Table 1. Muscle-strengthening program to treat lateral epicondylitis.

Patient instructions.^*

Start with a 1- or 2-lb dumbbell (purchase at department, sports, or other specialty store). Sit on a chair next to a table that has an edge or an overhang. Bend the elbow to 90º; palm should be facing the floor. Slowly lower the weight, then slowly raise it toward the ceiling. Be aware that performing this exercise can be painful. Lower and raise the weight 10 times or until a) it becomes too painful or b) you just don’t have the strength to move the dumbbell any further. Rest a few minutes. Fully straighten the elbow flat across a table (you might have to lean over the table or crouch next to it); palm should be facing the floor. Slowly lower and raise the weight 10 times, as described in step 3. Once 10 repetitions have become easy to do, with hardly any pain, increase the weight by 1 or 2 lb. Pain should start getting better by week 4 or 6. Continue the exercises once a day, 7 days a week, for about 3 months. Your doctor might need to make some adjustments to your program if there is no improvement after 6 weeks.

^*Remember that it will hurt to do the exercises. “Good pain” occurs when it hurts while doing the exercise but the next day the pain is not worse. “Bad pain” is pain that increases the day after the treatment. If you experience “bad pain,” you might have to cut back on the number of repetitions or the amount of weight used.

Modified with permission from Dr Ernest W. Johnson (Ohio State University in Columbus).