Tennis elbow exercises — Tyler protocol with eccentric wrist work

Lateral epicondylitis ('tennis elbow') is a degenerative tendinopathy of the wrist extensor origin, not an inflammatory condition — which is why ibuprofen and ice don't help past the first 48 hours. The published fix is the Tyler protocol: hold a light dumbbell palm-down with the forearm resting on a table, use the OTHER hand to lift the wrist up, then slowly (5 seconds) lower under load. The slow lowering is the eccentric loading that triggers collagen remodelling. Start light — 0.5 to 1 kg — and add weight every 2 weeks. 3 sets of 15, daily. Most users see meaningful change by week 4-6.

The mirror protocol works for golfer's elbow (medial epicondylitis): same setup but palm UP, loading the wrist flexors. Volya catalogues wrist-extensor-eccentric and wrist-flexor-eccentric as separate entries with the Tyler-protocol cues baked in: 'LOWER slowly under load — that's the eccentric' and 'use the OTHER hand to lift back up (no concentric load)'. The most common failure is doing the move concentrically — lifting under load — which gives zero benefit. Avoid for the first 2 weeks if pain is sharp at rest or the elbow is hot to touch (acute tendinitis, not yet degenerative). Manage the underlying cause: gripping technique on the racket, mouse + keyboard ergonomics, or repetitive wrist motion at work.