Rubber bar exercises help relieve tennis elbow

NEW YORK (Reuters Health) - People who suffer from tennis elbow may find relief by adding simple home-based exercises, using an inexpensive rubber bar, to standard physical therapy, according to a study presented at the American Orthopedic Society for Sports Medicine meeting in Keystone, Colorado.

In a study of 21 tennis elbow patients, those that did the rubber bar exercises "got significantly stronger and had significantly less pain and a better outcome than the people that did standard physical therapy alone," Timothy Tyler, who led the study, told Reuters Health.

"Ethically, we stopped the study because we saw such a vast improvement in the rubber bar group; we didn't feel that it was ethical to keep people that weren't getting better on the standard treatment protocol on that protocol," added Tyler, a clinical research associate at Nicholas Institute of Sports Medicine and Athletic Trauma at Lenox Hill Hospital in New York City.

Tennis elbow is an overuse injury to tendons around the outer side of the elbow. As the name implies, it often arises in racquet-sport enthusiasts, but can also result from other repetitive arm motions, such as using a screwdriver, hammering or painting.

Tyler's team assessed the effects of a novel "eccentric" wrist extensor exercise added to standard physical therapy for tennis elbow. Basically, eccentric exercise involves putting tension on a muscle as it opposes a stronger force, which causes the muscle to lengthen as it contracts.

All 21 tennis elbow patients in the study got standard physical therapy for 3 weeks and 11 added the isolated "eccentric" wrist strengthening exercises using an $8 rubber "FlexBar."

"We taught the patients how to use the rubber bar in the clinic and then sent them home to do the exercises," Tyler said. They performed 3 sets of 15 repetitions daily at progressively increasing intensity.

Study subjects who did the rubber bar exercises had vastly better results on all outcome measures including level of pain and tenderness, movement and strength, Tyler said.

For example, those who did the bar exercises improved on the so-called Disabilities of Arm, Shoulder, and Hand, or DASH, questionnaire by 76 percent, versus just 12 percent after standard physical therapy.

Pain, tenderness and strength improved 81, 70 and 72 percent, respectively, in the rubber bar exercise group, compared with 22, 4 and 11 percent in the standard physical therapy group.

As mentioned, given the consistently poor outcomes seen in the control group, the study was terminated and these patients were invited to start the rubber bar exercises.

The FlexBar used in the study is made by the Hygenic Corporation of Akron, Ohio, which also makes the Thera-Band physical therapy products. The company donated the FlexBars used in study but did not sponsor the study.