Injury Prevention: Stay Ahead of the Pain (of Tennis Elbow)

February 8, 2011 | By Holly Jonas
Tennis_Serve_Credit_Wendy_Hope
Credit:Wendy Hope

Whether you play tennis as a professional, competitive amateur or for occasional recreation, you’ve probably had—or know someone who has had—tennis elbow. The root cause of this syndrome can be as elusive as a correct diagnosis, which can be frustrating when pain is involved.

Tennis elbow is an overuse injury of the forearm’s common extensor tendon. While tennis may be the first activity to be negatively affected, this injury can eventually impact almost every part of your daily life, even becoming so painful that opening a door or lifting a package is extremely difficult.

The best approach to care is being proactive, but doing so is not always easy. Here are some recommendations for players of all levels who want to stay in the game.

Size matters
Every player needs to make sure they are properly fitted for the correct racquet, in the range of 95-110 in. Graphite composite mid-sized racquets (95-110 sq. in.) with synthetic strings and tension set at the lower end of manufacturer recommendations are optimal. Using these specifications will help reduce torque and vibration to one’s forearms. The proper grip size is also paramount and should be selected with the help a knowledgeable tennis specialist, because an over or under-sized racquet can aggravate an injury.

Ask an expert
A few sessions with a good professional tennis instructor can be invaluable. Often, it is a simple thing like a tendency to lead with your elbow on a backhand or over-pronation of the arm that can be the culprit. Video recordings are potent study aids because they can help drive the point home with visual feedback.

Keep your pace steady
If you are in the habit of playing once a week, switching to four or five times a week could be an overload. A proper build up is essential for maximum results. Even a competitive daily player who is getting ready for their season and suddenly increases their play time by a significant amount can experience problems.

Work it out
Proper strength training should be a part of every tennis player’s routine. The forearm muscles, arm muscles and the shoulder complex should be properly addressed. Seek out a certified strength and conditioning specialist to create a safe and specific strength program just for you.

So what should you do if you’re hurt?
The first thing to do is follow the conventional RICE protocol—Rest, Ice, Compression and Elevation. Avoid the use of anti-inflammatory medication in the early stages. Research has shown that anti-inflammatories have an inhibitory effect on the cell circulation in the initial healing process.

Soft tissue techniques, such as Active Release and Graston, are extremely important to ensure that the tendon and muscles heal with the proper elasticity they are meant to have and to reduce fibrotic changes within the muscles. Those techniques are complemented with a progressive series of exercises and stretching based on your tolerance levels. Many of these, especially eccentric exercises with the Theraband Flex Bar, can be done at home. Kinesiotaping, or the use of therapeutic tape around and over muscles, can be used initially to support the muscle and eventually applied in such a way as to facilitate and strengthen the area. Additionally, a counter-force brace with or without the kinesiotape can be an important element in the return to tennis.

Once you have been cleared to return to the court, you can continue to be proactive. Some players use dampers on their racquets to reduce the shock to the arm. You can also see your equipment specialist to have the string tension reduced on your racquet. Doing so can lessen your chances of incurring further injury.


Dr. Holy Jonas

Dr. Holly Jonas, DC, CSCS, CKT is a Phi Beta Kappa graduate of William Smith College and Valedictorian of her class at New York Chiropractic College. She has been listed in Who's Who Among American Colleges and Young Woman of America. For more information, call (516) 921-1295, e-mail dr.holly@jonaschiropractic.com or visit http://jonaschiropractic.com.

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