Tennis Elbow Exercises: What to Avoid

It may come as a surprise that you can get “tennis elbow” -- or lateral epicondylitis – from overuse activities other than tennis. Not surprisingly, playing tennis or other racquet sports, like the very popular pickleball, can cause this painful condition.

However, other activities and even occupations can contribute to tennis elbow, which involves the muscles and tendons of the forearm that are responsible for the extension of your wrist and fingers. The forearm tendons — often called extensors — attach the muscles to bone. The tendon usually involved in tennis elbow is called the extensor carpi radialis brevis (ECRB), which attaches the ECRB forearm muscle to the lateral epicondyle. 

According to the American Academy of Orthopaedic Surgeons (AAOS), many people with tennis elbow participate in work or recreational activities that require repetitive and vigorous use of the forearm muscle or repetitive extension of the wrist and hand.

“Painters, plumbers, and carpenters are particularly prone to developing tennis elbow,” states the AAOS. “ Studies have shown that auto workers, cooks, and even butchers get tennis elbow more often than the rest of the population. It is thought that the repetition and weightlifting required in these occupations leads to injury.”

Pickleball and Tennis Elbow

Alex Mafdali, M.D., a primary care sports medicine physician with Baptist Health Orthopedic Care..

Alan Saperstein, M.D., orthopedic surgeon with Baptist Health Orthopedic Care.

Additionally, the increasing popularity of pickleball, which is basically a mix of tennis, badminton and table tennis, is fueling higher rates of tennis elbow. Since the playing court is smaller than in tennis, and the ball moves slower, players of all ages are drawn to the sport -- from teenagers to retirees. Essentially, it’s a sport that appears easy to pick up. And that way it can lead to overuse injuries or overexertion, explains Alex Mafdali, M.D., a primary care sports medicine physician with Baptist Health Orthopedic Care.

“Since it's a sport that requires less stress on the body and it's easy to learn and play, a lot of the community is playing it more frequently and for longer periods of time,” explains Dr. Mafdali. “And that is increasing stress on joints, muscles and tendons.”

The most common tennis-related injuries stem from overuse in the dominant upper extremity (such as the patient’s dominant shoulder, elbow and wrist), explains Alan Saperstein, M.D., an orthopedic surgeon with Baptist Health Orthopedic Care who sub-specializes in sports medicine.

“Tennis commonly can result in overuse injuries in the dominant shoulder such as rotator cuff tendinitis, biceps tendinitis and labral tears,” Dr. Saperstein said. “Rotator cuff tendinitis and lateral epicondylitis, also known as tennis elbow, are particularly common in tennis.”

Other Causes of Tennis Elbow

Many people who suffer from tennis elbow don't play tennis. The problem can be caused by any repetitive movement. Other causes of tennis elbow include:

• Painting with a brush or roller;
• Working a chainsaw;
• Frequent use of other hand tools on a regular basis;
• Using repeated hand motions in various types of work. Some examples are butchers, musicians, dentists, auto workers, and carpenters.

Tennis Elbow Exercises to Avoid

Here are other “tennis elbow” exercises to avoid:

• Avoid end-range of motion extremes, both extending or flexing the affected arm.
• Avoid repetitive hand and wrist motions, and take breaks from such activities when necessary to perform them.
• Avoid letting heavy items with the arm in full extension; perform work or weight-lifting partially bent with the elbow.
• Use both hands to hold heavy tools, and use a two-handed backhand in tennis if you decide to play with tennis elbow.
• Limit repetitive grasping and gripping motions.
• If a movement causes the pain to return, avoid it, and report and see your doctor.

Explore tennis elbow treatments.