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Functional exercise progression for return to tennis following elbow tendinopathy*

After completing all phases of an appropriate rehabilitation program following injury, the athlete may begin returning to tennis using a functional progression such as that described below. The functional progression is a prioritized sequence of activities that enables the athlete to reacquire the skills and conditioning necessary for a safe and effective return to full play.

Step 1. May play mini-tennis from service line; essentially point of contact to follow through only.

Step 2. Perform step 1 as a warmup. May play on 2/3 court using a little more backswing than step 1. May apply gentle spin if able and does not cause pain.

Step 3. Perform steps 1 and 2 as a warmup. May play full court with good leg drive but no heavy spin or pace and no service.

Step 4. Continue step 3. May begin service practice by throwing tennis ball from service line to other side.

Step 5. Continue step 3. May begin practice serves from service line.

Step 6. Perform steps 1 and 2 as a warmup. May play full court using full groundstrokes and full serves, but avoid excessive or early spin¶ until symptom free for at least 1 month.

Step 7. May play full matches without restrictions provided you remain symptom free. Limit volume of play to no more than 6 hours per week for the first 1 to 3 months.

The progression described above is approximate. Each step from 1 through 5 is performed for approximately 10 minutes daily for several days. Steps are additive. As an example, for step 3, the workout would consist of controlled tennis at the service line for 10 minutes, then controlled tennis on 2/3 court, and finally full-court play following the restrictions described for 10 minutes. If a step can be performed without discomfort for several successive days, the player may proceed to the next step.

*This program may also be suitable for patients recovering from upper extremity injuries other than elbow tendinopathy and returning to tennis.
¶To reduce top spin on forehands, limit forearm pronation; to reduce backspin on backhands, limit wrist extension.

Graphic 60005 Version 6.0