Lateral elbow pain ยท Home exercise plan

Tennis Elbow Exercises for Common Extensor Tendinopathy

Common extensor tendinopathy usually improves through activity adjustment and progressive wrist-extensor loading. This plan moves from comfortable isometrics to slow strength, grip, and task-specific demand.

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Clinically reviewed July 17, 2026

Written and clinically reviewed by Jeremy Swisher, MD

Board-certified primary care sports medicine physician. Reviewed July 17, 2026.

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Jeremy Swisher, MD

Evidence-based home exercise program

Common Extensor Tendinopathy Home Exercise Program

Name: __________________________________

Affected side: ______________

Start date: __________________

Review date: _________________

Clinician or PT: ______________________________

This program may fit

Gradual pain and tenderness at or just below the outside elbow, aggravated by gripping, carrying, palm-down lifting, resisted wrist or finger extension, or stretching the wrist extensors.

Get assessed first

A sudden injury, major swelling or weakness, inability to fully move the elbow, locking or instability, neck pain with radiating symptoms, numbness or tingling, or pain located farther down the forearm that may reflect radial nerve involvement.

Stop signs

Seek same-day urgent assessment for a sudden pop with bruising or deformity, rapidly increasing pain, marked weakness, a hot, red, swollen elbow with fever, new numbness, or progressive weakness. Arrange a prompt evaluation for persistent rest or night pain or unexplained systemic symptoms.

Use the next morning

A small amount of familiar discomfort can be acceptable when it stays controlled, does not increase across repetitions, and returns to baseline by the next morning.

Fit and safety

Confirm this is the right diagnosis.

This starter program is intended for adults who have already been evaluated and told common extensor or lateral elbow tendinopathy is the likely diagnosis. It is not a self-diagnosis tool, a postoperative protocol, or a substitute for individualized care.

This program may fit

Gradual pain and tenderness at or just below the outside elbow, aggravated by gripping, carrying, palm-down lifting, resisted wrist or finger extension, or stretching the wrist extensors.

Get assessed first

A sudden injury, major swelling or weakness, inability to fully move the elbow, locking or instability, neck pain with radiating symptoms, numbness or tingling, or pain located farther down the forearm that may reflect radial nerve involvement.

Do not self-start with these warning signs

Seek same-day urgent assessment for a sudden pop with bruising or deformity, rapidly increasing pain, marked weakness, a hot, red, swollen elbow with fever, new numbness, or progressive weakness. Arrange a prompt evaluation for persistent rest or night pain or unexplained systemic symptoms.

This is a diagnosis-specific home program, not a substitute for an examination. A clinician may change the exercise, dose, range, or timeline based on your history.

Your home program

Load the wrist extensors, then restore the task.

Guidelines support isometric, concentric, and eccentric resisted wrist-extensor exercise, but no single dose is proven best. Use the isometric as the main load when the elbow is especially painful. As slow wrist extension becomes tolerable, use the isometric as a warm-up rather than treating both exercises as full sessions on the same day.

Frequency
Isometric daily when symptoms are sensitive; strength about 3 days per week
Equipment
Table, light dumbbell or water bottle, towel or putty, optional band
First checkpoint
Look for improvement by 4 to 6 weeks
Primary goal
Comfortable grip, carrying, lifting, work, and sport
  1. Exercise 1

    Isometric wrist extension

    Daily during the more painful phase

    Dose5 holds of 30 seconds with about 60 seconds of rest

    Support the forearm palm down with the wrist near neutral. Press the back of the hand into the opposite hand or a fixed surface without allowing movement. Use approximately 30 to 50 percent effort.

    Make it easier

    Use 3 holds of 20 seconds at lighter effort.

    Progress it

    Build to 5 holds of 45 seconds, then increase resistance gradually.

    My starting dose or notes

  2. Exercise 2

    Slow wrist extension

    Every other day, usually 3 days per week

    Dose3 sets of 12, progressing toward 15 repetitions

    Support the forearm palm down with the hand over a table edge. Raise the wrist for 2 seconds and lower for 3 to 4 seconds. Keep the fingers relaxed.

    Make it easier

    Use 2 sets of 10 with less weight or assist the lifting phase with the other hand.

    Progress it

    After two stable sessions, add the smallest available weight while keeping the slow tempo.

    My starting dose or notes

  3. Exercise 3

    Forearm pronation and supination

    3 days per week

    Dose2 sets of 12 repetitions in each direction

    Keep the elbow at 90 degrees against the side. Slowly rotate a light hammer or dumbbell from palm up to palm down without moving the upper arm.

    Make it easier

    Use no weight or hold closer to the weighted end.

    Progress it

    Hold farther from the weighted end, then add load.

    My starting dose or notes

  4. Exercise 4

    Controlled grip

    3 days per week

    Dose3 sets of 8 squeezes with a 5-second hold

    Squeeze a rolled towel or soft putty at submaximal effort. Keep the wrist straight rather than bending it back during the squeeze.

    Make it easier

    Use a lighter squeeze or a 3-second hold.

    Progress it

    Use firmer putty, then progress to short loaded carries with a neutral wrist.

    My starting dose or notes

  5. Exercise 5

    Band row with a neutral wrist

    3 days per week

    Dose2 to 3 sets of 12 repetitions

    Use a relaxed grip, keep the wrist straight, and draw the shoulder blade gently back without shrugging or clenching the band.

    Make it easier

    Use a lighter band or 2 sets of 10.

    Progress it

    Use a stronger band or progress to a controlled single-arm row.

    My starting dose or notes

Symptom response

Let the next day guide the dose.

A small amount of familiar discomfort can be acceptable when it stays controlled, does not increase across repetitions, and returns to baseline by the next morning.

Continue

Green light

Pain stays between 0 and 3 out of 10, grip remains steady, and symptoms return to baseline by the following morning.

Adjust

Yellow light

Pain reaches 4 to 5 out of 10, grip feels weaker afterward, or the elbow remains worse the next morning. Reduce weight, range, or repetitions by 25 to 50 percent and add recovery time.

Stop

Red light

Stop and seek prompt assessment for sharp, electric, or rapidly increasing pain, new numbness or weakness, major swelling, loss of motion, or symptoms that worsen week to week. Use same-day urgent care for rapidly progressive weakness or a hot, red, swollen elbow with fever.

Change one variable at a time

When symptoms are too reactive, first reduce range, resistance, repetitions, or frequency. When the current dose feels controlled for several sessions, progress only one of those variables.

Progression

Build capacity in stages.

  1. Stage 1: settle symptoms

    Reduce repetitive hard gripping and palm-down lifting. Use a neutral grip or palm-up lifting when practical and begin comfortable isometrics.

  2. Stage 2: build forearm capacity

    Add slow wrist extension, rotation, and controlled grip every other day. Progress repetitions before adding weight.

  3. Stage 3: return to work and sport demands

    Progress lever length, loaded carries, work tools, racquet handling, or lifting. Begin near half of your usual volume and increase only when symptoms return to baseline by the next day.

Signs you are ready for the next stage

  • Elbow and wrist motion are full or nearly full.
  • Daily tasks stay at 0 to 2 out of 10 without a next-day flare.
  • Resisted wrist extension and gripping stay controlled.
  • Two to three loading sessions and two graded task sessions do not escalate symptoms.

When to schedule an evaluation

Schedule a visit if neurologic or mechanical symptoms are present, pain is worsening, grip strength is progressively declining, or a correctly dosed program does not produce meaningful improvement after about four to six weeks.

Call UCLA Orthopedics at 310-319-1234

Mark up to three key program sessions each week. Use the notes column for symptoms, resistance, exercise duration, or an activity that became easier.

Week123Notes
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2
3
4
5
6

Questions or need an evaluation? Call UCLA Orthopedics at 310-319-1234.

Full guide, references, and updates: https://jeremyswishermd.com/lateral-elbow-tendinopathy-exercises/

Clinically reviewed: July 17, 2026.

This is the independent professional website of Jeremy Swisher, MD, not an official UCLA Health website. UCLA Health manages appointments and clinical communication.

For general educational information only, not individualized medical advice. If you have a medical emergency, call 911.

Common questions

Questions about this program

Do I need complete rest?

Usually not. Reduce the most provocative gripping and lifting dose while keeping tolerable movement and progressive loading.

Should I stretch the forearm?

Gentle stretching is optional and should not provoke a sustained flare. Stretching alone has not shown durable superiority over a loading-based plan.

Will a counterforce strap help?

A strap or wrist support may improve pain during an activity for some people, but long-term benefit is uncertain and it should not replace progressive loading.

Do I need imaging?

Imaging is not routinely required for a typical presentation. It becomes more useful after trauma, with mechanical or neurologic findings, or when appropriate care has not worked.

Evidence

Guidelines and primary sources

This plan translates current clinical guidance into a practical home program. The cited sources support the treatment principles, but they do not establish one universal exercise recipe for every patient.

Evidence and recommendations can change. Last clinical review: July 17, 2026.

Related care

Tendon guideEvidence-based tendon care Inside elbowCommon flexor tendinopathy exercises Shoulder programRotator cuff-related pain exercises

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