Elbow Tendonitis Exercises (UPDATED 2020)

What is Elbow Tendonitis?

It is the inflammation of the tendons in the elbow.

This can result in pain, swelling and/or stiffness in the elbow.


The content presented on this blog post is not medical advice and should not be treated as such. It is not intended to be used as a substitute for professional advice, diagnosis or treatment.

For more information: Medical disclaimer.


Types (Based on Location Of Pain)

1. Lateral Epicondylitis (“Tennis Elbow”)

lateral elbow tendonitis

The affected structures are located on the outer surface of the elbow.

These following tendons are part of the wrist/finger extensor muscle group and attach to the Common Extensor Origin. (See above)

Potential injury to:

  • Extensor Carpi Radialis Brevis
  • Extensor Digitorum
  • Extensor Carpi Ulnaris
  • Extensor Carpi Radiali Longus
  • Supinator

2. Medial Epicondylitis (“Golfers Elbow”)

medial elbow tendonitis

The affected structures are located on the inner surface of the elbow.

The following tendons are part of the wrist/finger flexor muscle group and attach to the Common Flexor Origin. (See above)

Potential injury to:

  • Flexor Carpi Radialis
  • Pronator Teres
  • Flexor Digitorum Superficialis
  • Palmaris Longus

(Note: I would advise you to check out the location of these muscles on Google.)

What causes elbow tendonitis?

Essentially – it is due to overuse, misuse and/or abuse of the elbow.

Any repetitive or prolonged use of a weak elbow increases the risk of damage to the tendons.

This involves:

  • Using your wrist in an ineffective position over a prolonged amount of time
  • Insufficient recovery times between periods of use
  • Weak tendons in the elbow
  • Performing activities at loads which exceed the capacity of the elbow tendons.

How to tell if you have Elbow tendonitis

a) Get a scan

An ultrasound or a MRI scan of the elbow is the best way to determine.

b) Location of pain

For Lateral Epicondylitis: The pain will be on the outside of your forearm and can span to the back of the fingers.

For Medial Epicondylitis: The pain will be on the inside of your forearm and can span to the front of the fingers.

c) Tests

For Lateral Epicondylitis:

lateral elbow tendonitis test

Instructions:

  • Place your arm in front of you.
  • Extend your fingers and have the palm facing downwards.
  • Using your other hand, apply a firm downward force on top of your fingers.
  • Resist this motion.

Results: If your pain is reproduced in the outer elbow, then it is likely you have Lateral Epicondylitis (Tennis Elbow).

For Medial Epicondylitis:

Instructions:

  • Place your arm in front of you.
  • Extend your fingers and have with the palm facing upwards.
  • Using your other hand, apply a firm downward force on top of your fingers.
  • Resist this motion.
Results: If your pain is reproduced in the inner elbow, then it is likely you have Medial Epicondylitis (Golfers Elbow).

Exercises for Elbow Tendonitis

Disclaimer: The following exercises are designed to be gentle. Please be careful! If any doubts, please consult a health practitioner before you commence any of these exercises.


Step 1: Address any activity that causes pain

Stop, Modify and/or Reduce exposure to any activity that makes your symptoms worse.

How can you expect the following Elbow Tendonitis exercises to help if you continue to aggravate your symptoms?

I can’t stress this enough: Failure to comply with Step 1 will make it very difficult for you to fix your elbow.

Step 2: Reduce Inflammation

Before starting the Elbow Tendonitis Exercises, it is important to reduce any excessive amounts of inflammation.

(If the inflammation is not controlled, the elbow may be too painful or sensitive to tolerate the exercises.)


a) Use a cold pack

  • to reduce excessive inflammation
  • to decrease the pain levels by numbing the area
  • to manage swelling

Recommendation: 10-15 minutes, 3-5 times a day

I generally recommend cold therapy for 2-3 days following any recent aggravation.

b) Anti-inflammatory gel

anti inflammatory medication

Apply an anti-inflammatory gel to the areas of pain to help manage excessive inflammation.

Recommendation: 2-3/day

c) Non-steroidal Anti-Inflammatory Drugs (NSAIDs)

This oral medication reduces inflammation in the whole body.

It is recommended that you take it strictly for 10-14 days, at the same time of day, regardless of pain levels.

(Consult your doctor before taking this medication to determine the appropriate dosage.)

d) Steroid injection

cortisone injection for elbow tendonitis

This injection consists of a strong steroid (Cortisone) which helps reduces local inflammation.

My recommendation: Try the following Elbow Tendonitis Exercises before you even consider getting the cortisone injection.

Step 3: Symptomatic relief

a) Use a heat pack:

  • to relax tight muscles
  • to improve circulation
  • attract nutrients and healing properties to the area

Recommendation: 10-15 minutes, 3-5 times a day

b) Pain killers

In the initial stages, pain killer medication can be helpful in the reduction of pain.

However, as the pain levels improve, I would advise to wean off as soon as you can.

(Please consult your doctor to determine what would be the most appropriate medication.)

Step 4: Releases

Starting position:

a) For Lateral Epicondylitis (Tennis Elbow): Place your forearm (palm facing upwards) onto a table.

b) For Medial Epicondylitis (Golfers Elbow): Place your forearm (palm facing downwards) onto a table.

medial elbow tendonitis releases

Instructions:

  • Place a massage ball underneath the painful points of the elbow.
  • Apply a firm downward pressure onto the ball.
    • If required, you can use your other hand on top of the forearm to apply additional pressure.
  • Make sure to search and release for all of the painful regions.
  • Whilst maintaining the pressure, proceed to do a combination of wrist movements:  Wrist circles, Open/close hand, Up/down, Side-to-side and Twisting movements.
  • Continue for 1-3 minutes.

Step 5: Stretches

Stretching is all about a game of angles. You may need to adjust the position of your hands until you get the specific stretch in the right location.

I suggest doing both stretches regardless if you have tennis elbow or golfer’s elbow.

Note: Do NOT stretch into sharp pain!


a) For Lateral Epicondylitis (Tennis Elbow)

tennis elbow stretch

Instructions:

  • Straighten your arm in front of you. (palm facing downwards)
  • Make a gentle fist with your hand.
  • Bend your wrist downwards.
  • Twist your wrist outwards.
  • Using your other hand, apply more pressure into the same direction.
  • Aim to feel a stretch on the outside of your elbow.
  • Hold for 30 seconds.
  • Repeat 3 times.

b) For Medial Epicondylitis (Golfers Elbow)

golfers elbow stretch

Instructions:

  • Straighten your arm in front of you. (palm facing upwards)
  • Keep your hand and fingers opened.
  • Bend your hand towards the floor.
  • Using your other hand, apply more pressure into the same direction.
  • Aim to feel a stretch on the inside of your elbow.
  • Hold for 30 seconds.
  • Repeat 3 times.

Step 6: Reduce nerve sensitivity

There are several nerves in the elbow that can amplify the amount of pain being experienced.

Nerve glides/stretches are great ways to reduce the sensitivity of the nerves.


(READ THIS: Do not over stretch the nerves as this can cause more irritation! Go slow! Avoid any tingling/numbness in the arms.)

a) For Lateral Epicondylitis (Tennis Elbow)

nerve glide for elbow tendonitis

Instructions:

  • Pull your shoulders back and down.
  • Keep your elbow completely straight throughout this exercise.
  • Lift your arm out towards the side towards shoulder height
  • Make a gentle fist with your hand.
  • Twist your entire arm inwards (internal rotation) so that the palm is facing behind you.
  • Bend your wrist backwards.
  • Slowly tilt your neck towards the opposite side.
  • Aim to feel a stretch anywhere along the side of the neck/upper arm/outside elbow and back of wrist.
  • Hold for 1-2 seconds.
  • Repeat 20 times.

b) For Medial Epicondylitis (Golfers Elbow)

Instructions:

  • Pull your shoulders back and down.
  • Keep your elbow completely straight throughout this exercise.
  • Lift your arm out towards the side to shoulder height.
  • Bring your arm backwards.
  • Twist your entire arm outwards (external rotation) so that the palm is facing upwards.
  • Extend your wrist/fingers backwards so that the fingers are pointing towards the floor.
  • Slowly tilt your neck towards the opposite side.
  • Aim to feel a gentle stretch anywhere along the side of the neck/upper arm/inside elbow and front of wrist.
  • Hold for 1-2 seconds.
  • Repeat 20 times.

Step 7: Isometric Contractions

Isometric contractions of the elbow is when you activate the muscle without moving the elbow/wrist/fingers.

The aim of the following Elbow Tendonitis exercises is to reduce pain and to commence gentle strengthening exercises.


a) Initial exercises

isometric elbow tendonitis exercises

Instructions

  • Bend your elbow to 90 degrees whilst keeping your elbow by your side.
  • For Lateral Epicondylitis (Tennis Elbow): Make a gentle fist with palm facing downwards.
  • For Medial Epicondylitis (Golfers Elbow): Make a gentle fist with palm facing upwards.
  • Maintain this position as you push down on the fist with your other hand.
  • The aim is to push as hard as possible without causing a significant amount of pain.
    • A slight discomfort and/or small amount of pain is acceptable.
  • Feel the contraction of the muscle at the site of pain.
  • Hold for 45 seconds.
  • Repeat 3 times.
  • Progression: Perform the same exercises with an open hand. (resistance applied at finger tips).
    • You can perform this exercise at different wrist angles as well.

Step 8: Strengthening exercises

These exercises are designed to improve tendon strength, endurance and load tolerance.

My recommendation:

  • Start with a light resistance with high repetitions.
  • Progress to heavier resistance with low repetitions.

a) Grip strength

grip strengthening elbow tendonitis exercises

Instructions:

  • Grip onto a stress ball.
  • Firmly squeeze as hard as you can without feeling any pain.
  • Hold for 5-10 seconds.
  • Repeat 10 times.
  • Progression: Move your hand in different directions as you squeeze. (eg. Up/down, circles, side to side, twisting)

b) Eccentric strengthening

eccentric exercises for elbow tendonitis

Instructions:

  • Support your forearm onto a table with your hand hanging over the edge.
    • For Tennis elbow: Palm facing downwards
    • For Golfers elbow: Palm facing upwards.
  • Place a suitable amount of weight in your hand.
    • (Challenging, but able to control)
  • Using your unaffected hand, lift both the weight and hand together upwards.
  • Let go of the hand, and allow the hand holding onto the weight to control the weight as it is slowly lowered.
  • Perform 20 repetitions.
  • Repeat 3 times.

c) Resisted Extension/Flexion

strengthening exercises for elbow tendonitis

Instructions:

  • Support your forearm onto a table with your hand hanging over the edge.
    • For Tennis elbow: Palm facing downwards
    • For Golfers elbow: Palm facing upwards.
  • Place a suitable amount of weight in your hand.
    • (Challenging, but able to control)
  • Whilst holding onto the weight, proceed to lift and lower the weight in a slow and controlled manner.
    • 3 seconds up/3 seconds down
  • Perform 20 repetitions.
  • Repeat 3 times.

d) Resisted Supination/Pronation

Instructions:

  • Support your forearm onto a table with your hand hanging over the edge.
  • Hold onto a hammer.
  • Proceed to twist your forearm (palms up/down).
  • Perform 20 repetitions.
  • Repeat 3 times.
  • Progression: Tie a resistance band to the hammer.

e) Finger strength

finger strengthening elbow tendonitis exercises

Instructions:

  • Apply the finger resistance band as shown above.
  • Proceed to open and close your hand.
  • Perform 20 repetitions.
  • Repeat 3 times.

Step 9: Reduce demand on the elbow

The elbow will tend to compensate for any weakness in other areas of the body.

Strengthening these weak areas will reduce the demand on the elbow muscles.


For Lateral Epicondylitis (Tennis Elbow):

a) Scapula retraction + Posterior shoulder strengthening

Instructions:

  • Tie a resistance band onto a stationary object at waist height.
  • Stand sideways.
  • Hold onto the band and keep your elbows by your side throughout the exercise.
  • Make sure to keep your palms facing forwards towards the resistance band.
  • Keep your shoulders wide/long and gently retract the shoulder blades.
  • Pull the band out to the side.
  • Aim to feel a contraction in between the shoulder blade and behind the shoulder joint.
  • If you feel your elbow is over working, reduce the amount of resistance on the band.
  • Hold for 3-5 seconds.
  • Repeat 10 times.

b) Shoulder flexion

Instructions:

  • Hold onto a suitable amount of weight.
    • (Challenging, but able to control)
  • Raise your arm up to shoulder height.
  • Keep your palm facing downwards.
  • Aim to feel a contraction in the front of your shoulder.
  • Make sure to keep your wrist and elbow locked into position.
    • The movement should be from the shoulder only.
  • Repeat 10 times.

For Medial Epicondylitis (Golfers Elbow):

a) Pulling (Latissimus dorsi)

Instructions:

  • Tie a resistance band in front of you.
  • Loosely grip the band with your hand.
  • Pull the band backwards.
    • Think about the elbow driving backwards (as opposed to pulling with the hand).
  • Feel the contraction in the latissimus dorsi and biceps muscle.
  • If you feel your elbow is over working, reduce the amount of resistance on the band.
  • Hold for 3-5 seconds.
  • Repeat 10 times.

For both:

This exercise will help with your grip strength.

a) Thumb opposition

thumb and pinky opposition

Instructions:

  • Place the tips of your pinky finger and thumb together.
  • Squeeze is hard as you can.
  • Keep your fingers curved as you squeeze. (see above)
  • Hold for 10 seconds.
  • Repeat 5 times.

Step 10: Use the Wrist in a neutral position

It is important to use the wrist in a neutral position as it encourages the most optimal use of the muscles.

(Keep in mind – depending on what you’re doing with your hand, this will not always be possible!)


The neutral position of the wrist:

a) The middle finger is aligned with the line of the forearm

neutral wrist position for elbow tendonitis exercises

b) The wrist is bent slightly backwards

Any deviation away from the neutral wrist position may increase the risk of aggravating your symptoms.

Step 11: Know your limits

Although I have highlighted in Step 1 to avoid all aggravating activities, you still need to keep your elbow as mobile as possible.

Enter what I call Threshold movements: This refers to the maximum amount of stress the elbow can tolerate before re-aggravating.

(It is important to monitor the pain levels during and 24 hours later.)

The trick is keeping your elbow activity as close to the threshold level without going over.

For example:
If you can tolerate 1 hour of typing without any issue, but your elbow aggravates when you type for 1 hr + 10 minutes, then ~1 hour will be your threshold level.
In that case, you should aim to type for ~1 hour and follow up by a rest period before resuming the activity.

Step 12: Address Rounded Shoulders

rounded shoulders

A forward position of your shoulder will place your elbow in a position where it will be forced to work inefficiently.

This means that the tendons in the elbow will have to work harder than they should!

a) Chest stretch

Chest stretch

Instructions:

  • Place both hands on the door frame. (see above)
  • Pull your shoulders back.
    • “Open up your chest”
  • Lunge forwards.
  • Do not arch your lower back.
  • Aim to feel a stretch in the chest region.
  • Hold for 30 seconds.

b) Scapula Retraction

exercises for rounded shoulders

Instructions:

  • Maintain wide and long shoulders.
  • Perform Scapular Retraction: (see above)
    • “Pull your shoulder blades together”
  • FEEL the contraction between the shoulder blades.
  • Hold for 30 seconds.
  • Repeat 3 times.
Do you have it?
For more information, check out this blog post:

Step 13: Elbow tendonitis Straps

Elbow braces can help  provide support to your muscles.

Just remember – DO NOT become dependent on them!


a) Elbow brace

brace for elbow tendonitis

Elbow braces provide a compression force on the elbow muscles providing stability.

b) Elbow taping:

For Lateral Epicondylitis (Tennis Elbow)

[See Video]

For Medial Epicondylitis (Golfers Elbow)

[See video]


How often should I do these Elbow Tendonitis Exercises?

  • Start with 1/week for the first 2 weeks.
  • Progress to 2/week for 4 weeks.
  • Aim for 3/week if tolerated.

How long does tendonitis in the elbow take to heal?

For a minor presentation, it is likely going to take 2-6 weeks to recover.

If you have a chronic case, it may take 3-6 months.

(Keep in mind – there are several factors which can influence the healing time.)

What to do next

1. Any questions?… (Leave me a comment down below.)

2. Come join me on the Facebook page. Let’s keep in touch!

3. Start doing the Elbow Tendonitis exercises!

50 thoughts on “Elbow Tendonitis Exercises (UPDATED 2020)”

  1. Tennis players and golfers have more chances to get elbow tendonitis, and stretching before and after would be really helpful.

    Reply
  2. Hi Mark – just wanted to leave a note to say thank you for putting this all together. I’ve had chronic elbow pain for the last two years in my right elbow and am starting to get it on the left, and from countless doctors visits and PT appointments, your list here is the most comprehensive and holistic set of resources I’ve found.

    You’re making a positive change for people, especially in this world where so many people are spending so much time working from home and causing these kinds of injuries (at least the tennis elbow ones for sure).

    Reply
  3. Hi Mark,

    I have crunching and cracking in my left elbow with no pain, every time it is extended. I have also had Tennis elbow in that arm, since August and wondered if the problems might be linked at all?

    I use the gym regularly and play tennis and have been resting now for a month in the hope they tennis elbow will go away. Although the pain is easing the cracking/ crunching sound in my left elbow is almost contact every time it is extended.

    Thank you,
    Josh

    Reply
    • Hey James,

      If the crunching is consistent with pure elbow extension, this could be due to an issue of the Ulnohumeral and/or radiohumeral joint.

      Have you had any scans to check it out?

      Mark

      Reply
    • Hi Mark,

      Thank you for your reply. I have not had a scan as it is causing me no real pain. As I currently have Tennis elbow, I thought the issue could be linked?

      Would you say that this likely to be a different issue? If so is this likely something that settles down on its own?

      Added to this, I was planning on returning to the gym/ tennis in two weeks, if this crunching sound is continuing in my elbow would you recommend not doing so?

      Thank you for your help.

      Reply
      • Hi James,

        Hard to say without assessing. If the clicking is occurring directly over the area you are experiencing your tennis elbow, it could also possibly be a tendon that is flicking over a bony prominence as you extend your elbow.

        However – you specifically mentioned that word “crunching” so this makes me feel it more so the joint. I would recommend getting it scanned (or at least assessed by a health professional) before returning to gym.

        Mark

        Reply
    • I should also add, the crunching sound is more when I exert force on the elbow. So lifting a weight, doing a press up or hitting a backhands in tennis. Again there is really no pain accompanied with this.

      Reply

Leave a Comment

This site uses Akismet to reduce spam. Learn how your comment data is processed.