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Exercise with FlexBar may help treat tennis elbow
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KEYSTONE, CO – People with pain in the elbow or forearm from playing sports or just from common everyday activities, might be able to use a Thera-Band FlexBar and strengthening exercise to alleviate pain, say researchers who are presenting their study results at the American Orthopaedic Society for Sports Medicine’s Annual Meeting in Keystone, Colorado, July 9th-12th.
Tennis elbow or lateral epicondylitis is a common condition effecting nearly three percent of the general population, not just those who play tennis. “Our study illustrated that a novel exercise, using an inexpensive rubber bar, may provide a practical and effective means of adding isolated wrist strengthening exercises to a treatment plan,” said lead author Timothy F. Tyler, PT, ATC, Clinical Research Associate, of the Nicholas Institute of Sports Medicine and Athletic Trauma in New York City.
The study randomized 21 patients with tennis elbow into two groups. Both received the wrist extensor stretching, ultrasound, cross-friction massage, heat and ice for treatment. The eccentric training group performed isolated eccentric wrist extensor strengthening using the rubber FlexBar (Thera-Band, Akron OH) while the standard treatment group performed isotonic wrist strengthening exercises. Three sets of 15 repetitions were performed daily as part of a home program with intensity increased progressively during the treatment period. A variety of pain and movement scales were utilized to determine progress. Patients using the rubber bar had vastly better results on all scales, especially related to strength. In fact, given the consistently poor outcomes for patients in the standard treatment group, it was deemed appropriate to terminate the randomization with 21 of the intended 30 patients having already completed the study.
“Compared to other treatments for tennis elbow such as cortisone injections or topical nitric oxide which require direct medical supervision and often side effects, this treatment is not only cost effective but dosage is not limited by the patient having to come to a clinic,” said Tyler.
Click here to download the study and protocol
SOURCE: American Orthopaedic Society for Sports Medicine
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about 2 years ago
What strength (light, med, heavy) do you recommend for use for tennis elbow? I’m a 135 lb. woman, not all that strong.
about 2 years ago
Hi Laura. You should begin with the lightest RED resistance bar. Begin with 3 sets of 5, work up to 3 sets of 15. Once you find 3 sets of 15 easy, you can progress to the next color, Green. Good luck!
about 2 years ago
I have chronic medial epicondylitis, which I treat with ice and PT trained stretching.
Can you reccomend a Flexbar excercise that can help stretch and strengthen the medial ligaments, much as the Tyler Twist does for the lateral side?
thanks!!
about 2 years ago
I have extremely painful tennis elbow. I had been resting it for 2 weeks and it was starting to become less painful during rest. I started using the thera band yesterday (4 reps of 15 each) w/red; and I am very sore now! Is this normal? Should I just work through the soreness? Thank you.
about 2 years ago
Lance, unfortunately, we don’t have any specific evidence that the FlexBar would help medial elbow pain as well as it does for lateral elbow pain. However, I believe it might be worthwhile to try. Remember that you will have to perform eccentric wrist extension rather than wrist flexion as with the Tyler Twist. Let us know how it works out.
about 2 years ago
Bruce, it is normal for you to be sore. Eccentric exercises commonly create “delayed onset muscle soreness” due to the microtrauma of the muscle. Use ice or heat to help reduce your soreness (or Biofreeze!) and be sure that you dont increase your repetitions or intensity until the soreness subsides. Good luck!
about 2 years ago
I have medial epicondylitis in both elbows, and have been in PT for about a month. I want to try this exercise and am hoping my Physical Therapist is game to go along to see how it works for my condition. While I am trying it, should I discontinue the classic exercises that he has had me do, which are the isotonic, resistance-based ones using thera-band exercise bands?
You mention above that we would have to use eccentric wrist extension rather than flexion to treat medial epicondylitis. How would you suggest doing this? Is the “uninvolved” arm in the Tyler Twist protocol performing eccentric wrist extension? Would doing the Tyler Twist be bad for medial?
about 2 years ago
We have just posted an exercise with the Thera-Band FlexBar for Golfers Elbow (medial epicondylitis) that was developed by Tim Tyler as well. Check it out at http://info.thera-bandacademy.com/flexbarelbowmedial
Love to hear your feedback!
about 2 years ago
We have just posted an exercise with the Thera-Band FlexBar for Golfers Elbow (medial epicondylitis) that was developed by Tim Tyler as well. Check it out at http://info.thera-bandacademy.com/flexbarelbowmedial
about 2 years ago
I have bilateral medial and lateral epicondylitis. Would it be harmful to do the exercises that are posted since I don’t have an uninvolved arm. My Dr. has me doing wrist flexion and extension with a weight.
Thank you
about 2 years ago
Does eccentric exercise with the theraband flexbar offer benefits different from eccentric exercise with a free weight? I had tried using free weights for eccentric exercise for lateral epicondylitis with limited results.
about 2 years ago
Keith: we dont have any research comparing eccentric exercise with the FlexBar to standard free weights… but I can tell you that the FlexBar exercise is different than using standard weights because you dont have to perform a concentric contraction to lift the weight first; therefore, it’s a pure eccentric exercise as Tim Tyler developed. I hope this helps.
about 2 years ago
Reza
I have a areversed prosthisis on my shoulder which has limited my arm motions. Would this improve my arm motions reaching up and back?
I thank you
about 2 years ago
I have bilateral lateral epicondylitis. How can I do the active exercise for the “involved side” when both sides are involved? Would treating one elbow aggravate the other elbow? Would I need to use a different technique than is shown on your video?
Thank you
about 2 years ago
It’s possible that you may aggravate the other side as well. I’ve had several people ask this question, but I haven’t heard if anyone has had problems or created a solution. Anyone?
about 2 years ago
How about having a partner hold the other end as if it were you(pretending to be the uninvolved side…
about 2 years ago
Would you always recommend starting with the lowest resistance?
about 2 years ago
Yes, In the tennis elbow study, all participants started with the Red resistance regardless.
about 1 year ago
Hi,
After having no success with all kind of treatments for Golfers Elbow, i landed on to the Flexbar. It has amazingly given me positive results (although it has reached a plateau now with very very slow progress), now i have developed tennis elbow in the same elbow where I had medial epicondylitis.
I think its because of the fact that during the motion while exercising I have to hold it tight.
Do you think I am doing something wrong?
I have a green bar and I am pretty comfortable with it.
about 1 year ago
After suffering from tennis elbow for three years I am happy to report that the exercises with the Thera-Band have reduced the pain about 98%. I have been doing these exercises for three months now. However, I still can find a couple of sore spots if I dig deep with my fingers into my forearm and the outside of my elbow. I am very tempted to get back into playing tennis but I’m affraid I may injure it again. What do you reccomend?
about 1 year ago
Tim Tyler, the physical therapist who studied the exercise, suggests that you see a physical therapist to receive a few more ‘touch-up’ treatments such as Graston Technique or Kinesiotaping.
about 1 year ago
I have been reading quite a bit about Prolotheraphy for treating tennis elbow. I can not find any conclusive studies or information however and the subject still seems hotly debated. Does anyone have any information regarding this?
about 1 year ago
what year was this study conducted?
about 1 year ago
The study was completed in 2009 and is in press now.
about 1 year ago
I have tennis elbow. I also have pain on the inside of my elbow. I’m confused about the reverse Tyler Twist. Will the reverse Tyler Twist be harmful to someone who has tennis elbow? In otherwords, is it okay to do both excercises (the Tyler Twist and the Reverse Tyler Twist) on the same elbow?
about 1 year ago
Mike, Unfortunately, we dont have a good answer for that. There have been several people asking that question, and all I can say is, “Give it a try.” If anyone else has experienced this, please comment. Thanks. Dr. Phil
about 1 year ago
Hi Dr. Phil. I have been suffering from golfers elbow for 2 years now with pain on the inside of the elbows. I have tried exercise, radial shockwave treatment, physical therapy and manual therapy and the pain is still there (both arms).
I have just ordered a red Flexiband and I will try to do the reverse Tyler Twist. Do you think it is harmful to do it when both arms are suffering? Has there been a study similar to the one conducted on the tennis elbow twist for this “Reverse Tyler Twist”? Have you heard any positive feedback? Thank you!
about 1 year ago
@Sverre: it sounds like you have ‘golfers elbow’, or medial epicondylitis. Unfortunately, we have no data on patients with symptoms in both arms, although several have asked that very question on our blog! No one has posted a comment one way or the other unfortunately. We are currently investigating the ‘reverse twist’ for golfers elbow to find out if it is effective; our preliminary work from Tim Tyler suggests it is very effective! Details on the exercise can be found here: http://www.hygenicblog.com/2009/09/29/reverse-tyler-twist-with-the-thera-band-flexbar-for-golfers-elbow/ Best regards, Dr. Phil.