Tennis elbow exercises at home

What's going on

Despite the name, most people with tennis elbow don't play tennis. It shows up after lots of gripping and wrist work: a new tool, a lot of mouse and keyboard time, carrying, painting, or a jump in training. You feel it on the outside of the elbow when you grip, lift a kettle or shake hands.

Tendons tend to get irritated when load goes up faster than they can adapt. The fix is usually two things together: ease off whatever spiked it, and then gradually load the tendon again so it gets stronger. Exercise that is too gentle does little, and too much flares it up, so the plan below builds in steps.

Step 1: settle it down

• Cut back on the activity that brought it on for a while, or change how you do it: a lighter grip, palm-up lifting, a bigger handle.
• Keep moving the elbow and wrist normally. Total rest tends to leave the tendon weaker.
• Start the holds below, which are often comfortable even when the elbow is sore.

Step 2: the exercises

1. Wrist extension holds. Rest your forearm on a table, palm down, hand over the edge. Lift the hand slightly and hold it level, or hold a very light weight there. 30 to 45 seconds, 4 or 5 times, with a minute's rest. Mild discomfort is OK.
2. Grip squeeze. Squeeze a soft ball or rolled towel at a comfortable effort for 5 seconds, relax. 10 reps.
3. Slow wrist lowering. Same position as the hold. Use the other hand to help lift the wrist up, then lower it slowly on its own over 3 to 4 seconds with a light weight. 3 sets of 10 to 15.
4. Towel twist. Hold a rolled towel in both hands and wring it like you're squeezing out water, one direction then the other. 10 each way.
5. Forearm rotation. Elbow bent at your side, hold a light hammer or a can and slowly turn the palm up and down. 2 sets of 10.
6. Gentle wrist stretch. Arm straight, palm down, use the other hand to bend the wrist down until you feel a stretch along the forearm. Hold 20 to 30 seconds.

Step 3: build the load

Once the slow lowering feels easy at 15 reps with little pain, make it harder: a slightly heavier weight, a thicker band, or doing it with the elbow straighter. Then bring back the activity that caused it, gradually, and keep a couple of sessions a week of the loading exercises going.

Tendons adapt slowly, so give each step a couple of weeks. A simple pain guide many people use: up to about 3 out of 10 during exercise is acceptable if it settles by the next day. If it's worse the next morning, drop back one step.

Everyday changes that help

• Lift with your palm facing up instead of down where you can.
• Make handles thicker with tape or foam so you don't need to grip as hard.
• Break up long spells of mouse or tool use with short breaks.
• Check your keyboard and mouse setup so the wrist isn't bent back all day.

Get it checked if

• The elbow swells, looks deformed or you can't straighten it after an injury
• There's numbness or tingling into the hand
• Pain is getting worse over several weeks despite easing off and doing the exercises
• You have pain at rest or at night that won't settle

A sample week

Weeks 1 and 2: wrist extension holds once or twice a day, plus grip squeezes and the wrist stretch. Week 3 onward, if the holds are comfortable: slow wrist lowering every other day, 3 sets, with the towel twist and forearm rotation on the same days. Keep the holds going on the days in between.

Every week or two, if the next-morning check is fine, make one thing a little harder: a heavier water bottle, a few more reps, or a thicker band. If the elbow is clearly worse the next day, go back to the previous week's version for a few days and try again.

Signs it's working

• Gripping a mug or shaking hands hurts less, or later in the day than before.
• You can do more reps, or use a heavier weight, for the same level of discomfort.
• Morning stiffness eases more quickly.
• You can do more of the activity that started it before it hurts.

Questions worth asking your physio

• How much pain is OK during the exercises for my elbow?
• When should I move from holds to lifting and lowering?
• Should I change anything at work or in my training while it settles?
• Would a forearm strap help me?

Changing how you grip and lift

• Lift with your palm facing up where you can, which takes load off the outer elbow.
• Use both hands for heavier objects.
• Thicker handles on tools, rackets and pens reduce strain.
• At the keyboard, keep the wrist level rather than bent back.
• Take short breaks from repetitive gripping tasks.

A sample week

• Isometrics: daily in the early stage, often before painful tasks.
• Slow lowering and grip: every other day.
• Heavier strength: three times a week once it's comfortable.

Keeping the routine going

Tendon rehab is about steady loading over weeks. Apex One has a guided tennis elbow program for between physio sessions. In Apex One+, the program talks you through each exercise out loud, times your holds, and asks you to rate pain before and after each session, so you have something concrete to show your physio. The voice counts reps at a steady pace; the camera isn't used for these exercises.

Count every rep with your phone

Questions

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