Tyler twist (flexible bar, for tennis elbow)

How to move

1. Hold the bar upright in front of you in the sore hand, gripping its lower end, with that wrist bent fully back.
2. Take the top end of the bar in the good hand.
3. Twist the bar with the good wrist, bending it forward, while the sore wrist stays bent back.
4. Holding the twist, straighten both arms out in front of you so the bar is level: the good wrist bent forward, the sore wrist bent back.
5. Let the bar untwist slowly, over about 4 seconds, by letting the sore wrist bend forward. The good hand stays still.
6. Bring the bar back upright, reset and repeat.

Form cues

• The good hand twists; the sore hand only lets go, slowly.
• Keep both elbows straight once the arms are out in front.
• Avoid: letting the bar spring back, twisting with the sore hand (that makes it a lifting exercise, not a lowering one), bending the elbows, or starting with a bar that is too stiff.

Practice and cautions

3 sets of 15, about 4 seconds per repetition, with 30 seconds' rest between sets: the dose in the Kazi 2023 trial, which moved people to a stiffer bar after 3 weeks of 3 sets of 15. The JOSPT guideline suggests 3 sets of 15 for 6 to 12 weeks for wrist-extensor exercise. Doing it once a day is an editorial starting point; the Tyler 2010 trial's own dose could not be checked.

Use the most flexible bar first. Elbow specialists suggest working with discomfort of about 3 to 4 out of 10; it should settle by the next morning. Sharp pain, or pain that is worse the next day, means a more flexible bar, a smaller twist or fewer reps. Stop if the hand tingles. After a recent elbow injury or surgery, ask your physiotherapist first. This is movement education, not an assessment or treatment prescription. Stop for sharp or increasing pain, dizziness, numbness or tingling; seek individual guidance for symptoms, injury or restrictions.