The Ultimate Tennis Elbow Guide

There are not many tennis holidays that I host without someone complaining of tennis elbow. It’s probably the most common injury I come across and unfortunately, once set in, is so difficult to get rid of.

Nearly every week we run there are always one or more clients that have their arm strapped to help them be able to play.

What Is Tennis Elbow & What Causes It?

Tennis elbow is generally caused by overusing the muscles attached to your elbow that work to straighten your wrist. With overuse the muscles become strained causing tiny tears and inflammation which develops on the outside of your elbow, near the bony lump (the lateral epicondyle).

Please note that: Pain that occurs on the inner side of the elbow is known as golfer’s elbow (even so you can still develop this from playing tennis).

In many cases the cause of tennis elbow is not always from just playing tennis. It can be caused by many repetitive gripping activities that the muscles of the arm are not accustomed to such as:

  1. Painting – Painting walls etc can put a lot of stress on the elbow
  2. Construction -Spending hours hammering, using screwdrivers, saws and a number of other tools can also cause it to flare up.
  3. Sports – Obviously Tennis, but all rackets sports, Volley ball, Cricket. Generally it can happen should your technique be poor. (I will discuss specific reasons for tennis related injuries later).
  4. Hobbies – Any hobbies that involves a lot of wrist action such as Knitting, Sewing, Pottery moulding.

In many cases you normally get tennis elbow from unaccustomed overuse, i.e. if you have just started to play tennis and you play too many hours when your muscles in your arm are not conditioned for it. It might be that you decided to paint your house, something that you don’t normally do and you put enormous amounts of stress on the joint that again it is not unaccustomed to.

Tennis Related Tennis Elbow Causes

Tennis elbow can also be caused via bad technique such as:

  1. Using the incorrect grip on your backhand – This can lead to you gripping your racket too hard to stop the racket from moving in your hand when striking the ball.
  2. Late contact point on your backhand ground shots and backhand volleys – this forces you to use your elbow muscles much more than if you have a good correct contact point. This is probably the number 1 cause of tennis elbow.
  3. Using too extreme a grip on your serve  – Past chopper grip, again this can place unnecessary stress on the elbow.

Other Causes:

  1. Having a racket that is too heavy for you.
  2. Having a grip size that is too small or too big (In both cases this forces you to grip the racket tighter than needed).
  3. Having an old grip (with no tackiness left) This is so common amongst the clients on our tennis holidays on the first day we always do a grip check and almost more than half of them have a grip that I would just not even consider using.
  4. Not warming up – Heading straight to the back of the court and catching a few late backhands can always cause problems. Again another thing we see our clients doing on our holidays and tennis clinics.
  5. Heavy tennis balls (low compression balls) or playing in the rain with wet balls – When the balls become heavy it puts so much more stress on the elbow. Playing on a wet, cold day where the balls are heavy and not bouncing thus causing you to hit late and miss more than normal.
  6. Playing against hard hitters or much higher level players (this can force you into making lots of late contact and miss-hit shots putting the elbow under a lot of pressure.
  7. Simply playing too much – Much more than you are used to – when you start feeling over tired the best thing is to stop.

Top Tips To Prevent Tennis Elbow

  1. Make sure you get some good coaching when you first start playing to hone your technique.
  2. Choose the correct racket for you with the right grip size and weight (see our tennis racket guide for more info).
  3. Always regrip your racket when it starts to lose the grippy feel.
  4. Don’t overplay – If you feel your outside muscles on your forearm are sore take rest before replaying.
  5. Don’t play against hard hitters if you are not ready to.
  6. If you catch a ball late on your backhand and feel pain in your elbow stop immediately – many people carry on and play through the pain – this tends to be fatal leading to tennis elbow for months.
  7. Do not do any form of weightlifting before playing tennis. Make sure you have a good gap to rest your elbow muscles (min 2hrs).
  8. If your hands sweat a lot when playing make sure you towel down regularly.

What Do I Do If I Have Tennis Elbow?

Having had tennis elbow myself on a couple of occasions the latter being for over 6 months I know exactly how frustrating it can be. Not only can it stop you from playing tennis it can also make everyday chores very difficult even just lifting an empty pint glass can be impossible. Obviously, prevention is the most important thing however let’s presume you already have it.

If you have just started to notice your outside forearm muscle feeling sore after playing my advice is not to play again until the soreness has gone (rest it, ice it). If you continue on you will just make the strain worse and the pain will eventually lead to the end of your elbow and then you are stuck with long term tennis elbow. Try and work out the cause – check through the checklists above – if you can identify the cause then it might help you prevent it next time you play.

If your tennis elbow has got to the point where the pain is at the end of the elbow then it will now be a lot more of a challenge to get rid of. Should you go to the doctors they will always advise you to rest – however in most cases I’ve seen once you get to this point rest does not always work. Many of our clients stop and the tennis elbow returns straight away once they start playing again.
Once it gets to the this final stage (pain at the end of the elbow) it is hard to get rid of due to there not being great blood flow around the injured area. You need good blood flow to help with the repairing process.
Once at this final stage you will be at the end of your tether and consider anything to help get it better. Many people opt for cortisone injections – however these generally only mask the problem for a few weeks due to having pain killing properties. I have had a cortisone injection and for 2 weeks had no pain whatsoever – however my tennis elbow slowly came back – this is generally quite common.
The latest research has shown PRPT (platelet-rich plasma therapy) to have better results albeit much more expensive than cortisone injections. The main benefit is that it acts to heal the injury rather than just mask it.
Platelet-rich plasma (PRP) therapy uses injections of a concentration of a your own blood platelets to accelerate the healing of injured tendons, ligaments, muscles and joints
As this area gets very little blood, the injured tendon heals notoriously slowly. Blood platelets attract healing growth factors, so the idea of PRP is to inject a patient’s own platelets at the site of a tendon injury.

I hope you enjoyed reading The Ultimate Tennis Elbow Guide. After suffering with it myself for many years, I wanted to share my experience. Please email me if you have any questions.

See you soon!
Steve & The Team

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The Ultimate Tennis Elbow Guide
Coach
Steve Davies

The Ultimate Tennis Elbow Guide

There are not many tennis holidays that I host without someone complaining of tennis elbow. It’s probably the most common injury I come across and unfortunately, once set in, is so difficult to get rid of.

Read More »