A counterforce brace should be worn. Each exercise is gradually progressed at its own rate, as different muscle groups may strengthen quicker than others. Exercises are done once a day; more is not better, and can exacerbate symptoms. Do each exercise properly and slowly. Each exercise is held for 2 seconds. Do not work through pain. Soreness that lasts for 1-2 hours after is OK, but sharp pain, or soreness the day after means that you should lower the weight used, or the number of repetitions performed.
Exercises: 1) Wrist extension, 2) Wrist flexion, 3) Pronation (holding onto the end of a dumbbell, or a theraband), 4) Supination (holding onto the end of a dumbbell, or a theraband), 5) Finger extension (using a rubber band wrapped around all 5 digits), 6) Ball squeeze
Use an isotube or other elastic device for resistance, not weights.
Start with low resistance. Perform10-15 reps/set. Slowly progress the number of repetitions every few days as pain allows until you’re comfortable doing 3 sets of 10 repetitions for 2 consecutive days without increasing your symptoms. Then increase resistance, going back to one set of 10-15 reps. Continue this gradual progression until you are using approximately 3 pounds of resistance for 3 sets of 10 repetitions. Then progress to the next stage, dropping back down to the lowest resistance for 1 set of 10-15 repetitions.
Stage 1: Elbow flexed 90°, forearm supported.
Stage 2: Elbow straight, forearm supported.
Stage 3: Elbow straight, forearm unsupported (held straight out in front of you at shoulder level). Exercises are now performed every other day, to allow the muscles to rest and prevent re-injury.
Perform strengthening exercises 6 days/week. *Once the symptoms resolve you no longer need to progress the weights. Once the symptoms resolve, continue to do the exercises 3 days a week for 3 months to prevent recurrence of symptoms.
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