Tennis Elbow Twister

- the answer to Tennis Elbow -

Tennis Elbow or lateral epicondylitis is a condition

in which the outer part of the elbow becomes
extremely painful and tender to touch. People
often complain of pain gripping an object, difficulty shaking hands, turning a door knob or using a
screw driver.

WHO
Contrary to popular belief, Tennis Elbow does not always or only
occur as a result of playing tennis! It has been shown to equally
affect both males and females and tends to be more common
over the age of about 40, although it can occur at any age.

Extensor Muscles

Lateral Epicondyle

Tendon

Overuse of the Extensor Muscles

leads to pain here

HOW
Trauma such as a direct blow to the lateral elbow or epicondyle or a drag type force to the elbow
(i.e. heavy load or over forceful extension or bending of the wrist) can cause Tennis Elbow. Incorrect
tennis technique, such as miss hitting a ball, changing grip or altering string tension may all also lead to a
strain on the wrist extension muscles and eventually to a Tennis Elbow.
WHY
Medical explanations of why Tennis Elbow may occur includes evidence that there are microscopic and small tears between the
common extensor tendons (muscles that bend the wrist backwards) and the periosteum (lining of the bone) of the lateral epicondyle. It
involves specifically the Extensor Carpi Radialis Longus and Extensor Carpi Radialis Brevis muscles which attach to the outside part of the arm,
just above the elbow. Sometimes there can be some involvement of one of the nerves on the outside of the elbow, the radial nerve. It is not uncommon for sufferers of Tennis Elbow to also develop of other conditions such as shoulder rotator cuff problems, or even wrist tendonitis.
DIAGNOSIS
The diagnosis of Tennis Elbow can involve a number of tests where a physician will press the affected area while requesting the patient to move the elbow, wrist,
and fingers. Tennis elbow sufferers will also complain of pain with stretching and resisted wrist extension. X-rays can be used to exclude fractures or arthritis as a
cause of the pain. Ultrasound and magnetic resonance imaging (MRI) can identify fluid and swelling where the Extensor Carpi Radialis Brevis muscle attaches to
the bone.

TREATMENT
Almost all Tennis Elbow sufferers complain that it can be a frustrating and painful condition
that negatively affects their ability to participate in sport, work and recreational activities.
Physicians may choose to trial a variety of injections to treat symptoms and underlying cause, all
with varying aims including Cortisone (CSI), Platelet Rich Plasma (PRP) and prolotherapy, often with a
mixed response.
On many occasions the severity of Tennis Elbow symptoms settle without any treatment, although it may take
between six months and two years. Such as prolonged period of activity modification is unacceptable to most
sufferers of Tennis Elbow and they will seek a more timely return to normal activity.
While many treatments have been proposed, exercises to stretch and strengthen the damaged muscles are a frequent
management strategy. This is most effectively done when it simulates the normal loading pattern of muscles, using an
alternating contraction and relaxation exercise technique. These loading and flexibility routines need to be undertaken within
a carefully monitored progression plan, and most successfully involve use of eccentric exercises. Eccentric exercises are those
where a muscle is gently lengthening under some load, as (for example) happens to the quadriceps muscles (muscles on the front
of the thigh) when slowly squatting. This is as distinct from concentric contraction as happens to the quadriceps muscles as you stand
up from a squat.
Recently published scientific studies have confirmed and highlighted the benefit of eccentric exercises in the treatment regimen for Tennis
Elbow. Details of references are listed on the web site.
The TETwister (Tennis Elbow Twister) has been developed by medical professionals for exactly this purpose.

HOW DOES IT WORK

Muscles acting around a joint will generally work in a balanced way, such that when the
muscles on one side of a joint are active (the agonist muscles), the muscles on the opposite
side of the joint (the antagonist muscles) will relax.
The TETwister exercises the muscles of both forearms in an alternating way to simulate normal muscle
activity. Agonist muscles contraction, and hence antagonist muscle relaxation, happens when twisted in one
direction, and this is followed by the reverse muscle loading in a controlled fashion when twisted in the other
direction.
The unique feature of the TETwister is the elastic recoil element that engages the agonist/antagonist muscle interaction, and
thereby allows better contraction performance in the agonist muscles, and encourages relaxation of the antagonist muscles.
The TETwister relies on repetitive low loads in an alternating fashion, reproducing controlled normal muscle contraction (both concentric and
eccentric) and relaxation, to encourage healing and rehabilitation of the damaged muscle attachments.

PROGRESSION PROGRAMS
LEVEL 1
WHERE GRIPPING IS VERY PAINFUL AND THE LATERAL ELBOW IS STILL EXTREMELY PAINFUL IN THE MORNING.
This level is extremely important as it is where you lay the groundwork for future progress. Do too much and your pain will worsen.

TIP :
Monitoring how painful your elbow is in the morning gives a great idea of progress. Do too much the prior day and it is most likely you will pay the
price with increased elbow pain the next morning. An ideal circumstance would be that you perform your TETwister program as directed one day and
you wake with elbow pain no worse than the prior day. As your elbow pain settles your capacity to exercise will increase, allowing more reps with the
TETwister.
No further increase in morning pain allows for more progressionbut slowly!
Start by gripping the TETwister with both hands. One hand twists the device in the forward direction while the other hand twists it in the opposing direction. The
aim is to perform the exercises with the elbows straight, however, in the initial stages, bending the elbows will reduce the stain on the painful muscle insertion.
Adjustment of the angle between the wrists facilitates a comfortable exercise position, and avoids strain to uninvolved structures. Moving your hands further apart
on the TETwister can reduce the twisting tension and may be a good idea initially. While the twisting tension may not feel very strong, overloading the damaged
muscle can be counterproductive. Start gently!
REPETITIONS

START WITH 5-10 REPETITIONS, AND JUST AT THE

PAINFUL LIMIT OF EACH TWIST, HOLD THE (ISOMETRIC)
POSITION FOR FIVE SECONDS.

SETS

DO THIS 4 TIMES A DAY AND INCREASE THE NUMBERS OF

TWISTS AND THE LENGTH OF TIME YOU HOLD THE
POSITION AS YOUR ENDURANCE INCREASES.

BEWARE

IF YOU GET PAIN, REDUCE THE REPETITIONS OR THE

LOAD TENSION AT THE START OF EACH EXERCISE.

WARNING :
If your elbow pain worsens in the mornings after a day of exercise, you may need to slow down even
further and perform a few gentle twists, but do this every hour until your pain starts to settle. Vary the
speed, hold times and repetitions to see what works the muscles most effectively.

The device is held with both hands, and twisted in an alternating fashion
to cause a contraction / relaxation cycle of the forearm muscles.

LEVEL 2
WHERE MORNING PAIN IS CONSIDERABLY IMPROVED AND GRIP STRENGTH IS IMPROVING
Start by gripping the TETwister with both hands. This time the opposite hand to the painful elbow twists the device in the forward direction
or away while the other hand with the sore elbow holds a neutral position ie does not move. Slowly the stationary hand allows the devices tension
to bend the wrist forward. This creates an Isometric (stationary) then eccentric contraction on the wrist extensors. Again this twisting tension may not
feel very strong, however considerable tension is being developed in the muscles and again overloading the damaged muscle can be counterproductive.
REPETITIONS

START WITH 10 REPETITIONS

SETS

BUILD TO DOING THIS 3 THREE TIMES IN A SESSION

SESSIONS

BUILD TO 3 TIMES PER DAY I.E. 3 X 10 SETS / 3 TIMES PER DAY

BEWARE

IF YOU GET PAIN, REDUCE THE REPETITIONS OR THE LOAD TENSION AT THE START OF EACH EXERCISE.

LEVEL 3
VERY LITTLE MORNING SORENESS PREFERABLY NONE. GRIP STRENGTH APPROACHING NORMAL.
Its time to add a little strength and endurance to your forearm muscles.
Start by gripping the TETwister with both hands. One hand twists the device in the
forward direction while the other hand twists it in the opposing direction. This time we
are looking to create some fatiguemaybe even a little muscle burn!
REPETITIONS

START WITH 20-30 REPETITIONS, NO HOLD JUST

ALTERNATING MOVEMENT TO THE EXTREME OF YOUR
RANGE.

SETS

PERFORM 3-5 SETS.

SESSIONS

PERFORM THIS PROGRAM 2-3 TIMES PER WEEK

BEWARE

IF YOU GET PAIN, REDUCE THE REPETITIONS OR THE

LOAD TENSION AT THE START OF EACH

TETwister really works. Although it will not fix ALL Tennis Elbows (or golfers elbows), TETwister allows you to easily and
conveniently carry out a targeted and effective exercise program without the need for expensive equipment, and hopefully avoid
more invasive treatments such as injections and surgery. TETwister is an ideal way to keep the forearm muscles tuned up to avoid injury
recurrence, once your symptoms have settled.

IMPORTANT TETwister is not a substitute for advice and treatment by a doctor or other health
professional, who you should consult if symptoms persist.
DISCLAIMER :
This product should be used only as described in the product brochure information.
We always recommend you should seek professional medical advice
in conjunction with the use of this product and the information contained with
it. Lockeroom sports will not accept responsibility for injuries while using the
product.

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