Tennis Elbow Exercise - Isometric Supination With Elbow Flexion

Tennis Elbow Exercise - Isometric Supination With Elbow Flexion

Tennis elbow refers to pain that is typically on the outside of the elbow and originates in what is known as the common extensor origin, where multiple muscles in the forearm attach to the elbow. It is a condition that affects 1-3% of the general population, both men and women, and most commonly in the 3rd to 5th decade of life. Tennis elbow is more common in manual workers and tennis players, however, we often see it in the clinic after people do a lot of activity that their elbow is not accustomed to. Activities such as home improvement, a new workout routine, or a new hobby/sport.

In most cases of tennis elbow, the affected fibers are the deep and anterior fibers of the extensor carpi radialis brevis (ECRB) component of the common extensor tendon origin. The ECRB muscle is responsible for extension and radial deviation of the wrist. In tennis elbow, the tendon itself may undergo cellular and matrix changes accompanied by alterations in pain, sensory, and motor functioning. These changes occur because the tendon is overworked and unable to handle the forces placed on the tendon in your day to day activities. There is a chance you have tennis elbow if you have pain to palpation over the lateral epicondyle (see the image above where the red is), pain with gripping, and pain with resisted wrist extension, middle finger, or index finger.

What we do know is that when the elbow is extremely sensitive and painful in acute cases of tennis elbow, the angry tendon responds well to rest, unloading, and isometric exercises early on. Isometrics produce what is called an analgesic effect that can reduce the pain you feel by altering the nociceptive/pain pathways to your brain.

Strengthening the supinator is also important with tennis elbow as it originates on the lateral epicondyle, which is also where the common extensor tendon originates. It is not uncommon for the supinator to be contributing to the tennis elbow symptoms as well. If movements such as opening a door or using a screwdriver bother your elbow, you should definitely include this.

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