Tennis Elbow Exercises: The Injection Wins at Six Weeks and Loses at One Year

Three separate randomised trials have now run the same experiment on tennis elbow, and all three produced the same uncomfortable shape.

At six weeks, the corticosteroid injection is the clear winner. In the Dutch trial that started this line of research, 185 patients were randomised to injection, physiotherapy, or a wait-and-see policy. Success rates at six weeks: 92% for injection, 47% for physiotherapy, 32% for waiting.¹

At 52 weeks, the order inverts. Injection 69%. Physiotherapy 91%. Waiting 83%.¹

Then a 2013 trial in JAMA added the control the earlier studies lacked — a placebo injection — and the result stopped being a ranking problem and became an active-harm problem. At one year, complete recovery or much improvement was 83% after corticosteroid versus 96% after placebo, and recurrence was 54% versus 12%.²

The shot doesn’t just fade. It appears to make the one-year outcome worse than doing nothing to the tendon at all.

That is the central fact of tennis elbow, and almost everything practical follows from it: this is a load-tolerance problem in a degenerative tendon, and the only interventions with a durable signal are the ones that rebuild load tolerance. Judging how much load a healing tissue can take this week, versus last week, is exactly the gap SensAI was built to read.

Here’s the whole protocol in one line before the detail: stop the specific grip that hurts, start isometric wrist extension below your pain threshold, progress to slow eccentrics with a rubber bar, add the concentric back in, and give it three to six months — not three weeks.

What tennis elbow actually is (and why the name is wrong twice)

The clinical label is lateral epicondylitis, and both halves of that word are misleading.

The -itis implies inflammation. When Barry Kraushaar and Robert Nirschl examined surgical specimens from tennis elbow patients using histology, immunohistochemistry, and electron microscopy, the paper they published in The Journal of Bone and Joint Surgery was titled for what they found: tendinosis — degenerative change in the tendon — not tendinitis.³

The tennis implies tennis. It mostly isn’t. In a representative Finnish population sample of 4,783 adults aged 30 to 64, the prevalence of definite lateral epicondylitis was 1.3%, peaked in the 45-to-54 age band, and showed no difference between men and women.⁴ The strongest occupational signal was the combination of repetitive arm movements and forceful activities: an odds ratio of 5.6 (95% CI 1.9–16.5) compared with people doing neither.⁴

Repetitive plus forceful is a fair description of a heavy pulling session, a day of trim carpentry, or eight hours of mouse-and-keyboard with a bad desk setup.

The affected tissue is the common extensor origin — where the wrist and finger extensors anchor to the bony bump on the outside of your elbow. Grip is what loads it. Every time you close your hand hard, those extensors fire to stabilise the wrist, which is why the classic tennis elbow story is “it hurts when I pick up the kettle,” not “it hurts when I bend my elbow.”

Jill Cook and Craig Purdam, then at Deakin University’s Centre for Physical Activity and Nutrition Research, proposed the model that makes this tractable: tendon pathology is not a binary healthy/damaged state but a continuum, running from reactive tendinopathy through tendon dysrepair to degeneration — and the position on that continuum determines which treatment is rational.⁵

That matters because it explains the injection paradox. A shot calms the reactive, painful end. It does nothing for the load tolerance of the degenerated tissue underneath, and there is a plausible mechanism by which it makes that tissue worse.

Is it tennis elbow? A short differential

Sign	Points toward tennis elbow	Points elsewhere
Pain location	Outer elbow, over or just below the bony prominence	Inner elbow → golfer’s elbow4 — medial epicondylitis
What triggers it	Gripping, lifting with palm down, wringing, shaking hands	Elbow bending/straightening alone → joint problem
Resisted wrist extension	Reproduces the pain	Painless → look elsewhere
Grip strength	Reduced, and reduced because of pain	Reduced without pain → nerve or systemic
Numbness or tingling	Absent	Present → radial or ulnar nerve involvement
Night pain at rest	Uncommon	Common → needs assessment
Neck movement changes it	No	Yes → cervical referral

Two practical notes. Medial epicondylitis — golfer’s elbow — is the same problem on the other side, and it’s less common: 0.4% versus 1.3% in that Finnish cohort.⁴ And if you have numbness, tingling, night pain, a history of trauma, or pain that doesn’t change with grip, this article is background reading. Get assessed.

The injection question, settled three ways

This is the section worth reading twice, because it is the single most consequential decision most people with tennis elbow make.

Trial one — Smidt et al., The Lancet, 2002. 185 patients randomised to six weeks of corticosteroid injection, physiotherapy, or wait-and-see. Injection dominated at six weeks (92% success). By 52 weeks the injection group had fallen to 69%, behind both physiotherapy (91%) and simply waiting (83%). The authors’ conclusion was that the relative gain of physiotherapy over waiting is small — but that injection’s early advantage does not survive.¹

Trial two — Bisset et al., BMJ, 2006. 198 participants aged 18 to 65 with at least six weeks of symptoms, randomised to eight sessions of physiotherapy, corticosteroid injection, or wait-and-see. Same pattern, with a number that sticks: of the 65 people whose injection was initially a success, 47 subsequently regressed.⁶ The authors called the reversal “paradoxical” and wrote that injection “should be used with caution.”⁶

Trial three — Coombes et al., JAMA, 2013. This one added a placebo injection, which is what turns a fading benefit into a measurable cost. 165 patients, 2×2 factorial design, one-year follow-up. Corticosteroid produced lower complete recovery at one year than placebo (83% vs 96%; RR 0.86, 99% CI 0.75–0.99) and more than four times the recurrence (54% vs 12%; RR 0.23, 99% CI 0.10–0.51).²

The senior author on both the 2006 and 2013 trials is Bill Vicenzino, Professor of Sports Physiotherapy at the University of Queensland’s School of Health and Rehabilitation Sciences — the research group that has done more to define this condition’s treatment landscape than any other.

There is a legitimate use for the shot: someone who must be functional for a specific, dated event within six weeks and accepts the one-year trade. Outside that, the evidence is what it is.

One more finding from the JAMA trial that gets less attention than it deserves. At four weeks, physiotherapy added a large benefit on top of a placebo injection (39% recovered vs 10% without physio; RR 4.00) — but added nothing on top of a corticosteroid injection (68% vs 71%).² The steroid doesn’t just fail later. It appears to blunt what the exercise would otherwise have done early.

What exercise actually delivers — stated honestly

If the injection is the wrong answer, exercise is the right one. It is not, however, a dramatic one, and posts that claim otherwise are selling something.

The definitive meta-analysis is Karanasios and colleagues in the British Journal of Sports Medicine, 2021: 30 randomised trials, 2,123 participants. Its title carries the conclusion: exercise beats passive interventions, but the effects are small.⁷

Against corticosteroid injection, exercise won on essentially everything except short-term pain, and the pain-free grip strength differences were clinically meaningful at every follow-up — mean difference 12.15 points short-term, 22.45 mid-term, and 18 long-term (95% CI 11.17–24.84 at long-term).⁷ Against wait-and-see, the picture was thinner: statistically significant differences in self-perceived improvement short-term, and in pain and disability at short and long term, all at very low certainty.⁷

A 2024 network meta-analysis in the Journal of Hand Surgery reinforced the honest version. Across 13 trials and 12 comparators judged on the Patient-Rated Tennis Elbow Evaluation pain score, no treatment beat placebo in the short term. In the midterm, physiotherapy/exercise was the one that did — mean difference −4.32 (95% CI −7.58 to −1.07) versus placebo.⁸

So the honest framing is: exercise is the intervention that works, its edge is modest, and its main advantages are that the benefit keeps accruing and that it carries no recurrence penalty.

The tennis elbow exercise protocol

The trials disagree about the perfect contraction type. They agree strongly about the direction of travel: load the wrist extensors, progressively, at an intensity your tendon tolerates.

Stage 1 (weeks 0–2): Isometric wrist extension

Start here if gripping a coffee cup hurts.

Forearm supported on a table, palm down, wrist hanging off the edge. Extend the wrist to a neutral or slightly-up position and hold. No weight at first; add a light dumbbell or a resistance band when the unloaded hold is easy.

Dose: 5 holds × 30–45 seconds, once or twice daily.

Here is the rule that decides whether this stage helps or backfires. Coombes and colleagues had 24 people with lateral epicondylalgia perform 10 × 15-second isometric wrist extensions at an intensity 20% above and 20% below their individual pain threshold. Above threshold, pain was significantly higher during the contraction, immediately afterwards, and still 30 minutes later. Below threshold, the session was indistinguishable from doing nothing at all.⁹

Translation: work at or below the level that provokes pain, not through it. In tennis elbow specifically, pushing into pain buys you a flare, not an adaptation. This is where a training system that actually records your session-by-session response earns its place — SensAI logs what you did, what it cost you, and whether yesterday’s dose was tolerated before it prescribes today’s.

Be clear-eyed about what isometrics alone achieve. When Vuvan and colleagues randomised 40 people to eight weeks of unsupervised daily progressive isometric exercise versus wait-and-see, the exercise group improved on the PRTEE (SMD −0.92, 95% CI −1.58 to −0.26) and on worst pain — but not on global rating of change (29% vs 26% success) and not on pain-free grip strength.¹⁰ Their own conclusion: as a sole treatment, it is “doubtful.”¹⁰

Isometrics are the on-ramp, not the destination.

Stage 2 (weeks 2–8): Eccentric wrist extension — the Tyler Twist

This is the exercise with the largest single-trial effect in the literature, and it needs a flexible rubber bar (a FlexBar or equivalent) that costs about as much as one physio visit.

How to do it:

1. Hold the bar vertically in the painful hand, gripping it low, wrist extended.
2. Grasp the top of the bar with the healthy hand, palm facing away.
3. Twist the bar with the healthy hand while the painful hand holds its extended wrist position — the bar winds up under tension.
4. Extend both arms in front of you, bar horizontal, still twisted.
5. Slowly untwist by letting the painful wrist flex — a 4-second lower against the bar’s recoil. That slow release is the eccentric.

Dose: 3 sets × 15 repetitions, once daily.

Timothy Tyler and colleagues at PRO Sports Physical Therapy randomised 21 patients with chronic lateral epicondylosis to standard physical therapy alone or standard therapy plus this exercise, over roughly seven weeks. The added-eccentric group improved substantially more on every measure: DASH 76% vs 13%, pain (VAS) 81% vs 22%, tenderness 71% vs 5%, and extension strength 79% vs 15% — all statistically significant.¹¹

That is a small trial, and 21 patients is 21 patients. But the effect size is large, the exercise is nearly free, the risk is minimal, and it fits the mechanism the meta-analyses support. It earns its spot.

Stage 3 (weeks 6+): Eccentric-concentric plus isometric

The trial that compared contraction types head-to-head randomised 34 patients with lateral elbow tendinopathy to eccentric training, eccentric-concentric training, or eccentric-concentric combined with isometric contraction, five sessions a week for four weeks. The combined group produced the largest reduction in pain and improvement in function both at the end of treatment and at follow-up a month later.¹²

Practically: keep the slow lower, add the lift back under control, and finish each set with a hold.

Dumbbell version (once the bar work is easy): forearm on a table, palm down, light dumbbell (start at 1 kg). Lift the wrist over 2 seconds, lower over 4, then hold at the top of the final rep for 20 seconds. 3 × 12, three to four times weekly.

The whole progression at a glance

Stage	Timeline	Exercise	Dose	Move on when
1	Weeks 0–2	Isometric wrist extension, below pain threshold	5 × 30–45 s, 1–2× daily	Holds are comfortable and pain settles within an hour
2	Weeks 2–8	Eccentric bar twist (4-second lower)	3 × 15, daily	You can complete all sets at ≤3/10 with no next-morning flare
3	Weeks 6+	Eccentric-concentric + isometric hold, dumbbell	3 × 12, 3–4× weekly	Pain-free grip approaches your other side
4	Ongoing	Full-chain: grip, forearm, shoulder, scapula	2× weekly maintenance	Indefinitely — this is the recurrence insurance

The 24-hour rule

The single most useful self-check, and it is not about how the set feels:

Pain during loading up to about 3–4/10 is acceptable. It must return to baseline by the next morning. If your elbow is worse 24 hours later, the dose was too high — drop it, don’t stop.

That rule is the practical expression of the pain-threshold finding above,⁹ and it applies far beyond the elbow — it is the same logic that governs Achilles tendon loading.

If you lift: what to change and what to keep

Most tennis elbow advice is written for office workers. If you train, this is the part you actually need — and the answer is emphatically not “stop lifting.”

Movement	Problem	Substitution
Barbell rows, palm-down	Peak extensor load under a hard grip	Supinated (underhand) rows, or chest-supported with neutral grip
Pull-ups	Long isometric grip under bodyweight	Neutral-grip or supinated chin-ups; add straps temporarily
Heavy deadlifts	Sustained maximal grip	Keep the lift, use straps for the top sets
Farmer’s carries, direct grip work	Directly provocative	Pause 4–6 weeks, reintroduce last
Reverse curls, wrist extensions to failure	The exact aggravating pattern	Replaced by the rehab protocol above
Bench, overhead press, squats	Usually fine	Keep as-is; watch bar-grip width

Two rules that matter more than the table.

Use straps without guilt, temporarily. Straps let you keep training pulling volume and heavy deadlifts while removing the grip demand that is driving the symptoms. You will rebuild grip in stage 4. Losing eight weeks of back training to protect a tendon that responds to load anyway is a bad trade.

Don’t deload everything. The recurrence risk in tennis elbow is a load-tolerance problem, and detraining the whole arm lowers the ceiling you eventually have to return to. Reduce the provocative pattern; hold everything else. If you’re autoregulating, RPE-based effort management gives you a cleaner lever here than a fixed percentage.

Tracking the swap is where most people lose the thread — six weeks later they can’t remember whether the neutral-grip row was tolerated or whether the flare came from the carries. SensAI keeps that record automatically: what was substituted, what was tolerated, and when the original movement is safe to reintroduce.

Braces, PRP, shockwave, needles: what the evidence says

Intervention	Evidence	Verdict
Counterforce brace	Meta-analysis of 17 RCTs, 1,145 participants: no meaningful short-term pain difference vs physiotherapy overall (SMD −0.02); possible short-term benefit under age 45; physiotherapy better long-term, SMD 1.1713	Reasonable short-term symptom aid. Not a treatment.
PRP / autologous blood	Cochrane review, 32 studies, 2,337 participants: moderate-certainty evidence of no clinically significant benefit vs placebo injection at 3 months — mean pain 0.16 points better on a 0–10 scale; treatment success 67% vs 65%14	Not supported. Expensive.
Corticosteroid injection	Worse one-year recovery and 4.5× recurrence vs placebo2	Avoid unless you have a dated, short-horizon reason.
Exercise / physiotherapy	The only treatment beating placebo in the midterm network meta-analysis8; best long-term across all three injection trials126	The actual answer.
Wait-and-see	83% success at 52 weeks in the Dutch trial1	Genuinely viable. Slower, and you keep the recurrence risk.

That last row deserves emphasis, because it’s rarely said out loud: most tennis elbow resolves within a year even if you do nothing. The case for exercise isn’t that it rescues you from a permanent injury. It’s that it gets you there faster, with better grip strength,⁷ and it addresses the load-tolerance deficit that would otherwise let it come straight back.

The senior author of the Cochrane PRP review, Rachelle Buchbinder, Professor at Monash University’s School of Public Health and Preventive Medicine, has spent a career documenting exactly this pattern in musculoskeletal medicine: plausible-sounding injectables that don’t outperform a saline shot.

How long does tennis elbow take to heal?

Honest ranges, from the trial data rather than from marketing:

Timeframe	What to expect
Weeks 1–2	Pain settles somewhat once the provocative grip stops. No structural change yet.
Weeks 4–8	The window where exercise starts separating from doing nothing28
3 months	The primary endpoint in most trials. Many people are substantially better; many are not yet.
6 months	Corticosteroid vs placebo gap was already stark by 26 weeks — 55% vs 85% recovered2
12 months	83–96% recovered depending on what you did (or didn’t do) to it12

The symptom duration in the Cochrane review’s included trials ranged from 1 to 22 months.¹⁴ This is a slow condition. Anyone promising you two weeks is describing a different problem.

How to not get it again

Recurrence is the real enemy — 54% within a year after a steroid shot, 12% after placebo.² The prevention levers are all load-management levers:

• Rebuild grip strength deliberately, last. Don’t just stop hurting and return to farmer’s carries. Grip strength is trainable and worth training — and pain-free grip is the outcome measure the trials themselves track.⁷
• Vary grip orientation. The Finnish population data flagged repetitive plus forceful as the multiplier.⁴ Rotating between pronated, neutral, and supinated pulling spreads the demand.
• Ramp forearm-intensive volume gradually. Sudden jumps in pulling volume, climbing, racket sport frequency, or manual work are the classic trigger. A structured load-progression framework beats intuition here, because intuition doesn’t remember what last month looked like.
• Fix the desk if the desk is the cause. Repetitive low-force work with a poor wrist position generates the same cumulative exposure as training does.
• Address the shoulder. Weak scapular control shifts work distally. If your rotator cuff and scapular mechanics are the limiting factor, the elbow pays for it.

When to see a clinician

Book an appointment if any of these apply:

• Numbness, tingling, or weakness in the hand — suggests nerve involvement, not tendinopathy
• Pain at night or at complete rest
• A history of a specific injury or fall onto the elbow
• Locking, catching, or loss of elbow range of motion
• No change after 6–8 weeks of genuinely consistent loading
• Pain that doesn’t vary with grip

None of those are tennis elbow presenting normally, and each points somewhere different.

How SensAI fits into this

Nothing above requires an app. All of it requires memory.

The tennis elbow protocol is a sequence of load decisions made over three to six months: which grip you swapped and when, whether that swap was tolerated, whether yesterday’s eccentrics flared you overnight, how fast your pulling volume is climbing back, and whether you actually rebuilt the grip strength before returning to carries.

That is a record-keeping problem wearing an injury’s clothes — and it is where good intentions reliably fail. Six weeks in, nobody remembers which session caused the setback.

SensAI holds the whole record: every session, every substitution, the 24-hour response, the ramp rate on your pulling volume, and the recovery signals from your wearable. When your load progression crosses the line the research flags, that becomes a conversation before it becomes a recurrence — and when you’re returning to the movements you paused, the ramp is built from your actual tolerance rather than a generic template.

Not a threshold. Not a black-box score. Your training history, read in context, turned into the next decision.

Frequently asked questions

What is the fastest way to heal tennis elbow?

There isn’t a fast way, and the treatment that looks fastest is the one that costs you at a year. Corticosteroid injection produced 92% success at six weeks and 69% at 52 weeks in the Dutch trial,¹ and worse one-year recovery than a placebo shot in the JAMA trial (83% vs 96%).² The fastest durable route is stopping the provocative grip, loading the wrist extensors below your pain threshold, and progressing over 8 to 12 weeks.

What exercises are best for tennis elbow?

Eccentric wrist extension has the largest single-trial effect: adding an isolated eccentric exercise with a flexible rubber bar to standard therapy improved DASH scores 76% versus 13% for standard therapy alone.¹¹ The strongest head-to-head comparison of contraction types favoured eccentric-concentric training combined with isometric contractions.¹² Start with isometric holds if gripping hurts.

Should I get a cortisone shot for tennis elbow?

Only with a specific short-horizon reason. Three randomised trials agree that corticosteroid injection is superior at six weeks and inferior by one year.¹²⁶ In the placebo-controlled trial, one-year recurrence was 54% after corticosteroid versus 12% after placebo.² In the BMJ trial, 47 of 65 initially successful injections regressed.⁶

Does tennis elbow go away on its own?

Often, yes — but slowly. In the Dutch trial, the wait-and-see group reached 83% success at 52 weeks without any treatment.¹ Exercise gets you there faster, with better pain-free grip strength,⁷ and addresses the load-tolerance deficit that drives recurrence.

Does PRP work for tennis elbow?

The Cochrane review of 32 studies and 2,337 participants found moderate-certainty evidence that autologous blood or PRP injection probably does not produce clinically significant improvement in pain or function versus a placebo injection at three months. Mean pain was 0.16 points better on a 0–10 scale; treatment success was 67% versus 65%.¹⁴

Can I still lift weights with tennis elbow?

Yes, and you generally should. Remove the specific provocative pattern — palm-down rows, prolonged hard grip, direct wrist extension work — and keep the rest. Straps let you maintain heavy pulling volume without the grip demand. Complete detraining lowers the load ceiling you eventually have to return to.

Does a tennis elbow brace work?

Modestly, and only as a symptom aid. A meta-analysis of 17 RCTs and 1,145 participants found no meaningful overall short-term pain advantage over physiotherapy (SMD −0.02), a possible short-term benefit in people under 45, and physiotherapy superior over the long term.¹³ Wear it if it helps you function. Don’t mistake it for treatment.

How long should I do the exercises?

Through the symptomatic phase and then indefinitely at maintenance volume. Trial protocols ran 4 to 8 weeks of daily loading,¹¹¹² but the meta-analysis measured pain-free grip advantages that were still present at long-term follow-up.⁷ Two sessions a week of forearm and grip work is cheap recurrence insurance.

Is it tennis elbow or golfer’s elbow?

Location decides it. Tennis elbow is the outside of the elbow, aggravated by resisted wrist extension and gripping. Golfer’s elbow (medial epicondylitis) is the inside, aggravated by resisted wrist flexion. Tennis elbow is roughly three times more common in the general population — 1.3% versus 0.4% in the Finnish cohort.⁴

Why does my elbow hurt when I grip things?

Because gripping is a wrist-extensor task. To close your hand forcefully, the extensors on the back of your forearm must contract to stabilise the wrist — and those extensors anchor at the exact spot that hurts. That’s why the pain shows up carrying a kettle or shaking hands rather than bending the elbow.

The bottom line

Tennis elbow is a degenerative tendon problem, not an inflammatory one,³ and it sits on a load-tolerance continuum rather than in a healthy/injured binary.⁵

The corticosteroid injection is the most effective six-week treatment and the worst one-year treatment — worse than placebo on both recovery and recurrence.² Platelet-rich plasma doesn’t beat a saline shot.¹⁴ Braces help you function; they don’t heal you.¹³

Progressive loading is the only intervention with a durable signal, and the honest version is that its effect is modest.⁷⁸ It works because it fixes the actual deficit: a tendon that can’t tolerate the grip demands you’re placing on it.

Start below your pain threshold. Progress by the 24-hour rule. Keep lifting, with straps. Give it three to six months.

And keep the record — because the difference between recovery and recurrence is almost entirely a question of whether anyone remembered how last month’s load was tolerated.

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References

Footnotes

1. Smidt N, van der Windt DA, Assendelft WJ, Devillé WL, Korthals-de Bos IB, Bouter LM. “Corticosteroid injections, physiotherapy, or a wait-and-see policy for lateral epicondylitis: a randomised controlled trial.” The Lancet, 2002;359(9307):657-662. https://pubmed.ncbi.nlm.nih.gov/11879861/ ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹

2. Coombes BK, Bisset L, Brooks P, Khan A, Vicenzino B. “Effect of corticosteroid injection, physiotherapy, or both on clinical outcomes in patients with unilateral lateral epicondylalgia: a randomized controlled trial.” JAMA, 2013;309(5):461-469. https://pubmed.ncbi.nlm.nih.gov/23385272/ ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹ ↩¹² ↩¹³

3. Kraushaar BS, Nirschl RP. “Tendinosis of the elbow (tennis elbow). Clinical features and findings of histological, immunohistochemical, and electron microscopy studies.” The Journal of Bone and Joint Surgery (American Volume), 1999;81(2):259-278. https://pubmed.ncbi.nlm.nih.gov/10073590/ ↩ ↩²

4. Shiri R, Viikari-Juntura E, Varonen H, Heliövaara M. “Prevalence and determinants of lateral and medial epicondylitis: a population study.” American Journal of Epidemiology, 2006;164(11):1065-1074. https://pubmed.ncbi.nlm.nih.gov/16968862/ ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶

5. Cook JL, Purdam CR. “Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy.” British Journal of Sports Medicine, 2009;43(6):409-416. https://pubmed.ncbi.nlm.nih.gov/18812414/ ↩ ↩²

6. Bisset L, Beller E, Jull G, Brooks P, Darnell R, Vicenzino B. “Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial.” BMJ, 2006;333(7575):939. https://pubmed.ncbi.nlm.nih.gov/17012266/ ↩ ↩² ↩³ ↩⁴ ↩⁵

7. Karanasios S, Korakakis V, Whiteley R, Vasilogeorgis I, Woodbridge S, Gioftsos G. “Exercise interventions in lateral elbow tendinopathy have better outcomes than passive interventions, but the effects are small: a systematic review and meta-analysis of 2123 subjects in 30 trials.” British Journal of Sports Medicine, 2021;55(9):477-485. https://pubmed.ncbi.nlm.nih.gov/33148599/ ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸

8. Lowdon H, Chong HH, Dhingra M, Gomaa AR, Teece L, Booth S, Watts AC, Singh HP. “Comparison of interventions for lateral elbow tendinopathy: a systematic review and network meta-analysis for Patient-Rated Tennis Elbow Evaluation pain outcome.” The Journal of Hand Surgery (American Volume), 2024;49(7):639-648. https://pubmed.ncbi.nlm.nih.gov/38678448/ ↩ ↩² ↩³ ↩⁴

9. Coombes BK, Wiebusch M, Heales L, Stephenson A, Vicenzino B. “Isometric exercise above but not below an individual’s pain threshold influences pain perception in people with lateral epicondylalgia.” The Clinical Journal of Pain, 2016;32(12):1069-1075. https://pubmed.ncbi.nlm.nih.gov/26889612/ ↩ ↩²

10. Vuvan V, Vicenzino B, Mellor R, Heales LJ, Coombes BK. “Unsupervised isometric exercise versus wait-and-see for lateral elbow tendinopathy.” Medicine and Science in Sports and Exercise, 2020;52(2):287-295. https://pubmed.ncbi.nlm.nih.gov/31425384/ ↩ ↩²

11. Tyler TF, Thomas GC, Nicholas SJ, McHugh MP. “Addition of isolated wrist extensor eccentric exercise to standard treatment for chronic lateral epicondylosis: a prospective randomized trial.” Journal of Shoulder and Elbow Surgery, 2010;19(6):917-922. https://pubmed.ncbi.nlm.nih.gov/20579907/ ↩ ↩² ↩³

12. Stasinopoulos D, Stasinopoulos I. “Comparison of effects of eccentric training, eccentric-concentric training, and eccentric-concentric training combined with isometric contraction in the treatment of lateral elbow tendinopathy.” Journal of Hand Therapy, 2017;30(1):13-19. https://pubmed.ncbi.nlm.nih.gov/27823901/ ↩ ↩² ↩³

13. Shahabi S, Bagheri Lankarani K, Heydari ST, Jalali M, Ghahramani S, Kamyab M, Tabrizi R, Hosseinabadi M. “The effects of counterforce brace on pain in subjects with lateral elbow tendinopathy: a systematic review and meta-analysis of randomized controlled trials.” Prosthetics and Orthotics International, 2020;44(5):341-354. https://pubmed.ncbi.nlm.nih.gov/32635812/ ↩ ↩² ↩³

14. Karjalainen TV, Silagy M, O’Bryan E, Johnston RV, Cyril S, Buchbinder R. “Autologous blood and platelet-rich plasma injection therapy for lateral elbow pain.” Cochrane Database of Systematic Reviews, 2021;9(9):CD010951. https://pubmed.ncbi.nlm.nih.gov/34590307/ ↩ ↩² ↩³ ↩⁴