The Dreaded Tennis Elbow | AskThePro

Recently, I have a reoccurrence of the dreaded tennis elbow. What can I do about it?

Unfortunately, sooner or later, most of us have to suffer through the dreaded tennis elbow.  Between 10 and 50 percent of players suffer from tennis elbow so you’re not alone. And as most of us find out – rest doesn’t help.

Tennis elbow occurs when repetitive forces cause micro-trauma injuries to the tissues around the elbow.  Common initiating factors include: using a new racket, using nylon strings that are too tight, oversized grips, playing in the wind, hitting ‘heavy wet balls’.

In addition, if you suddenly increase your playing intensity and couple this with poor technique, especially the backhand and serve, you reduce your body’s ability to withstand these forces and develop tennis elbow. Striving for that little extra can really hurt you!

In a study by Kelley (1994, “sufferers showed poor body positioning and greater involvement of their forearm extensor muscles. They also showed rapid change from wrist flexion to wrist extension when striking the ball and early in the follow-through. This placed the wrist in an unstable position to withstand repeated forces. Importantly, the backhand stroke heightened these differences.”

If you are suffering from tennis elbow, you will have pain radiating down the lateral side of your elbow or stiffness in this area. Your symptoms may disappear if you stop playing, but this is obviously self-defeating. If you consult a doc, they’ll suggest anti-inflammatory drugs, injections, and RICE (rest, ice, compression and elevation) method. These, however, merely treat the symptoms and don’t address the underlying factors that caused the injury.

Another paper by Noteboom (1994) suggested 5 stages of treatment for tennis elbow: 1. Reduce pain, 2. Reduce inflammation, 3. Induce the healing process, 4. Maintain fitness, and 5. Control force placed on injured tissues.

Part of reducing the pain and inflammation is to get the inflamed tendons and muscles to ‘release’ (this is why some people have success with acupuncture). Typically the muscles and tendons are displaced away from your body causing your arm to be ‘bent’ and exacerbating the stress on the elbow point. You need to find the pressure (i.e pain) point, and gradually increase the pressure there until you feel the muscle release – sometimes takes a couple of minutes depending on how extreme your case!.

Repeat liberally and at the same time, start hot massage beginning at the wrist and gradually work your way up to the elbow to both release and stimulate blood flow to the muscles and tendons. Be patient, since there’s typically little blood flow to tendons which is why it takes time for the inflammation to go down. Gradually you’ll see your arm “unbend” as the muscles and tendons return to proper alignment.

In my own case, it takes about 10 days to get my elbow in reasonable shape if I’m diligent. Thereafter, after I’ve completed stages 1-3, I use a series of stretching exercises coupled with reducing the force in hitting the ball.  Racket stringing technology is developing all the time and I’ve found that one of Gamma’s strings, Live Wire, definitely eases the force on my arm.  While it might costs a few $$ more for a restring, even so, you’ll easily make up for this in frustration and injury reduction.

Candidly, putting the right strings in your racket is worth at least a point-a-game advantage in power, control, and injury prevention! If you can afford the technology, buy it!! Likewise, if you worried about your technique, spend a few $$$ on lessons.

Rob, USPTA Pro

Tennis Whisperer