Lateral Epicondyle Tendinopathy Toolkit: Section E - Exercise Prescription

Concentric/Eccentric Home Exercise Program (Peterson et al 2011[1])[edit | edit source]

  • Daily, 3-month program.
  • Forearm supported in pronation with elbow in some flexion.
  • Resistance 1kg women, 2kg men (1 litre of water = 1kg).
  • 3 sets of 15 once daily.
  • Increase resistance by 0.1 kg (100ml water) weekly.
  • No comment was made regarding pain during exercise.
Fig 1 of LET App C
    Figure 1


Supervised Eccentric Exercise and Stretching Program (Stasinopoulos et al 2006[2])
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Protocol:
  • 3 times a week, 4 weeks.
  • Forearm supported in pronation with elbow extended.
  • Wrist extended as high as possible then lowered into flexion slowly counting to 30, return to starting position using the other hand.
  • 3 sets of 10, 1 minute rest between sets.
  • Resistance, free weights.
  • Increase resistance when the exercise is pain-free.
  • Exercise with mild pain. Stop if pain becomes disabling.
  • Passive stretching of the extensor carpi radialis brevis tendon (ECRB) done by therapist 3 times before and 3 times after the eccentric exercise. Forearm pronated, elbow extended, wrist flexed and ulnar deviated. Hold 30-45 seconds. 30 second rest between stretches.


Directions:

  • Extend the wrist using the unaffected hand (2A).
  • Allow the wrist to flex (eccentric contraction of wrist extensors) (2B).
  • The original research used hand held weights. We have substituted a bag with weights.
Fig 2a of LET App C
    Figure 2A
Fig 2b of LET App C
    Figure 2B


The “Tyler Twist” Eccentric Wrist Extensor Exercise (Tyler et al 2010[3])
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Download Lateral Epicondyle Tendinopathy Toolkit: Appendix C - Details of Exercise Prescription[edit | edit source]

http://physicaltherapy.med.ubc.ca/files/2013/07/Appendix-C.-Lateral-Epicondyle-Tendinopathy-Details-of-Exercise-Prescription-June-2013.pdf


References[edit | edit source]

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  1. ↑ Peterson M, Butler S, Eriksson M, Svardsudd K. A randomized controlled trial of exercise versus wait-list in chronic tennis elbow (lateral epicondylosis). Uppsala Journal of Medical Science. 2011; 116: 269-279.
  2. ↑ Stasinopoulos D, Stasinopoulos I. (2006) Comparison of effects of cyriax physiotherapy, a supervised exercise programme and polarized polychromatic non-coherent light (bioptron light) for the treatment of lateral epicondylosis. Clinical Rehabilitation. 2006; 20(1): 12-23.
  3. ↑ Tyler T, Thomas G, Nicholas S, McHugh M. Addition of isolated wrist extensor eccentric exercise to standard treatment for chronic lateral epicondylosis: a prospective randomized trial. Journal Of Shoulder And Elbow Surgery. Sep 2010; 19(6): 917-922.
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