The hard-hitting repetitive moves of tennis cause pain at the lateral epicondyle of the elbow. The pain comes from one or both of two muscle sources, the supinator muscle and the extensor muscles of the hand and fingers. Effective stretching using Active Isolated Stretching methods is an important treatment for maintenance, prevention and pain relief.

The first cause of tennis elbow, the supinator muscle attaches deep at the outside of the arm from the tip of the elbow (olecranon process of the ulna) to the bony protrusion where you feel the pain (lateral epicondyle of the humerus) and into the fleshy part above it where it attaches to the radius, the bone that turns the arm from palm down to palm up (supination). Tendonitis or Trigger Points from this muscle is a major cause of pain.

Supinator stretch: With your right arm in front of you turned palm down, place your  left hand on top of it with your left palm against the back of your right hand with all fingers facing  forward. Hook your left thumb around the fleshy pad on the pinkie side of the hand (hypothenar eminence). Turn your right hand so the palm faces away from you toward the right. Using your thumb to grip the hand, twist it farther. You should feel the pull at the  outside of your arm at your elbow. Actively stretch for two seconds, release the hands to palm down again. Repeat 10 times.

Pronator stretch: The pronator muscle works opposite to the supinator to turn the hand from palm up to palm down. Because it works together with the supinator, it is best to stretch it too. Do the opposite of the supinator stretch. Turn the right palm up and place the palm of your left hand underneath on the back of the hand. Wrap the fingers around the wrist and the fleshy part of the thumb (thenar eminence). Turn the hand farther toward the right and assist the twisting stretch for two seconds. The pull will be between the inner elbow across diagonally to the middle of the radius bone.

The second major cause of tennis elbow pain is inflammation of the tendons of the muscles that grip the handle of the raquet and bring it back at the wrist (extensor carpi and extensor digitorum). Trigger Points from the extensors can also refer pain into the lateral epicondyle.

Hand and wrist extensor stretch: Extend your right arm straight out in front of you with your palm down.  Place your left hand against the back of your right hand. Actively point your fingers toward the floor and pull your hand closer to the inner arm. Keep the fingers themselves relaxed. Release and repeat 10 times.

Finger extensor stretch: In the same position, make a fist and point it toward the floor. With the left hand palm up and gripping the fist from underneath, pull the fist closer to the inner arm. Actively stretch for two seconds and release to a relaxed position. Repeat 10 times.