Home > Uncategorized > Fixing tennis elbow with a “rubber bar” [updated with pics]

Fixing tennis elbow with a “rubber bar” [updated with pics]

July 12th, 2009

[updated to include pictures of how to do the exercise]

The annual meeting of the American Orthopaedic Society for Sports Medicine is taking place right now in Colorado. Among the research being presented is a new approach to “tennis elbow,” which apparently affects three percent of the population. The study took 21 patients and gave them both the standard conservative treatment (stretching, ultrasound, massage, heat and ice), and then split them into two groups for wrist strengthening exercises:

The eccentric training group performed isolated eccentric wrist extensor strengthening using the rubber bar (Flexbar, Akron OH) while the standard treatment group performed isotonic wrist strengthening exercises.

Apparently the fancy rubber bar worked so well that they halted the trial early to let the controls get the good stuff, which is generally a sign that the researchers are seeing a very strong effect. Given how much of a nuisance tennis elbow can be, this seems like good news. The only problem is that I have no idea what an isolated eccentric wrist exercise with a rubber bar looks like. I’ve asked for some further description or diagrams to help clarify, and I’ll post them here when I get them.

Update: I just received a copy of the research paper, along with some pictures to illustrate the exercises. The paper is “Addition of a Novel Eccentric Wrist Extensor Exercise to Standard Treatment for Chronic Lateral Epicondylitis: A Prospective Randomized Trial,” by Timothy Tyler of Nicholas Institute of Sports Medicine and Athletic Trauma in New York, along with his collaborators. The results do appear fairly impressive: pain improved by 81% compared to 22% in controls, tenderness by 70% versus 4%, and strength by 72% versus 11%.

Here’s how they describe the exercise:

The isolated eccentric strengthening exercise was performed using a rubber bar (Thera-Band ® FlexBar, The Hygenic Corporation, Akron OH) which was twisted using wrist flexion of the uninvolved limb and slowly allowed to untwist with eccentric wrist extension by the involved limb (Fig 1). Each eccentric wrist extensor contraction lasted approximately 4 seconds (i.e. slow release). Both upper extremities were reset for the subsequent repetitions. A 30 second rest period was timed between each set of 15 repetitions and 3 sets of 15 repetitions were performed daily. Intensity was increased by giving the patient a thicker rubber bar if the patient reported no longer experiencing discomfort during the exercise.

And here are two pictures:

Figure 1: Arms brought in front of body with elbows in extension while maintaining twist in rubber bar by holding with noninvolved wrist in full flexion and the involved wrist in full extension.

Figure 1: Arms brought in front of body with elbows in extension while maintaining twist in rubber bar by holding with noninvolved wrist in full flexion and the involved wrist in full extension.

Figure 2: Rubber bar slowly untwisted by allowing involved wrist to move into flexion i.e. eccentric contraction of the involved wrist extensors.

Figure 2: Rubber bar slowly untwisted by allowing involved wrist to move into flexion i.e. eccentric contraction of the involved wrist extensors.

  1. mary
    July 13th, 2009 at 13:45 | #1

    thanks for the pictures of the exercises – i’m going to give it a try!

  2. alex
    July 13th, 2009 at 15:00 | #2

    Good luck with it, Mary — and hey, let us know how it goes!

  3. July 19th, 2009 at 03:48 | #3

    Can I try this exercise by imagining that I’m using a rubber bar and doing the same motion as explained?

  4. alex
    July 19th, 2009 at 17:44 | #4

    The rubber bar provides resistance, so “imagining” the exercise would the equivalent of lifting weights without the weight (or with just the bar) — it stimulates the right muscles, but at a much lower level.

    If you wanted to try something equivalent, maybe try holding a towel that’s already twisted up in one direction, so the motion of the exercise tries to twist it further in the same direction. That might offer some resistance for you — and as you get stronger, you could start with the towel more twisted so that it offers higher resistance. (This is NOT medical advice! Just some brainstorming about ways to mimic the effects of the rubber bar.)

  5. robert
    July 30th, 2009 at 15:09 | #5

    this sounds fantastic – i’m desperate enough to try anything!
    pardon my ignorance, but could someone explain the following terms?
    “elbows in extension”
    “wrist in full flexion”
    “wrist in full extension”
    “move into flexion”
    “eccentric contraction of the involved wrist extensors”
    your most gratefully, humbly and dumbly…

  6. peter
    August 26th, 2009 at 19:57 | #6

    where can i buy that rubber bar?

  7. robert
    August 28th, 2009 at 08:24 | #7

    the nytimes has reported on this technique, including a youtube video and the following explanation: “In the exercise, a person holds the bar upright at his or her side using the hand connected to the sore elbow, then grasps it near the top with the good hand. The top hand twists as the bar is brought around in front of the body and positioned perpendicular to the ground; the sore hand then takes over, slowly untwisting the bar by flexing the wrist. “Afterward, you should be sore,” Tyler says.’That’s how we know it’s effective.”
    SweatScience got there first.
    Thanks!
    http://well.blogs.nytimes.com/2009/08/25/phys-ed-an-easy-fix-for-tennis-elbow/?scp=1&sq=tennis%20elbow&st=cse

  8. alex
    August 31st, 2009 at 00:32 | #8

    Peter: you can order directly from the company at this URL: http://www.thera-band.com/order.php.

    Robert: thanks for the link to the NYT piece — good to have some more details!

  9. Jule
    September 7th, 2009 at 19:17 | #9

    Does anyone know of a Vendor in Vancouver, BC who sells the Flex-Bar?

    I have been “living” with Tennis Elbow for over 3 years. Tried everything – ART, Chiro, Phsyio, Massage, IMS, anti-inflammatory meds, etc. Nothing has worked! Thanks for the tip about the towel, I’m going to use that until I can get the flex-bar ordered & shipped to me via the internet as I can’t find anyone in Vancouver whose even heard of this new treatment.

  10. Lou
    September 19th, 2009 at 01:26 | #10

    what about rolling up one of those Physio/evercise rubber fitness bands??? the heavy duty ones are quite wide and would provide good resistance…

  11. alex
    September 19th, 2009 at 04:42 | #11

    Interesting idea, Lou. Off the top of my head, I don’t see why it wouldn’t be able to provide a similar stimulus. I guess the caveat is that, if it doesn’t work, you don’t know whether that’s just because you weren’t getting the right action from the rubber band. Still, I don’t see any harm in trying it if you have some of the bands lying around — if it works, that’s great, if it doesn’t, then you move to ordering the rubber bar…

  12. Timothy Frink
    December 16th, 2009 at 00:58 | #12

    @Jule
    You can buy the Flexbar on Amazon.com for about $25. It really works great. I have used one for about 2 months and the symptoms are gone after one year of pain!

  13. meenakshi sharma
    November 2nd, 2011 at 19:53 | #13

    from where can we we buy these rubber bars and can we use therabands instead of rubber bars

  14. August 29th, 2013 at 11:48 | #14

    This is bullshit. I cant even grip the bar nor turn it without severe pain. The doctors won’t believe me that this hurts me so bad. The pain I feel just sitting down not moving kills me. i Cant sleep it hurts so bad. i can’t work anymore. This is a load of crap to get your money. There is no such thing as a “cure” for tennis elbow. Explain that science.

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