This is a question I answered on Quora. Here’s my answer:
Whether it’s wise or safe to continue working out your upper body when you have Tennis Elbow depends on several factors:
- The first being how severe your injury is – which is a difficult thing to know objectively – (unless you’ve had an MRI or Sonogram) but the severity of the pain may give you some idea…
- The second being how you were injured in the first place. (If your injury stems from lifting weights to begin with, then more weight training as you’re trying to recover may not be a good idea.)
But the most important rule if you do keep working out your upper body is:
- You should absolutely not be feeling any significant pain in your Tennis Elbow “symptom area” while you’re exercising.
(Some mild to moderate soreness or slight increase in symptoms for a day or so afterward isn’t necessarily a negative – But flare-ups that go on for days are.)
Here’s a 3-minute video with my thoughts on who should and who shouldn’t keep working out and how to do it wisely:
For a more thorough answer to this question, please see my in-depth article with longer video and podcast here:
“Active Rest” Vs. “Passive Rest”
Some authorities will advise total rest and avoidance of most, if not all, upper body exertion for a set period of time = “Passive Rest.”
This sounds perfectly reasonable at first glance – If you’ve been told that Tennis Elbow is an ‘Acute’ / inflammatory type of injury like a sprain or fracture that requires a certain amount of total rest in order to heal.
But this does not make sense once you know that Tennis Elbow is most often the result of a gradual, degenerative process known as ‘Tendinosis’ marked by stagnation, gradual tendon breakdown and failed healing – Not an acute injury:
Tennis elbow tendinosis (epicondylitis) is most commonly caused by tendon overuse and failed tendon healing. The pathoanatomy of overuse tendinopathy is noninflammatory “angiofibroblastic tendinosis.” – Nirschl RP1, Ashman ES.
(Robert P. Nirschl, MD is a pioneer in tendon-related medical research and surgical procedure.)
And there’s absolutely no guarantee that any healing whatsoever will take place in your tendon while you’re “resting, hoping and waiting.”
More time and rest will not reverse a degenerative “failed healing” state.
It’s a counter-intuitive dilemma, because we want to visualize, categorize and treat it the way we do “Acute-type” injuries – But it isn’t (usually.)
I’m in favor of an “active rest” / mobilization approach (keep active; moving and working out – but try to minimize (rest from) the activity that caused the “Overuse Injury”
…As opposed to a “passive” or total-rest approach with immobilization (braces, splints, etc.) Here’s more on that:
I also think how you treat the muscles and tendons involved in your Tennis Elbow is the most important factor. (I’m admittedly biased in favor of a soft-tissue mobilization approach to break the cycle of stagnation.)
Beyond that, when it comes to upper-body exercise, I think the most important things are:
- To use much less weight in your upper-body workouts, and
- To avoid certain highly-aggravating exercises
Here’s a link to my Quora Blog post on which specific exercises to avoid: