Jeremy Swisher, MD
Evidence-informed home exercise program
Common Flexor Tendinopathy Home Exercise Program
Name: __________________________________
Affected side: ______________
Start date: __________________
Review date: _________________
Clinician or PT: ______________________________
Before you start
This starter program is intended for adults who have already been evaluated and told common flexor or medial elbow tendinopathy is the likely diagnosis. It is not appropriate for a suspected ulnar collateral ligament injury or ulnar neuropathy.
This program may fit
Gradual focal pain and tenderness at or just below the inside elbow, aggravated by gripping, resisted wrist flexion, forearm pronation, or stretching into wrist extension.
Get assessed first
A sudden throwing injury, loss of throwing velocity, a feeling that the inner elbow is unstable during throwing, numbness or tingling into the ring and small fingers, hand weakness, snapping at the medial elbow, major swelling, locking, or neck symptoms radiating into the arm.
Stop signs
Call 911 for chest pain, trouble breathing, fainting, or another medical emergency. Seek same-day urgent assessment for a sudden pop with bruising or deformity, marked or progressive hand weakness, acute throwing-related instability, or a new painful, hot, red, or swollen elbow with or without fever. Arrange a prompt evaluation for persistent ring-finger or small-finger numbness, unexplained rest or night pain, weight loss, or other systemic symptoms.
Check the next morning
A small amount of familiar tendon discomfort can be acceptable when it stays controlled and returns to baseline by the next morning. Neurologic symptoms or throwing-related instability are not acceptable loading symptoms. These numbers are practical monitoring guides, not validated universal thresholds.
Fit and safety
Confirm this is the right diagnosis.
This starter program is intended for adults who have already been evaluated and told common flexor or medial elbow tendinopathy is the likely diagnosis. It is not appropriate for a suspected ulnar collateral ligament injury or ulnar neuropathy.
This program may fit
Gradual focal pain and tenderness at or just below the inside elbow, aggravated by gripping, resisted wrist flexion, forearm pronation, or stretching into wrist extension.
Get assessed first
A sudden throwing injury, loss of throwing velocity, a feeling that the inner elbow is unstable during throwing, numbness or tingling into the ring and small fingers, hand weakness, snapping at the medial elbow, major swelling, locking, or neck symptoms radiating into the arm.
Do not self-start with these warning signs
Call 911 for chest pain, trouble breathing, fainting, or another medical emergency. Seek same-day urgent assessment for a sudden pop with bruising or deformity, marked or progressive hand weakness, acute throwing-related instability, or a new painful, hot, red, or swollen elbow with or without fever. Arrange a prompt evaluation for persistent ring-finger or small-finger numbness, unexplained rest or night pain, weight loss, or other 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
Strengthen the forearm while watching for signs of nerve or ligament injury.
Use wrist-flexor loading as the main exercise. When the elbow is especially painful, start with the static hold. As slow wrist flexion becomes tolerable, use a brief easy hold as a warm-up instead of doing both as full loading sessions. Add rotation and grip one at a time as tolerated; the row is optional. Direct research for medial elbow tendinopathy is limited, so use the next-morning response to guide the dose.
- Frequency
- Isometric daily when symptoms are sensitive; strength about 3 days per week
- Equipment
- Table, light dumbbell or water bottle, light hammer, towel or putty, optional band
- First checkpoint
- Look for improvement by 4 to 6 weeks
- Primary goal
- Comfortable grip, pulling, lifting, work, racquet, or golf demand
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Exercise 1Daily during the more painful phase
Isometric wrist flexion
Dose5 holds of 30 seconds with about 60 seconds of rest
Sit with the forearm supported, palm up, and wrist straight. Place the opposite hand across the palm. Try to curl the palm toward the forearm while the opposite hand holds the wrist still. Keep the fingers relaxed and breathe normally. Begin at light effort, usually around 20 to 40 percent, and use less if symptoms are highly irritable.
Make it easierUse 3 holds of 20 seconds at lighter effort.
Progress itBuild toward 5 holds of 45 seconds before increasing hand pressure. Change one variable at a time and keep the next-morning response at baseline.
My starting dose or notes
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Exercise 2Every other day, usually 3 days per week
Slow wrist flexion
Dose3 sets of 12, progressing toward 15 repetitions
Rest the forearm palm up on a table with the elbow bent and only the hand beyond the edge. Hold a light dumbbell or water bottle. Curl the palm toward the forearm for 2 seconds, then lower for 3 to 4 seconds. Keep the forearm supported and avoid rolling the wrist sideways.
Make it easierUse 2 sets of 10 with less weight or a smaller range. If needed, help lift with the other hand, then lower slowly with the affected hand.
Progress itOnce 15 repetitions are controlled for two sessions without a next-morning flare, add a little water to the bottle or the smallest weight increment. Keep the same slow tempo.
My starting dose or notes
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Exercise 33 days per week
Slow forearm rotation with a hammer
Dose2 sets of 12 repetitions
Support the forearm with the elbow bent to 90 degrees and the hand beyond the table edge. Start thumb up with the hammer head pointing toward the ceiling. Slowly lower the hammer toward a palm-up position over 3 to 4 seconds, keeping the wrist straight and upper arm still. Use the other hand to help return to thumb up. This loads the pronator muscles as they control the lowering.
Make it easierPractice without the hammer, or grip close to its head and use a smaller comfortable arc.
Progress itMove the grip a small distance farther down the hammer handle to increase the lever length. Keep the same controlled range and speed before trying a heavier hammer.
My starting dose or notes
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Exercise 43 days per week
Controlled grip
Dose3 sets of 8 squeezes with a 5-second hold
Support the forearm and keep the wrist straight. Squeeze a rolled towel or soft putty at submaximal effort, hold, then fully relax between repetitions. Avoid maximal gripping.
Make it easierUse a lighter squeeze or a 3-second hold.
Progress itUse firmer putty, then try a light carry at your side with the wrist straight. Start with a brief carry and increase time or weight separately.
My starting dose or notes
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Exercise 53 days per week
Optional band row with a neutral wrist
Dose2 to 3 sets of 12 repetitions
Use this optional exercise when shoulder-blade strength or endurance is limited or it supports your task. Secure the band at lower-chest height. With a relaxed grip and straight wrists, pull the elbows toward the ribs without shrugging, then return slowly.
Make it easierUse a lighter band, stand closer to the anchor, or use 2 sets of 10.
Progress itTake a small step away from the anchor or use a slightly stronger band. Keep the wrists straight and avoid clenching harder to finish the repetitions.
My starting dose or notes
Optional video companion
See the movement principles in context.
The written program above remains the prescription. This independent third-party video adds a visual explanation of the condition and common exercise options.
E3 Rehab video
Golfer’s Elbow Rehab (Education | Myths | Stretching & Strengthening Exercises)
YouTube content does not load until you choose this button.
A visual overview of medial elbow tendinopathy, activity modification, and progressive wrist, grip, and upper-limb loading.
Watch on YouTube (opens in a new tab)Use this video for education and technique, not as a second exercise program. Follow the exercises, dose, progression, and symptom rules on this page. Video examples are options, not additions. Links or promotions inside the video are provided by E3 Rehab and are not part of this program. Do not stack the video’s full exercise menu onto this page’s dose. Acute throwing pain, lost velocity or instability, snapping, or ring- and small-finger symptoms need ligament or nerve assessment. Throwers also need a separate interval throwing plan.
Symptom response
Let the next day guide the dose.
A small amount of familiar tendon discomfort can be acceptable when it stays controlled and returns to baseline by the next morning. Neurologic symptoms or throwing-related instability are not acceptable loading symptoms. These numbers are practical monitoring guides, not validated universal thresholds.
Green light
Pain stays between 0 and 3 out of 10, grip remains steady, and the elbow returns to baseline by the following morning.
Yellow light
Pain reaches 4 to 5 out of 10 or remains worse the next morning. Return to the prior tolerated dose or reduce one or more loading variables and allow more recovery.
Red light
Call 911 for chest pain, trouble breathing, fainting, or another medical emergency. Stop and seek prompt assessment for ring-finger or small-finger numbness, hand weakness, snapping, sharp pain, major swelling, or pain or a feeling of instability during throwing. Use same-day urgent care for a sudden pop with bruising or deformity, marked or progressive hand weakness, acute throwing-related instability, or a new painful, hot, red, or swollen elbow with or without 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.
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Stage 1: settle symptoms
Reduce hard gripping, repeated wrist flexion and palm-down rotation, and painful throwing. Begin comfortable isometric loading.
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Stage 2: build forearm capacity
Add slow wrist flexion, controlled pronator lowering, and grip every other day. Introduce one movement at a time and progress repetitions before adding load.
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Stage 3: restore the task
Progress neutral-wrist carries, pulling, work tools, racquet or golf demand. Throwing athletes need ligament and nerve assessment plus a separate interval throwing plan.
Signs you are ready for the next stage
- Elbow, forearm, and wrist motion are full and comfortable.
- Daily activity stays at 0 to 2 out of 10 without a next-day flare.
- Resisted wrist flexion, pronation, and gripping remain controlled.
- Two to three loading sessions and two graded task sessions do not escalate symptoms.
When to schedule an evaluation
Schedule a visit for any nerve symptoms, snapping, pain on the inside of the elbow during throwing, instability, progressive weakness, or no meaningful improvement after about four to six weeks. Overhead athletes should be assessed before beginning an interval throwing program.
Call UCLA Orthopedics at 310-319-1234Progress tracker
Use this tracker through the first checkpoint above. Mark up to three key sessions each week, check weekdays for frequent work, and note symptoms, resistance, duration, or activity gains. Continue through a longer condition-specific trial when useful.
| Week | Key sessions | Daily or most-day work | Notes | ||
|---|---|---|---|---|---|
| 1 | 2 | 3 | |||
| 1 | MTWTFSS | ||||
| 2 | MTWTFSS | ||||
| 3 | MTWTFSS | ||||
| 4 | MTWTFSS | ||||
| 5 | MTWTFSS | ||||
| 6 | MTWTFSS | ||||
Common questions
Questions about this program
Is this only golfer's elbow?
No. Common flexor tendinopathy also occurs with work, lifting, climbing, racquet sports, and other repeated gripping or forearm tasks.
Can I keep using the arm?
Usually yes, with the most painful gripping, palm-down rotation, or throwing dose reduced. Mild, stable discomfort can be acceptable when symptoms return to baseline by the next morning.
Will a brace fix it?
A brace can be tried for short-term activity tolerance, but it should not replace progressive loading and task modification.
Why do throwers need an assessment first?
Pain on the inside elbow during throwing may reflect the ulnar collateral ligament, ulnar nerve, or other structures rather than an isolated tendon problem.
When can I use the harder options?
Wait until the current dose feels controlled for at least two sessions, grip remains steady, and symptoms return to your usual baseline by the next morning. Reach the top of the repetition range before adding resistance. Change one variable at a time, such as weight, lever length, hold time, or task duration. A harder option replaces the easier version; it is not extra work to stack onto the session.
Evidence
Guidelines, reviews, and clinical studies
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.
- Eccentric Exercise for Medial Epicondylitis, Systematic Review, 2026 (opens in a new tab)
- Tyler et al.: Eccentric Wrist-Flexor Exercise for Chronic Medial Epicondylosis (opens in a new tab)
- Current Concepts of Natural Course and in Management of Medial Epicondylitis: A Clinical Overview (opens in a new tab)
- Review: Medial Elbow Tendinopathy and Differential Diagnosis (opens in a new tab)
- AAOS: Therapeutic Exercise Program for Tennis Elbow and Golfer’s Elbow (opens in a new tab)
- NHS Dynamic Health: Elbow Pain and Progressive Home Exercises (opens in a new tab)
Evidence and recommendations can change. Last clinical review: August 28, 2026.