Tennis Elbow: Cause/Cure


If you play tennis long enough, you will eventually get a pain on the outside of your elbow.  What causes it and what can you do about it?

The Mayo Clinic says …

“Tennis elbow (lateral epicondylitis) is a painful condition that occurs when tendons in your elbow are overloaded, usually by repetitive motions of the wrist and arm.

“The pain of tennis elbow occurs primarily where the tendons of your forearm muscles attach to a bony bump on the outside of your elbow. Pain can also spread into your forearm and wrist.

“As the name suggests, playing tennis — especially repeated use of the backhand stroke with poor technique — is one possible cause of tennis elbow.

Symptoms

“The pain associated with tennis elbow may radiate from the outside of your elbow into your forearm and wrist. Pain and weakness may make it difficult to:

  • Shake hands or grip an object
  • Turn a doorknob
  • Hold a coffee cup

Cures

“Tennis elbow often gets better on its own. But if over-the-counter pain medications and other self-care measures aren’t helping, your doctor may suggest physical therapy. Severe cases of tennis elbow may require surgery.

“If your symptoms are related to tennis, your doctor may suggest that experts evaluate your tennis technique or the movements involved with your job tasks to determine the best steps to reduce stress on your injured tissue.

“A physical therapist can teach you exercises to gradually stretch and strengthen your muscles, especially the muscles of your forearm. Eccentric exercises, which involve lowering your wrist very slowly after raising it, are particularly helpful. A forearm strap or brace may reduce stress on the injured tissue.

Have you suffered through this common ailment?

And if so, what did you do about it?

How about straps and braces?

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14 thoughts on “Tennis Elbow: Cause/Cure

  1. About 25 years ago I had severe tennis elbow.
    I switched to a two handed backhand and it cleared completely.
    Interestingly, in a match against you, George, my right wrist was injured. I switched to a two handed forehand and that has solved that problem.
    The old adage holds for me “two hands are better than one”.

    Michael, great advice! thanks, george

  2. As a much younger man I had a terrible and painful case of TE, ended up stopping playing for at least 3 months and played RB instead…found the action in the wrist of RB was OK but not all the topspin I was using in Tennis. When I came back to try tennis I used a much more forgiving racket (not as stiff))…think I was playing with an Arthur Ashe Competition (stiff as board)…also put in some gut cross strings and lower string tension…..all helped.

    In later years I have struggled a couple of times with golfers elbow (even though a very infrequent golfer) that is pain in the underside of the elbow. Only way I remedied that was again taking a few weeks off….since then, when playing tennis I ALWAYS wear a forearm strap….and that has kept the boogeyman away.

    Those of us that love to play 3 or 4 times weekly take quick notice and concern at the first symptoms of tennis elbow.

    Healthy tennis New Year to all!

    Dave, yes, i think “early intervention” is critical! thanks, george

  3. I never had TE until this year. Our friend Bill Macom thought it might be due to new use of hybrid strings. I have since switched to synthetic gut at his suggestion and there is noticeably less discomfort. Even before that, on our second day at Newks this year, Byron Miller loaned me a neoprene compression band for the upper forearm and elbow and the results were immediate and quite effective. Not a cure but virtually complete absence of pain.

    Doc, when the Luxilon Big Banger came out and i switched to it, within one month i was in pain. If you use poly strings (as i do now in my mains), the tension should be lowered. thanks, george

  4. George – As you know I’m a big proponent of using equipment that is very forgiving on your elbow; Technifiber NRG2 string and of course a Pro Kennex racket. Technfiber NRG2 string has a multifillament core with a multifillament wrap which plays similar to gut. Inside the throat of the Pro Kennex racket is the following claim, “K. I. Kinetic system has been independently proven to be the most effective shock reduction system in tennis racket technology. The K. I. Kinetic system helps to dramatically reduce risk of Lateral Epicondylitis(tennis elbow) and has been known to CURE tennis elbow. (See MIT Sportslab results on http://www.prokennex.com).
    More times than I can remember I’ve put a Pro Kennex demo in a member’s hands and it’s been largely responsible for their ability to continue enjoying tennis.

    Pam, no question about it … vibration causes the problem; and if you can reduce it, you are better off. thanks for the good info! george

  5. a player can tell the early symptoms of tennis elbow. you find yourself continually stretching that area. that’s the time to use an elbow brace. i have found that the Band-It brace is the best.

    Joe, thanks and see you down here soon! george

  6. About 20 years ago I developed painful tennis elbow. I wore one of those air-cushioned elbow braces which helped a little, but what cured it was learning a new backhand stroke. The pro at the club pointed out that I was twisting my arm (causing the condition), so he showed me how to swing “from thigh to eye” in one, smooth, upward stroke. That totally cured it & I haven’t had it happen again! My wrist has been bothering me lately, though … I think I need lower string tension. I ‘copied’ Pam’s advice & will get my racket restrung. Thanx, Pam! Happy New Year to all!…hope it’ll be better than last year!

    Caroline, changing the stroke is exactly what the Mayo clinic suggested! thanks, george

  7. I suffered from very painful tennis elbow not long after I took up the game in my mid-40s when very stiff light-weight titanium racquets were the rage. The solution (after some physical therapy and a few months off) was to switch to a more flexible head-light racquet with greater overall weight and softer multi-filament strings. I played with ProKennex frames for fifteen years without a recurrence of tennis elbow, then “recently” (five years ago) switched to even more flexible Prince frames (yes, they’re still in business). The Tennis Warehouse website has lots of useful data about racquets (including stiffness, balance, overall weight and swing weight) that can be very helpful in making educated comparisons. Technibre NRG was my favorite multifilament string until they came out with X-One Biphase which seems to have a bit more “feel” and is also very arm-friendly. The strings fray and need to be replaced fairly often, but better the strings than my elbow. A couple of years ago I tried some polyester strings out of curiosity and my elbow immediately said “no”. As for recovery from tennis elbow and preventive maintenance, this might of interest:
    https://well.blogs.nytimes.com/2009/08/25/phys-ed-an-easy-fix-for-tennis-elbow/

    Joe, thanks for the added info! george

  8. Tennis Elbow is no fun and most of us have had it more than once. Here are some tips that I can offer.

    1. Take an old broom handle and cut it about 12” long. Tie a rope to it and add a weight. With your arms straight out in front of you practice rolling the weight up and down.
    2. Place a rubber band, like that wrapped around broccoli at the super market, around the outside of your fingers and then exercise by opening up your hand. It’s important that we exercise both flexor and extensor muscles.
    3. I also put on a body helix elbow support 30 minutes before I get to the court and continue to wear it for 30 minutes after I finish. I wear these throughout the winter “always” and haven’t had elbow issues since.
    4. Lower your string tension during the winter months.

    Here is a Free injury guide for anyone who wants it.

    https://bodyhelix.com/elbow-buyers-guide/

    Coach Fred

    Coach Fred. thanks for the good advice; but after stealing those broccoli bands, Publix will now never let me back in the produce section! 🙂

  9. I had a nasty case of tennis elbow in 2011, caused by playing too much with a new, heavier racquet. The whisper of pain never entirely disappeared and I was apprehensive about it reappearing, so three months ago I started a course of PT in an attempt to clear it completely. In addition to receiving good manual work from my PT, I did daily stretching and strengthening, working with a variety of eccentric exercises. I’ve now graduated from PT, but will continue to do ongoing maintenance exercises 3X per week. I think this is key for me to eliminate the problem permanently.

    Gyata, (thanks for your first comment) i too do the preventative exercises three times a week — and am sure that it helps! george

  10. I had tennis elbow badly several times during my playing career. I haven’t had it return for over 15 years. Here’s what I did to prevent it from coming back:

    1. Played less tennis. Instead of every day, maybe 2-3 days a week in the summer and once a week in the winter.
    2. Switched to a diagonally strung racket which reduces string vibration, plus have several vibration dampeners in that 115 head sized racket strung at no more than 57 lbs.
    3. I ALWAYS wear a strap or band made out of rubber, or wrap athletic tape on my forearm just under my elbow. My arm aches every time I play without this device. It somehow reduces the stress on those tendons that cause tennis elbow.

    Lynn, i can go with two and three; but still like playing a LOT! thanks, george

  11. I have never had actual tennis elbow, and I hope I never do (knock on wood). But at least twice in my playing career, most recently about 7 or 8 years ago, I have been diagnosed with floating bone chips in my elbow cavity. The diagnosis is by x-ray, and I recall actually seeing a small bone chip on the film when the doctor showed it to me the second time. Apparently, in some people, tiny pieces of bone can break away and start floating around in a joint. As long as the bone chips don’t wind up somewhere that affects a nerve, they are only mildly painful and eventually the chips get absorbed by the body and all problems go away. But in my case, twice a bone chip got in the area of the “funny bone” nerve and the pain was extraordinary. However, on each occasion, just as suddenly as the pain came it went away on its own, which I gather was probably because the bone chip moved to another area away from the nerve. The doctors have told me this may or may not come back again, but the treatment seems to be just to wait it out, at least in my case.

    Marty, wow. Sounds like an uncomfortable situation. Hope it goes and stays away for you! george

  12. George: after two rounds of PT for TE I researched and discovered the simple solution: heavy racquet and copoly strings (e.g. rpm blast). Racquet should be below 69 on stiffness index. Stretching arm before and after is also a must. I’ve been free from TE ever since.

    Barry, funny, one other comment was for lighter racquets! I guess it varies by elbow to elbow. thanks, george

  13. Thanks George,
    I enjoy reading your wonderful insights. I note that you did not mention avoiding tennis elbow by “swinging through the ball” instead of choking the shot to gain control. Is this not useful? Thanks, JIm

    Jim, i think you are right because the looser the swing, the more relaxed the muscles will be; and the tighter the swing, the tighter the muscles will be. And in addition to hitting a less effective shot, the tighter arm, IMO, would lead to more elbow problems. thanks, george

  14. George

    Years ago, I had a bad case of tennis elbow (so bad I could not shake hands, brush my teeth, lift a briefcase, etc.). And I had it for months. The solution from my physical therapist was ICE! 6 times a day. you ask, “How can you ice up, 6 times a day?” the answer was one ice cube rubbed on the spot of the tennis elbow until it completely melted. With a towel you can ice while at work, reading, having a beer and you can do it six times a day. For me it was magic.

    Ted, I agree that icing is a very underrated solution to many ailments. Thanks. George

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