Lateral Tennis Elbow and Eccentric Physical Therapy Exercises

Lateral Tennis Elbow and Eccentric Physical Therapy Exercises

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A two-handed backhand swing reduces strain on the wrist.

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Tennis elbow doesn't affect only tennis players. Overuse of the tendon on the outside of the elbow -- the lateral side -- often occurs with other racquet sports and occupations that require repetitive use of hand tools. Physical therapy exercises are often prescribed to treat tennis elbow.


Tennis elbow -- also called lateral epicondylitis -- is a painful condition caused by tiny tendon tears. The muscles that bend the wrist backward run along the back of the forearm. These muscles come together to form one tendon that attaches to the pointed bone on the outside of the elbow. Tennis elbow typically causes pain just below this bone. Physical therapy uses treatments such as heat, ultrasound, electrical stimulation, ice and massage to decrease pain from tennis elbow. Eccentric exercises are prescribed to target healing of the damaged tendon.

Eccentric Strengthening

Traditional exercise programs focus on concentric strengthening, meaning the muscle shortens as it contracts. The muscle is stronger than the resistance being applied against it during this "lifting" phase of movement.

Eccentric exercises, in contrast, strengthen the muscle as it lengthens, during the "lowering" phase of an exercise. According to a study published in 2008 by "Canadian Family Physician," eccentric exercises improve strength more than concentric exercises. Eccentric exercises are often used to treat tennis elbow. New scar tissue forms as stress is put on the tendon as it lengthens in the lowering movement. This new tissue strengthens the tendon, compensating for the damage from the tiny tears caused by tendinitis.

Resistance Band Exercise

Tennis elbow exercises target the wrist extensors -- the muscles that bend the wrist backward. These exercises can be performed in a sitting position with an elastic resistance band. The band is knotted together at the ends to form a large loop. With the knot firmly under one foot, the band is brought up over the back of the hand, holding the fingers out straight while the forearm rests along the thigh. The opposite hand lifts the exercising hand with the band to bring it into a backward bent position. From this position, the exercising hand slowly lowers back down against the resistance of the band. The exercise is typically repeated 15 times, 3 sets in a row with 1 minute of rest between each set.


Tennis elbow programs may combine concentric and eccentric exercises. Holding a free weight in the hand, the wrist is supported on the thigh in a palm-down position. With the elbow bent to 90 degrees, the wrist is slowly bent forward as far as possible, then backward. Movement in each direction should last 5 to 10 seconds.

The exercise is repeated with the elbow straight. The weight should be heavy enough to allow each exercise to be performed only 10 times -- the arm should be too tired to do more repetitions. These exercises are performed once daily for 4 to 6 weeks. Pain from tennis elbow should diminish with these exercises.