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Box 101

Eccentric Elbows

Two exercises to improve strength and reduce pain in your elbows.

Tennis elbow and golfer’s elbow can show up in CrossFitters who never play tennis or golf. Both conditions can be extremely painful and make holding even modest weights almost impossible. If you can’t pick up a gallon of milk, odds are you’re not going to set any deadlift PRs anytime soon. It’s important to help your box members alleviate these conditions quickly so they don’t turn into people who used to do CrossFit. It turns out there’s a really simple tool that’s been clinically proven to reduce pain, increase strength and keep your members showing up for the daily WOD.

Physical therapist Tim Tyler, MSPT, ATC, and his team developed two specific exercises to induce eccentric loading in the forearm: the Tyler twist for tennis elbow and the aptly named reverse Tyler twist for golfer’s elbow. And according to the research, the team found a pretty profound way to treat both conditions.

In two separate studies, Tyler and his team found that by incorporating exercises designed to eccentrically load forearm tendons — using the TheraBand FlexBar TheraBand FlexBar — they could significantly reduce pain and strengthen the affected arm. The studies showed that performing specific exercises with the FlexBar was significantly more beneficial than treating these conditions with standard physical therapy practices.

For example, in Tyler’s study on tennis elbow in 2010, the difference between using a FlexBar and using only standard physical therapy practices was extreme. The control group of patients saw a pain decrease of 15 percent and a strength increase of 22 percent. That sounds great, but the group who used the FlexBar exercises decreased pain by 81 percent and increased strength by 79 percent.1 Tyler’s study on golfer’s elbow in 2014 had similar results.2

This wasn’t the first time that eccentric loading had been shown to improve tennis elbow, but previous studies involved a large (and expensive) piece of equipment called a dynamometer. Tyler wanted a tool that patients could take home and exercise with as a part of their daily routine. The FlexBar is portable and cheap, making it a perfect solution for any athlete looking to treat their conditions without constantly being tethered to a clinic.

Basically, the eccentric loading — lengthening the muscle while it’s in contraction — stresses the tendon and encourages the affected area to build and strengthen during exercise. Physical therapist Andre Labbe, PT, MOMT, tested forearm muscle activation during the Tyler twist and saw increased activation in the wrist extensors during the exercise.3 “The activation of the wrist extensors is what loads the tendons and promotes strengthening and healing — which tends to be a good thing,” Labbe says.

If your members start complaining of junky tendons and painful elbows, it’s a good idea to get a FlexBar and show them the Tyler twist. Keeping them mobile, pain-free and active means you’ve kept them a loyal member, and still in the right spot on the continuum of fitness.


1 Tyler et al. 2010 J Shoulder Elbow Surg. (1): 917-922

2 Tyler et al. 2014 IJSPT. (9,3): 365-370

3 Labbe et al. 2010 Proceedings of the 12th Annual TheraBand Research Advisory Committee: 8