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Tennis Elbow Rehabilitation

Many tennis players, recreational as well as professional, will experience pain just below the elbow joint, commonly referred to as “tennis elbow”. Tennis elbow (also referred to as lateral epicondylitis) actually is an inflammation (tendinitis) of the wrist extensor tendon, which is formed by four forearm muscles (extensor carpi radialis longus & brevis, extensor digitorum communis, and extensor carpi ulnaris; see attachment - you must be logged-in to view attachment).

  • How Tennis Elbow Develops

Most scientists believe that tennis elbow starts with a micro tear in the wrist extensor muscles (see Figure 1). This occurs due to improper warm-up and/or overuse. More specifically, tennis elbow mainly is caused by regularly reinforcing poor stroke production technique, in particular during the backhand ground stroke. Slapping or punching the ball instead of swinging fully through the shot increases pressure on the wrist extensor tendon. In other words, hitting a backhand groundstroke (making contact with the ball) while leading with a flexed elbow (elbow is at or near 90˚) instead of the shoulder/body will cause inflammation of the wrist extensor tendon.

Another key factor is poor hand-eye coordination skills, which causes you to hit the ball off center – outside the racquet’s “sweet spot” – causing additional pressure.

  • Treatment Options

If you currently are experiencing pain stop playing tennis and refrain from any activities that cause you to hold something with a firm grip. You can ice the area or use anti-inflammatory drugs or foods (e.g. pineapples). Once the pain has subsided you should start with the following:

Optimizing the Backhand Groundstroke

You should make contact with the ball in front of the body with the wrist and elbow fully extended (straight wrist & elbow). This can be accomplished by making contact with the ball in front of your right foot (right-handed players; LEFT foot for lefties) while you are positioned perpendicular to the net, leading with the shoulder (shoulder points to the net). Take the racquet back so that the racquet head points behind you towards the fence. Now release and swing through the shot without stopping the “follow through” – let the racquet fly! Another option is to switch to a two-handed backhand, thereby decreasing the stress.Now you are hitting the ball with power generated from the trunk and upper arm/shoulder instead of the wrist extensor musculature.

Perform Strengthening & Flexibility Exercises Regularly

Before you walk onto the court and after the match you need to perform the wrist extensor stretch. Make sure that you warm-up the wrist first by moving your hand up and down a few times. Hold the stretch for 40 – 60 seconds for optimal results and repeat 4 – 6 times.

To strengthen the wrist flexors place your lower arm on a flat surface (e.g. table) so that the wrist and hand are hanging in the air and your palm faces towards the ground and the lower arm is supported. Then take a light resistance (e.g. 2lb dumbbell, water bottle) and move the wrist upwards so that your knuckles move towards you. Then release and repeat.

  • Possibly Get Treatments
  1. Ultrasound
  2. Iontophoresis
  3. Galvanic Stimulation
  4. Transverse Friction Massages

Most importantly, regular warm-up, stretching and strengthening will ensure that the pain won’t be recurring and you can enjoy playing tennis again!