Exercise considerations for medial epicondylopathy?

• A. Focus only on elbow flexion strengthening.
• B. Include AROM/PROM of elbow, wrist, forearm, hand; shoulder/scapular strengthening; and functional exercises.
• C. Avoid any shoulder strengthening in early rehab.
• D. Use high-load, high-intensity training from the start.

Answer: (B)

Rehabilitation for medial epicondylopathy should address the whole upper limb and progress loading in a controlled, functional way. The best approach includes active and passive range of motion for the elbow, wrist, forearm, and hand to maintain mobility and begin tendon loading without overloading the tissue. It also incorporates strengthening of the shoulder and scapular stabilizers to improve alignment and reduce undue stress on the medial elbow during movement. Pairing this with functional exercises helps the tendon adapt to real tasks you’ll perform in daily life or sport, ensuring the rehab translates to better performance and less pain.

Why this fits: medial epicondylopathy is a tendinopathy of the common flexor origin, and the mechanics of the forearm, wrist, and shoulder all influence how the elbow bears load. Ignoring any part of the kinetic chain—such as only doing elbow flexion strengthening—can leave faulty mechanics unresolved. Early shoulder strengthening supports better control and lowers strain on the elbow. High-load, high-intensity work from the start can inflame the tendon and hinder recovery, so a graded, moderate-load progression is favored.