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Tennis Elbow Rehab: How to Fix It for Good (Part 2)

Last week in Part 1, we talked about what tennis elbow actually is, why it happens, and what not to do if you want it to get better.


Quick recap:


  • Tennis elbow = irritation of the common extensor tendon on the outside of your elbow

  • It’s not a tear or permanent damage

  • Rest, stretching, massage, or needling might help temporarily but won’t fix it long term

  • Tendons get stronger with the right kind of loading — not with avoiding stress


This week, we’re diving into the good stuff: the exercises, principles, and sample plan I use with patients at Made 2 Move to help them finally get rid of tennis elbow and get back to lifting, gripping, and living pain-free.


The Science You Need to Know


Tendons are mechanosensitive — meaning they remodel based on the stress you put on them.


  • Too much load too soon → flare-up

  • Too little load → they weaken

  • Consistent, progressive loading → stronger, more resilient tendons


The goal is to find that Goldilocks zone of stress: just enough to challenge the tendon without overwhelming it.


Step 1: Calm Things Down


If you’re in pain right now, that’s your body saying the cup is overflowing. We need to take some water out of the cup so it stops spilling over.


That means:

  1. Modify any activities that cause more than a 3–4/10 pain during, right after, or in the next 24–48 hours.

  2. Reduce overall stress on the elbow and forearm extensors.


But here’s the catch: if all you do is calm things down and then go back to business as usual, the pain comes right back. Once symptoms ease, you have to build things back up.


Step 2: Build It Back Up


Now comes the fun part: loading the tendon so it gets stronger and can handle everything you throw at it.


Here’s an example of how I progressed a recent patient’s plan:


Phase 1 (1x per week)

  • Zottman curl (up palms up, down palms down)

  • Wrist curl/extension eccentrics

  • Farmer’s carry (light)

  • Elbow-on-knee external rotations


Phase 2 (2x per week)

  • Zottman curl (slower on the way down)

  • Wrist curl/extension eccentrics

  • Farmer’s carry (a bit heavier)

  • Elbow-on-knee external rotations


Phase 3 (2x per week, higher load)


  • Reverse curl (palms down)

  • Wrist curls/extensions (full motion)

  • Dumbbell head carry

  • Sidelying external rotations

  • DB bench press


At each stage, we followed two rules:


  1. Pain had to stay below a 3 during/after the workout (and the next day).

  2. The exercise had to feel fatiguing and challenging.


Over time, as pain decreased, we could push the volume, intensity, and difficulty until he was back to all of his usual lifts without pain.


The Big Picture


Here’s what you need to know if you’re dealing with tennis elbow:


  • It happens when the load on your tendon exceeds its capacity.

  • The fix is simple but not always easy:

    1. Calm it down by reducing the load to a tolerable level.

    2. Build it up by progressively loading the tendon and surrounding muscles so they can handle more stress over time.


Key Takeaway


Tennis elbow isn’t forever. With the right plan, your elbow can go from cranky and painful to strong and resilient.


If you’re in Charleston, Daniel Island, or Mount Pleasant and struggling with tennis elbow, our team at Made 2 Move can help. We specialize in performance-based physical therapy that gets you back to doing what you love — without relying on short-term fixes.


If you missed the first post in this series, catch up below!




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