7 Best Tennis Elbow Exercises (Step-by-Step)

Why exercise works for tennis elbow

Tennis elbow is a tendon overload problem, not a simple inflammation. The tendon has lost some of its capacity, so everyday tasks now go beyond what it can comfortably handle. Rest lowers the load, but it doesn't rebuild that capacity. That's why pain often comes straight back when you return to normal activity.

Progressive loading exercises stimulate the tendon to remodel and get stronger. Clinical trials of eccentric exercise, including the FlexBar "Tyler Twist", have shown meaningful reductions in pain and better grip strength compared with usual care. (New to the condition? Start with our guide to tennis elbow symptoms and causes.)

The pain rule: how hard to push

Use a 0–10 pain scale while you exercise:

0–3: Safe. Carry on.
4–5: Acceptable only if it settles within 24 hours. Otherwise, reduce the load.
6+: Too much. Stop, and use a lighter weight or fewer reps next time.

Check your elbow the morning after. If it's worse than usual, scale back the next session.

The 7 best tennis elbow exercises

1. Isometric wrist extension

5 holds × 30–45 seconds, 1–2 times a day

This is the best exercise to start with, especially when pain is high. Isometrics often reduce pain for a while afterwards.

Sit with your forearm resting on a table, palm facing down, wrist just over the edge.
Place your other hand on the back of your affected hand.
Push your hand up against the resistance without letting it move, at about 30–50% effort.
Hold, relax for 1 minute, then repeat.

2. Eccentric wrist extension

3 sets × 15 reps, once a day

This is the core strengthening exercise for tennis elbow. It focuses on the lowering phase, which loads the tendon effectively.

Rest your forearm on a table, palm facing down, holding a light dumbbell (start with 0.5–1 kg or a water bottle).
Use your other hand to help lift the weight up into wrist extension.
Remove the helping hand and slowly lower the weight over 3–4 seconds.
Repeat. Increase the weight once 3×15 feels easy.

3. The FlexBar "Tyler Twist"

3 sets × 15 reps, once a day

This is an eccentric exercise using a rubber resistance bar, and it's well supported by research.

Hold the bar upright in your affected hand, with your wrist bent back.
Grab the top of the bar with your other hand, palm facing away.
Twist the bar with your unaffected wrist while keeping the affected wrist bent back.
Bring both arms out in front of you with your elbows straight.
Slowly let your affected wrist untwist the bar over 4 seconds.

4. Wrist extensor stretch

3 × 30 seconds, 2–3 times a day

Hold your affected arm straight out in front of you, palm facing down.
Use your other hand to gently bend your wrist down until you feel a stretch along the top of your forearm.
Hold the stretch without bouncing. It should feel like a mild pull, not pain.

5. Forearm rotation (supination & pronation)

3 sets × 10–15 reps each way

Sit with your forearm on your thigh, holding a hammer or light dumbbell by one end.
Slowly rotate your palm up, then palm down, keeping your elbow still.
Hold the hammer closer to the head to make it easier.

6. Grip strengthening

3 sets × 10 squeezes, holding each for 3–5 seconds

Squeeze a soft stress ball, rolled towel or hand gripper.
Keep your wrist slightly extended (bent back) rather than bent forward.
Add this once the exercises above feel comfortable, since gripping can be provocative early on.

7. Shoulder and upper-back strengthening

3 sets × 12 reps, 3 times a week

Weak shoulder and shoulder-blade muscles can push extra work onto the forearm. Band rows and external rotations with a resistance band help share the load across the whole arm.

A simple 12-week plan

Phase	Focus	Exercises
Weeks 1–2	Calm the pain	Isometrics (1), stretch (4)
Weeks 3–6	Build strength	Add eccentrics (2), Tyler Twist (3), rotation (5)
Weeks 7–12	Return to full activity	Heavier weights, add grip (6) and shoulder work (7)

Progress to the next phase only when your pain stays within the pain rule. Some people move faster than this and others need longer, and both are normal.

Equipment that helps

You can start with household items, but a few inexpensive tools make your programme easier to follow and to progress:

Resistance flex bar: needed for the Tyler Twist. Bars come in colour-coded resistance levels, and most people start with the lightest.
Adjustable light dumbbell: lets you add weight in small steps for eccentric exercises.
Resistance bands: for shoulder and upper-back work.
Counterforce strap: can make daily tasks more comfortable while you rehab. See our tennis elbow brace guide.

Mistakes to avoid

Doing too much too soon. Increase the weight gradually, by about 10% at a time.
Stopping when the pain eases. Keep going for several weeks after you feel better to prevent a relapse.
Only stretching. Stretching alone doesn't rebuild the tendon. Strengthening is essential.
Pushing through sharp pain. Follow the pain rule above.

Exercise works best as part of a wider plan. Our guide to tennis elbow treatment covers the other options, and how long tennis elbow lasts explains what to expect along the way.

Frequently asked questions

Should tennis elbow exercises hurt?

Mild discomfort of up to about 3 or 4 out of 10 is generally acceptable, as long as it settles within 24 hours. Sharp pain, or pain that is worse the next morning, means you should reduce the weight or the number of reps.

How often should I do tennis elbow exercises?

Most programmes use isometric exercises daily and strengthening exercises once a day or every other day, continued for at least 6 to 12 weeks.

How long before tennis elbow exercises work?

Many people notice less pain within 4 to 6 weeks of consistent exercise, with bigger improvements by 12 weeks. Tendons adapt slowly, so being consistent matters more than intensity.

If your pain is severe, getting worse, or comes with numbness or swelling, see a doctor or physiotherapist before starting an exercise programme.