Tennis elbow painMurray-mania has inspired thousands to take up their dusty rackets and head to the local court. This is a good thing. Tennis is a fantastic, whole-body, highly aerobic workout, and is competitive – so keeping those with gym-fatigue from getting bored.  Many new or returning tennis enthusiasts, however, will find their passion cooled by a bout of “tennis elbow” (or “lateral epicondylitis”, to give it the proper name!).  This painful and lingering condition happens when the stress on the muscles in the forearm – those that work the wrist – causes damage at their most vulnerable point; where their tendons attach to a small area on the outside bony prominence of the elbow.  Commonly associated with tennis (and that’s mostly what I’ll talk about here), it can also be triggered by other repetitive activities involving the wrist – especially if there’s a sudden increase in activity levels.

What can you do about it?  Avoidance is the best tactic:

  1. Get the right racket.  There’s some controversy over whether grip size is a major factor contributing to development of tennis elbow.  Grips that are too small are considered a problem as they make it harder to control twist so your muscles have to work harder; although grips that are too large mean your arm muscles are not so “mechanically efficient” during strokes – more stress!  Make sure your grip size is comfortable for you.  Bear in mind that it’s easier to increase a grip size (using an overgrip or wrap) than to reduce it.  Rackets been developed to be ever lighter and stiffer – this may be great for a seasoned player, but remember that a light, stiff racket will absorb less force, meaning more force is passed into your arm (and your muscles have to be able to cope with it).  If it’s early days in your tennis career, maybe choose a softer-playing racket.  There’s an interesting list of the ways your racket can be customized to reduce stress on your arm here.
  2. Get some advice on your technique.  Tennis elbow commonly occurs as a result of less-than-ideal backhand technique, requiring a lot of the force of the strike to come from the small forearm muscles.  If the backhand shot is played using a reasonably straight, firm elbow, and body weight forward, most of the power will come from body weight shift and the bigger, more capable shoulder muscles.
  3. Strong, healthy muscles will cope with more stress; so do some strengthening workouts if you want to play regularly; and do some warming up before a match so your circulation is working well and your muscles and tendons are ready for action.  Simply stretching out and curling up your fingers will help prepare your forearm muscles.

And if you already have a bout?…

  1. You’re going to need to take a break from the court for a while!  How long depends a lot on the stage of the injury, what else you do, etc.  That doesn’t mean stop moving your arm altogether, though.  Tendons need movement and blood flow to heal and absolute rest will inhibit that.  If you need to continue with an activity that aggravates your elbow, use an elbow splint or brace, designed for tennis elbow, to take the stress off the tendons – but only use it whilst you’re doing that activity – again, total rest for your tendons isn’t good.
  2. Tennis elbow has an inflammatory component, and a measure of inflammation is your body’s natural response to damage, to aid healing, so you don’t want to entirely prevent that happening.  However, ice-packing and an anti-inflammatory won’t do any harm if you’ve just done something that’s flared your elbow up – these steps can help control the pain.  This isn’t going to heal your elbow, though, it’s just pain management, so restrict using these measures to times you’re really in need!
  3. Get some treatment.  Physio, chiropractic, osteopathic, sports therapist – you need someone who can release tension in the muscles and get the joints of your wrist, elbow, shoulder, neck, upper back and even beyond, working at their best.  There’s a whole chain of function here that needs addressing.  Some people also find acupuncture (or “dry-needling”) a very effective treatment for tendon problems.
  4. You’ll need to do some exercises for those arm muscles.  Current research suggests “eccentric” exercise best helps tendons heal.  That doesn’t mean slightly barmy exercise..!  It means loading the muscle whilst it lengthens rather than while it’s shortening (imagine having a heavy book in your hand and lowering to a table – your biceps muscle in the front of your arm is loaded, as it’s controlling the weight of the book in your hand, and lengthening, as it allows your hand to move downward towards the table).  If you’re interested, there’s a link to some research about it here.  Your therapist will be able to advise you how to do these kind of exercises.

So, if you’re an avid tennis-fan, look after your elbows and enjoy years of great sport!

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