7 Tennis Elbow Physical Therapy Exercises and Stretches

Despite the name, about 95% of tennis elbow cases have nothing to do with a racket. Kneading dough, whisking batter, or lifting boxes all day works the same forearm muscles, and repeating those movements can overload the tendon on the outside of your elbow.

The fix is not to stop using the arm. It is to load the tendon again, gradually, so it can rebuild. These seven tennis elbow physical therapy exercises combine controlled strengthening with gentle stretching.

Where Does the Pain Come From?

Lateral epicondylitis, commonly called tennis elbow, affects the tendon attachment on the outside of the elbow. The forearm extensor muscles attach at the lateral epicondyle, the outer bony bump, through the common extensor tendon. The extensor carpi radialis brevis (ECRB) is commonly involved.

These muscles extend your wrist and steady it during gripping, which explains why hand movements can hurt near the elbow. You may also hear lateral epicondylosis, which describes degenerative tendon changes associated with repeated overload. “Lateral elbow tendinopathy” is the broader term.

Golfer’s elbow, or medial epicondylitis, affects the inside of the elbow instead.

Build Grip and Wrist Strength With Controlled Exercises

The clinical practice guideline for lateral elbow pain recommends resisted wrist-extensor exercises for subacute or chronic lateral elbow tendinopathy. These can include holding a position, lifting against resistance, and lowering slowly. Progressively loaded exercise reduced pain faster than waiting in a 81-person randomized trial, although disability and quality-of-life scores did not differ.

What’s the single best exercise? Eccentric wrist extension is a well-supported option, but no exercise wins for everyone. A meta-analysis of six trials involving 429 participants found benefits for pain relief and strength when eccentric exercise was added to other treatment.

Before you begin: Keep discomfort mild and manageable. Stop if pain becomes sharp or increases as you continue. The NHS Dynamic Health guidance on exercise tolerance advises adjusting exercise when symptoms fail to settle or affect sleep or next-day activities. Shorten the interval, reduce resistance, or try a smaller movement.

Isometric Wrist Extension Hold

Hold your wrist steady against a light weight for an isometric contraction: the muscles work without moving the joint. The extensor carpi ulnaris works alongside the other wrist extensors to hold this position. In a small randomized trial, combined lifting, lowering, and isometric work produced greater improvements than the other tested programs.

1. Rest your forearm on a table or thigh, hand beyond the edge, holding a light dumbbell palm down.
2. Lift your wrist slightly above neutral.
3. Hold still and breathe normally, keeping your forearm on the support.

Eccentric Wrist Extension

In this eccentric exercise, the wrist extensors work while lengthening as you slowly lower the weight. Adding eccentric training with a rubber bar helped in a small trial of rubber-bar training. Researchers also found better pain and strength outcomes with eccentric than concentric exercise in a 120-person comparison of eccentric and concentric exercise. This version uses a dumbbell.

1. Support your forearm on a table or thigh, hand beyond the edge, holding a light weight palm down.
2. Use your opposite hand to lift the working wrist.
3. Remove the assistance and lower slowly into comfortable wrist flexion.
4. Assist the lift again and repeat without lifting your forearm.

Wrist Radial Deviation (Handshakes)

This small handshake motion builds control toward the thumb side of your wrist, called radial deviation. Practice empty-handed if a weight makes you lift your shoulder or swing your arm.

1. Hold a light dumbbell with your thumb pointing up.
2. Lift the thumb side of your hand toward your forearm.
3. Lower smoothly and repeat, keeping your elbow still.

Hammer Rotation

Turning a key uses forearm rotation: supination turns the palm upward, and pronation turns it downward. Keep your wrist straight throughout. Gripping closer to the weighted end of the hammer shortens the lever and makes the exercise easier.

1. Bend your elbow about 90 degrees and tuck it beside your body.
2. Hold a hammer or end-held light dumbbell upright, thumb up.
3. Slowly rotate toward palm-up, then toward palm-down through a comfortable range.

Towel Crush

Grip exercises like this train the flexor digitorum superficialis and flexor digitorum profundus, which bend your fingers around the towel. Your wrist muscles keep your hand steady as you squeeze and release. Keep the towel still; wringing it into a forceful towel twist adds a turning demand.

1. Hold a rolled towel with your wrist straight.
2. Squeeze gradually without curling your wrist.
3. Release fully, then repeat.

Gentle Forearm Stretches

Keep stretches gentle and avoid bouncing. In a randomized trial of 94 people, stretching alone and stretching with added strengthening both produced improvements, without significant differences between groups.

Wrist Extensor Stretch

This stretches the muscles along the back of your forearm, including the extensor digitorum, which helps straighten your fingers. Bending your wrist downward is wrist flexion, even though it stretches the extensor muscles. Apply pressure across the hand rather than pulling individual fingers.

1. Reach forward, palm down, with your elbow straight but not locked.
2. Bend your wrist so your fingers point down.
3. Gently draw the back of your hand toward you with your other hand.
4. Hold, then release slowly.

Wrist Flexor Stretch

On the palm side of your forearm, wrist-bending muscles such as the flexor carpi radialis and palmaris longus lengthen as you ease into this stretch. With your palm up, bend your hand back into wrist extension, letting your fingers angle toward the floor without rotating your arm. Stop the stretch if it causes tingling or numbness.

1. Reach forward, palm up, with your elbow straight but not locked.
2. Bend your hand back at the wrist.
3. Gently guide your fingers down and toward you with your other hand.
4. Hold with your arm still, then release.

Try the Tennis Elbow Starter Workout

Tennis Elbow Starter takes 8 minutes, 30 seconds, including rests. Follow the sequence below, completing each side where indicated.

You’ll need a light dumbbell, a hammer or end-held light dumbbell, a small towel, and a chair or table for support.

Rest 10 seconds between strengthening exercises, take 30 seconds between blocks, and rest 5 seconds between stretches.

How Often to Exercise

Tennis Elbow Starter is a short, standalone workout in the Sporty Doctor app. When you want a guided schedule, the Tennis Elbow Recovery Protocol walks you through an exercise program in three phases. There’s four 12-20 minute workouts per week for six weeks.

Once the routine is manageable without a lingering flare, increase one thing at a time: resistance, duration, or range of motion.

Exercises and Repetitive Movements to Avoid or Modify

The NHS guidance for managing tennis elbow recommends reducing or avoiding activities that worsen symptoms. Sporty Doctor flags these exercises to avoid while symptoms are active:

• Hand-supported movements: Shoulder Taps, Mountain Climber, and Dumbbell Renegade Row.
• Rows and raises: Standing Dumbbell Upright Row, Bent Over Dumbbell Rows, and Frontal Shoulder Raises.
• Overhead presses: Standing Dumbbell Arnold Press and Banded Shoulder Press.
• Chest presses and flyes: Dumbbell Floor Chest Press, Floor Chest Flyes, and Bridge with Chest Presses.
• Swings and thrusters: Dumbbell Swing and Dumbbell Thruster.

NHS Fife’s guidance on activity-related symptoms explains that repeated wrist lifting, gripping, and pulling can aggravate the tendon. Common everyday triggers include:

• Home projects: Repeated paintbrush or roller strokes, hammering, and turning a screwdriver.
• Gardening: Squeezing pruning shears, pulling weeds, and prolonged gripping of garden tools.
• Cleaning and cooking: Wringing towels, forceful scrubbing, opening tight lids, or repeatedly lifting a heavy pan.
• Desk work and hobbies: Long sessions using a mouse, typing, sewing, knitting, or playing an instrument without breaks.
• Sport and lifting: Repeated racket swings, tightly gripping weights, or carrying heavy bags with a palm-down grip.

Pay attention to force, repetition, and sudden increases in activity. Our guide to elbow pain when lifting weights or other objects explores common triggers. If you’re considering extra support, our tennis elbow brace guide explains the different options.

Corticosteroid injections deserve a discussion about long-term outcomes. A placebo-controlled trial of 165 people found higher one-year recurrence after injection than placebo, 54% versus 12%, and lower rates of recovery or major improvement.

Recovery and When to Get Help

In a randomized trial of 198 people, exercise plus elbow mobilization helped more than waiting during the first six weeks. By one year, most people in both groups reported a successful outcome.

For care beyond your exercise routine, see our guide to treating tennis elbow at home. See a clinician if symptoms persist, repeatedly flare, or leave you unsure of the cause.

The NHS Dynamic Health guidance on elbow warning signs advises assessment for pain after an injury, a hot, red, swollen elbow, or tingling and numbness in the arm or hand. Seek help for worsening weakness as well, rather than continuing to increase your exercise load.

A physical therapist can check your grip strength and movement, then adjust your exercise program to the demands of your work or sport. Learn how sports physical therapy can fit into recovery.

Build a Routine You Can Follow

You don’t have to figure out every movement on your own. Download Sporty Doctor for physician-designed video guidance. The free plan includes 10 exercises picked for you; full workouts are included in the annual plan. Start where you are and build at a manageable pace.

About The Author

Dr. Kristina DeMatas, DO

Dr. DeMatas practices holistic, evidence-based family medicine that focuses on treating injuries and transforming lives through prevention, rehabilitation, and diet. She is a licensed, practicing Physician in Jacksonville, FL.

Last updated: September 25, 2026