Treatment
Icing should be done multiple times a day at the muscles origin until the pain is completely gone. An ice pack for 15 -20 minutes is recommended.
Ice for Tennis Elbow
To warm up, preform gentle range of motion of the wrist. Flex the wrist then extend back to neutral for 10 times.
Wrist Extension Warm Up
Next, follow this with a full wrist and finger flexion stretch. Make sure to keep the elbow fully extended. Each stretch should be held for 15-20 seconds and done multiple times a day.
Full Wrist and Finger Flexion Stretch
Another way to do the same type of stretch is to use a wall. Again, elbow straight and wrist flexed.
Full Wrist and Finger Flexion Stretch With Wall
Once the pain has decreased, you may begin strengthening exercise. Start with eccentric, or "the negative contraction," of the muscle only. Support the elbow and forearm on a table with the backside of your hand facing upward. Extend the wrist fully. Once extended, place a weight in your involved hand then lower the weight down. Remove the weight and return your wrist into full extension. Build up to 3 sets of 10 reps.
Wrist Extension Eccentric Strengthening With Dumbbell
The same type of exercise may be done with a stretchy band. Again, make sure to focus on doing the negative or lengthening contraction of the muscle only. Remember to build up to 3 sets of 10 reps. If your pain increases you may be doing too much, too soon.
Wrist Extension Eccentric Strengthening With Band
A Flex Bar is another tool that may be used to preform eccentric contraction exercises. Hold the bar firmly in both hands. Twist the non-effected side forward while stabilizing with the effected side. Now slowly allow the effected side to rotate forward. Remember only rotate back to the starting point with the non-effected side. Build up to 3 sets of 10 reps.
Wrist Extension Eccentric Strengthening With Flex Bar
If you are feeling little to no pain with the previous eccentric exercise, you may move to doing both concentric and eccentric muscle contractions. These may be done using a dumbbell or stretchy band. Build up to 3 sets of 10 reps.
Wrist Extension Concentric and Eccentric Strengthening With Dumbbell
Wrist Extension Concentric and Eccentric Strengthening With Band
Massage may help as well. A gross rubbing of the muscle is Ok, but is not as effective as a cross friction massage shown here. Apply light to moderate pressure, to begin and remember to massage across the muscle not with it.
Cross Friction Massage
A counter pressure elbow strap may help during activates. Secure the strap slightly below the elbow joint. Find the bony knot on the outside of the elbow and place the strap just below that. Don't allow the strap to fall down on the larger part of the muscle belly.
Counter Pressure Strap
