Lateral and medial epicondylitis (known on the streets as tennis and golfer’s elbow respectively) plague those who have never even considered picking up a golf club or tennis racket. Overuse of the tendons of the forearm and elbow cause nagging pain and can interrupt daily activity for people of all ages. Dr. Thomas Hyde, DC, DACBSP, CKTP, FRCSS (Hon), FICC has treated plenty of these patients over the years, and has capitalized on the successful combination of eccentric exercise and instrument assisted soft tissue mobilization (IASTM) to heal both of these conditions. Read on to learn his recommendations for exercise, IASTM and additional rehabilitation progressions to take a swing at your patient’s elbow pain and enhance your treatment with inexpensive devices.

Lateral epicondylitis exercise and IASTM protocol

Tennis elbow may produce a daunting amount of pain, but the ease of rehabilitation is anything but. One single exercise known as the “Tyler Twist” lead to an 81% pain decrease and 79% strength increase in patients with lateral epicondylitis (Tyler TF, et al. 2010). Yep… it’s that simple. Have your patients perform this TheraBand FlexBar exercise to eccentrically load the tendon while you simultaneously scrape with an IASTM tool to create an incredibly impactful therapy experience!

How to do the Tyler Twist:

Medial epicondylitis exercise and IASTM protocol

Golfer’s elbow is the reverse of tennis elbow. So, reverse the treatment! Performing the Reverse Tyler Twist targets the medial elbow with the same eccentric fashion the OG Tyler Twist targets the lateral elbow. Again, scraping the tendon while the patient performs this exercise is key for optimal targeting and benefits. Dr. Hyde also recommends scraping while the patient performs FlexBar perturbations as an additional treatment option.

How to do the Reverse Tyler Twist:

Watch Dr. Hyde demonstrate his protocol and learn the details of his full progression in the video below!


Tyler TF, et al. 2010. Addition of isolated wrist extensor eccentric exercise to standard treatment for chronic lateral epicondylosis: A prospective randomized trial. J Shoulder Elbow Surg. 19(6):917-922.

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