weights). It helps restore strength, balance, and mobility to the wrist joint.

Remember to focus on active engagement during this drill- we are really working to improve range of control here.
lateral epicondylitis exercises - wrist extension mobilization

  • Come into a quadruped position and sit back a little bit, leaning some weight into your feet
  • As you do this, extend one wrist and extend the fingers, bringing the hand and fingers up toward your wrist while keeping the elbow straight
  • Rock your weight forward slowly, maintaining that extension & the contraction of the extensors in the wrist and fingers, until your hand comes all the way down back onto the floor, with some pressure into the hand and generating some passive mobilization
  • Start to move back, lifting the fingers and the hand off the ground as quickly as possible, still maintaining that extension and that straight elbow
  • Repeat, keeping the extensors active the entire time, for 4-6 reps, then switch sides

Eccentric DB Wrist Extensions

This exercise will bring a lot of blood flow to the area as you work your extensor muscles. This drill will also help ensure you build strength throughout your range of motion, setting you up for a great range of control.

Grab a dumbbell for this move – probably between 2 to 5 pounds, depending on your pain level and starting strength. Be sure to maintain a strong grip on whatever dumbbell you’re using throughout the whole exercise!
lateral epicondylitis exercises - Eccentric DB Wrist Extensions

  • Kneel in front of a bench so that you can rest your working elbow on the bench, palm facing out away from you
  • Using your other hand, help yourself lift the dumbbell into full range of motion, with your wrist fully extended
  • Hold your wrist in full extension for a second, then slowly and with CONTROL, uncurl the wrist into full flexion over the edge of the bench – this motion should take about 4-5 seconds
  • Complete 3 sets of 12 reps, focusing on the eccentric motion

Extended Fist to Flexed Flare

Once again, this drill restores full range of control – not just range of motion. This is going to allow you to better do activities like gripping things while moving through different wrist motions – a very common movement pattern in sports like tennis and hockey.
lateral epicondylitis exercises - Extended Fist to Flexed Flare

  • Come back into that full flared position of the hand – with fingers both extended out and abducted away from each other
  • Keeping this flare of the hand, flex the wrist so these flared fingers are now pointing slightly downward
  • Hold this for 5 seconds, maintaining both full flexion of the wrist and extended flare of the hand
  • Slowly make a fist and move into wrist extension. Hold this strong fist and full wrist extension for 5 seconds
  • Return to the flared hand and wrist flexion position and repeat
  • Complete anywhere from 3-6 cycles on each side and make sure not to let the elbow bend at any point in the movement

If you’ve got chronic tennis elbow and these exercises trigger some pain around your lateral epicondyle, don’t freak. That’s to be expected. These tissues have been damaged and we’ve got to build back up strength slowly – not always an easy or pain free process.

Just don’t take on more weight than you can handle and stick with the exercises. Before you know it, the pain will be gone.

Give these lateral epicondylitis exercises a go and you might find that your symptoms disappear in a matter of weeks.

But it’s also important to remember that the involved muscles and tendons don’t work in isolation. They are a part of the intricate machine of your upper limb which is itself part of the bigger kinetic chain of the body.

lateral epicondylitis exercises - male gymnast

An issue like tennis elbow could easily be a sign or symptom of an imbalance or deficiency elsewhere.

Don’t ignore these warning signs. Instead, take the time to address these issues before they grow.

My Upper Limb Control Program is a great way to comprehensively uncover and address uncover and issues room your fingertips to your delts and everything in between.

Check it out and take a step to protect yourself from being sidelined by injuries like tennis elbow in the future.

About the Author

Eric Wong (aka Coach E) is the founder of Precision Movement and has a degree in Kinesiology from the University of Waterloo. He's been a coach since 2005 and spent his early career training combat athletes including multiple UFC fighters and professional boxers. He now dedicates himself to helping active people eliminate pain and improve mobility. He lives in Toronto (Go Leafs Go!) with his wife and two kids and drinks black coffee at work and IPAs at play. Click here to learn more about Eric.