Tennis Elbow (also called Lateral Epicondylitis by the medical profession) is a common condition that when mild is inconvenient but in severe cases quite disabling.

It is caused by inflammation at the point where the muscles controlling wrist and finger movements connect to the elbow. It is usually caused by overuse or a change in useage patterns, but occasionally by trauma. Tennis elbow is so common that most people know someone who has had the condition at some time.

It is famously resistant to treatment and in many cases becomes a chronic condition causing long term pain and loss of function.

There have been many treatments used over time for Tennis Elbow. Stretches, ultrasound, injections and even surgery. All of these helped some people but did not help most.

The new treatment came about by seeing what worked for similar conditions elsewhere in the body. Achilles Tendonitis is one such condition. This was shown to respond well to a specific type of exercise called Eccentric Exercise.

Eccentric exercise is where the muscle and tendons in question acts as brakes, slowing or resisting a movement. It is not important for you to understand exactly what this means or why it helps. All you need to know is that a recent study (at the Nicholas Institute of Sports Medicine and Athletic Trauma in New York City) had to be stopped mid way through, as the treatment was so effective it was unethical to deny it to the control group.

Doing Eccentric Exercises for tennis elbow was previously difficult as there was no easy way to provide the force to resist. This has now changed with a single, inexpensive piece of exercise equipment. Called a 'flexbar' (see right) this rubber bar is readily available for around $20 and is the only expenditure required to successfully treat your tennis elbow.

Below is a video of the exercise. You will need to watch it numerous times to get it right - it is important to do each component correctly if you wish to be effective.

To describe the exercise we first have to know which arm is doing the eccentric exercise, and which is assisting. In this video, the lady's right arm is the arm being treated. The left arm is the one providing the force to exercise against. Here is how to do the exercise:

• The rubber bar is held in the right hand with the wrist cocked back. The wrist must move from this position.
• The other hand grasps the opposite end of the flexbar and this hand provides all the force required to twist the bar. The right wrist remains cocked and does not add to the twist.
• Both arms are moved out in front of the body. If the moves have been done correctly so far, the arm being treated, the right, should be gripping the twisted rubber bar with the wrist cocked back. Everything up to this point has been preparation. The beneficial exercise is the bit that comes next.
• Keeping everything else still, the right wrist now slowly bends forward,rolling the knuckles away from the body as the flexbar slowly unwinds. This is the eccentric exercise, the aggravated muscle is controlling, but allowing the flexbar to untwist.

Now re-read this, checking each point off on the video until you understand all of it. Although only the unwinding is the exercise itself, if the set up is done incorrectly, (and the right hand provides some of the twist), it can make things worse.

When first starting out you need to be gentle. Doing a set of 5 exercises, 3 times a day is a good introduction. As this gets easier you can continue with 3 times a day but slowly increase the number you do each time towards 10, then 15, then 20.

It will be sore afterwards. That is why you should start off slowly. You should only increase the repetitions when you can do so with the same (or less) post exercise soreness that you had at the previous level.

This exercise is not a magic wand so it won't happen overnight, but it does seem to work for all those who persist with the exercises. Once the condition is resolved, any future symptoms can quickly be banished by briefly reintroducing the exercises.

For those struggling with chronic tennis elbow, this is great news. Now they can be active in treating this disabling condition and empower themselves to prevent its return.

Firstly, if there is one activity that really causes your pain, avoid it as much as possible. Use the other arm whenever you can. If it is not an activity you can avoid, see if you can break the task up, having rests during it to help decrease the strain on the tendon.

If you are able to take anti-inflammatory medication, they can provide symptomatic relief while you wait for the tennis elbow exercises to work. Discuss these with your doctor.

There are also arm bands specifically designed to take the pressure off the tendon. These bands, such as the Aircast Tennis Elbow Support, are useful for people with busy lifestyles who are constantly using their arms. By helping decrease aggravating forces on the tendon, they should speed up the results of the tennis elbow eccentric exercises. If you already have one simliar to this but found it unable to treat your tennis elbow on its own, dust it off and use it again in conjunction with the exercises.