Wrist flexion/extension (eccentric)

Purpose of the exercise

Therapeutic strength exercise for the wrist flexors and extensors with a focus on eccentric loading. Improves tendon strength and resilience, helps recovery from overuse injuries and reduces pain in tennis elbow and golfer's elbow. Also effective for strengthening tendons without causing new inflammation, and for improving muscle strength during lengthening contraction.

Supplies

• Table or support for forearm support
• Light dumbbell or weight (1-3 kg, start light)
• Optional: towel under wrist for comfort

Starting position

1. Sit down with your forearm supported on a table
2. Let your hand hang over the edge of the table
3. Hold light weight in your working hand
4. Keep your forearm still on the table

Implementation

For wrist extensors (tennis elbow):

1. Start with palm down (pronation)
2. Use your other hand to raise the working wrist (extension)
3. Or: lift the weight with both hands
4. Now lower very slowly using only your working hand (5-8 seconds)
5. Actively control downward movement with your wrist sensors
6. Lower to full flexion
7. Again, use your other hand to bring up
8. Repeat only the eccentric (downward) phase

For wrist flexors (golfer's elbow):

9. Start with palm up (supination)

10. Use your other hand to raise the working wrist (flexion)

11. Now lower very slowly using only your working hand (5-8 seconds)

12. Actively control downward movement

13. Lower to full extension

14. Again use your other hand to bring up

Points of interest

• ✓ Focus on very slow down phase (5-8 seconds)
• ✓ Use other hand for upward movement
• ✓ Keep your forearm completely still on the table
• ✓ Move through full range of motion
• ✓ Stay within tolerable pain (may be slightly uncomfortable)
• ✓ Breathe calmly during the exercise
• ✗ Avoid rapid or uncontrolled downward movement
• ✗ Don't use too heavy weight (start conservatively)
• ✗ Don't do the concentric phase with the working leg (use help)
• ✗ Don't lift your forearm from the table
• ✗ Don't stop at mild discomfort - some pain (max 5/10) is acceptable
• ✗ Don't train through acute, sharp pain

When this exercise?

This exercise is suitable for tennis elbow (lateral epicondylitis), golfer's elbow (medial epicondylitis) or other wrist/lower arm tendon complaints (in consultation with physiotherapist). Ideal in subacute to chronic phase of tendinopathy (after the acute inflammatory phase). Highly effective as main treatment for tennis elbow - scientifically proven effective. Perfect as daily exercise (often prescribed twice a day, 3 sets of 15 repetitions). Also valuable for prevention of overuse complaints in racquet sportsmen or people with repetitive work. Suitable from about 2 weeks after onset of symptoms. Expect mild pain during exercise (max 5/10) - this is normal and not a sign to stop. In case of acute, severe pain or worsening of symptoms, consult physiotherapist first. Start with very light weights (even 0.5-1 kg) and build up over weeks. Patience is essential - recovery often takes 8-12 weeks.