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Avoid Tennis Elbow

by TN

Since I am off tennis for a while due to tennis elbow (for the first time in my life), I wanted to write a bit about how to avoid tennis elbow.

I have been a week without tennis now and it is painful. Mostly because I can’t practice the sport I love. This is why I have been researching ways to avoid tennis elbow. As always, following a fitness program, is a good way to stay healthy, but when injuries occur you need specific treatment. Although it seems fairly common, stats say that only 5% of people who suffer from tennis elbow (lateral epicondylitis) get it from tennis.

Typical symptoms of tennis elbow are:

  • pain on the outside of your upper forearm, just below your elbow
  • pain when lifting or bending your arm
  • pain when writing or gripping small objects – for example, when holding a pen
  • pain when twisting your forearm – for example, when turning a door handle or opening a jar
  • pain and stiffness when fully extending your arm

Things I have done to battle my tennis elbow:

I use a compression sleeve (link to Amazon) when playing (I also use something called Babolat Strong Wrist as I also have pain in my wrist (I am sure these are related).

I use a cooling/heating cream to soothe the pain and relax the muscles.

I play with arm-friendly strings to reduce shock when I play.

I also play with arm friendly racquets.

I rest a lot more than usual (this is the first week without tennis in a long while).

I am going to my physio to do shock wave therapy etc.

I use a foam roller to relax and massage the muscles.

Today I also bought a hand strengthener training set to avoid tennis elbow in the future.

A lot of people have also recommended the Flexbar, which I will order next.

Can you sense my desperation to get back on the tennis court?

Treatments for Tennis Elbow

I also found a couple of interesting treatments for tennis elbow. My friend and tennis nerd writer, Henrik Wallensten, recommended the Gua-Sha technique, but I have yet to try it. I also found this exercise which made me by the hand strengthener training set. And I will try this tennis elbow trigger point massage as described in this video.

By doing all these things and resting, I hope to be back to hitting balls and testing racquets very soon!

Here is a video of me testing arm friendly strings from my most recent hitting sessions:

Have you been suffering from tennis elbow or other injuries? What have you been doing to combat and prevent them? Please share below.

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20 comments

Laurean October 24, 2019 - 00:08 - 00:08

I”ve also had tennis elbow last year. I use PureAero Tour, and I was stringing it with stiff polys like rpm blast at 54 or 52 lbs. Despite complete rest being recommended, I continued training (1-2 times a week), but I started wearing an elbow sleeve, cooling sessions in the morning, evening, and after training. I was also exercising for elbow every day, and doing a thorough warmup before training. I also changed the strings to Solinco Hyper G, 50/48 lbs. After about one month, it completely healed, and I didn’t have any problems since there, even if this year I play much more tennis, and I don’t wear any sleeve, no cooling, no special exercising for elbow. Just proper warmup, and hyper g at 50/48. Hope this helps, and get well and back on court soon!

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Steve October 24, 2019 - 01:44 - 01:44

I had Golfers elbow, the opposite side from what is called Tennis elbow, from playing tennis. I had it for a year and at its worse it hurt to wash my hands. Obviously tennis was restricted but I continued to play on a restricted basis. If I stopped it got better but came back as soon as I started playing. I did a bunch of reading and study. I iced, took Aleve when needed and did what these guys said. https://youtu.be/xCZoFTVKJQk. One has to be careful with advice you get on the net, etc and take everything with a good dose of skepticism. I am now pain free for the most part and don’t know if what I did helped or things just healed. I am 68 years old, still hit pretty hard and have always played, and still do, with the Babolot Pure Drive strung with RPM Blast at 50#. If the elbow starts hurting, it’s been a year pain free, I will definitely go to a more forgiving racket and string.
Thanks for having such an interesting site and I hope your recovery is complete.
Steve,
Los Alamitos, Ca

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Reval October 24, 2019 - 06:14 - 06:14

I had suffered from tennis elbow for 1,5 years. Have read dozens of articles, saw few specialists, tried several arm friendly racquets. After all that my conclusion: avoid mental stress and most importantly NUTRITION. Please don’t forget that tennis elbow is an inflammation. Sugar, white flour products, alcohol and coffee irritate inflammation. Therefore my recommendation would be a 3-4 months if diet without sweets, pizza, coffee etc. In my case it helped. ;) P.S.: the racquet and the proper techniques are of course still important.

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Christoforos Giatzakis October 24, 2019 - 06:37 - 06:37

I developed tennis elbow by using the wilson ultra tour (…!!!!) with kirschbaum pro line evolution at 22kg.
I got rid of it in two months time by doing 3 things… 1. purchased the diadem elevate and 2. followed the advice and protocol in this link http://drjuliansaunders.com/ask-dr-j-issue-223-dodgy-elbows-revisited/ 3. heat it and massage it. The finger band exersice is good as is the flexbar exersice. Follow the advice and protocol of the guy in the link above you will not regret it.

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Alec Wasa October 24, 2019 - 08:04 - 08:04

Hi,

I had tennis elbow a few years back. basically stayed 4 months away from playing tennis. It always back to haunt me, until I found out through a physiotherapist friend that apparently the single best way to keep it away (and cure it) is to do so called “eccentric exercises” for the forearm.

Check in this video: https://www.youtube.com/watch?v=D4yT2B9Qhfo

It is called the “Therand Flexbar” and it is sold on Amazon etc. It really works. Several of my friends who don’t play tennis but had tennis elbow problems, got better when using this bar. It kind of has to be used quite often, 3 times per week or so and it is possible to keep that tennis elbow from resurfacing again.

Sometimes I get a bit lazy and forget to use it and I then start feeling some discomfort in the elbow/arm but a few days of doing the exercises, my arm feels good again.

Try it out. It is quite cheap, approx 20 Euros or so.

Good luck. Wish there was something for treating knee pain as well as my knees are in bad shape :(

it works for me and I have seen many friends benefit from it.

I am surprised that not more physiotherapists don’t know more about the benefits of eccentric exercises.

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Scriabin October 24, 2019 - 09:10 - 09:10

I developed epicondylitis two times. The first was when switching to the stiff Adrenaline Luxilon string (using a highly flexible Prince exo3 tour 16×18 with 20gr lead tape). After switching back to my usual (and less stiff) Luxilon Big Banger, pain disappeared. The second time was when testing Yonex ezone (too stiff and too light racquet). Now I am using a heavy (330gr) head light and flexible Volkl C10 pro with Luxilon 4G. I can play 8 hours per week without any pain! :)

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CK October 24, 2019 - 10:10 - 10:10

Yes, Alec Wasa. I agree, I think anyone experiencing tennis elbow should try the theraband flexbar. I did it when i felt it was developing and it helped me . On and off I still use it to strengthen the relevant muscles.

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Eduardo Gavira Crespillo October 24, 2019 - 11:02 - 11:02

My advice is that of a person whose only source of income was to teach tennis. And this type of injury led me near depression.
I suffered tennis elbow and had to stop for a year and a half, due to the racket material. I was sponsored by Head, and they constantly changed the racket. The second time, I stood for almost a year. That second was for the grip. On the first occasion, it hurt when I hit and on the second, even without hitting. That second was easier, because it was due to having reduced the size of the grip, from a 3 of a lifetime to a 2.
I was treated with infliltrations, massages, rest, shock waves, Intratisular Percutaneous Electrolysis (EPI®) and finally came to consider operating my elbow.
RESTING DOES NOT SERVE ANYTHING, moreover, it is counterproductive since you lose muscle.
I stopped many times because of the pain, and when the only option they gave me was to go through the operating room, I had to do a Völkl event at my school. It was a racket test for my students. I tried two of them out of curiosity, and it was impossible. By chance, at the end of the session I had to play with a student, who was left alone and taking any racket from the bag, I began to play. Not only did he play normal, but I could also hit with full power. Völkl event manager told me that it was very flexible because it was made of fiberglass (c7 pro).
Conclusions: If one model is going well, do not make changes and if you have to try others (as is your case), try not to hit too hard.
Another factor that damages the elbow is overgrip that slips you, as well as those that are mounted with much supersosition. The overgrip must be placed very tight and overlapping only about 2 millimeters. That will prevent the area from being padded and exerting excessive force with the tendons having to squeeze the hand.
I hope you get well soon, Jonas.

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Jerry October 24, 2019 - 11:48 - 11:48

I used the Theraband Flexbar and still do after recovering. I was advised to sleep with a wrist brace that keeps you from curling your wrist while sleeping. I used ice and heat as well. I then needed some technique work to not aggravate it again. I currently play the Clash. I noticed that head heavy (and stiff) racquets are not an option. Take your time with your rehab and good luck. TE sucks..

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Robin October 25, 2019 - 13:29 - 13:29

Hi Jonas,
Its bad to read that you have a tennis elbow. As you know im a tenniscoach, stringer and customizer, and I play/teach tennis with pain for 19 years now. When I was 18 I torn my bicep, tricep, tendons and my shoulder joint and capsule were torn in half and a tendon next to my shoulder joint was torn off. (yeey tennis is good for you…) It never healed good and still have pain every day when I sleep/play. for me dry needling helps a lot and exercises every day. But first take your time to recover! It is a very nasty injury.
What also helps for me is playing with low kilo’s. My PT57A’s are also helping, but each other racket cause more pain for me. I play with 15 kilo’s and use the Diadem Evolution17 in mains and Diadam Solstice power 18 in the crosses. At the moment im busy with testing the Stringproject strings, also at 15 kilo’s.
Im not a fan of different kilo’s in mains and crosses. And when stringers say that you have to string the mains harder because the extra length , I tell them that’s bullsh*t. When you string mains at 15 kilo and the crosses at 15 kilo, then its 15 kilo. My ert300 confirms that for me. But its easy, when you use a handmachine, you have to do more with the mains before it reaches 15 kilo then when you do the crosses. In the end, both are 15 kilo. Beside that its a personal thing, but mains don’t have to be strung harder then the crosses.

This you won’t like to hear, but all the time different rackets and strings, won’t help your injury.. Constantly different balances, head heavy, head light and so on won’t help your arm. choose your string setup wisely when you start playing again so you can play without pain!
Good luck Jonas!!

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Tennisnerd October 26, 2019 - 06:11 - 06:11

Hi Robin,
I appreciate your comment and advice! I completely agree that constantly testing new setups is not great for your injury, so I need to find a better approach to it in the future.

Regards / Jonas

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Allan October 25, 2019 - 17:06 - 17:06

One more endorsement for the Flexbar! I have both the red and green models. Recommend the red model, as you can always twist more for additional torque. I followed the protocols from the Theraband site, and various Youtube videos. The key is to rest first and allow the inflammation to subside. Then do the exercises with the Flexbar – focusing on the eccentric contraction phase. I had tried other therapies unsuccessfully, but the Flexbar protocol worked well for me, showing massive improvement in a few days. Again, give your elbow a rest first. Once the inflammation has gone down, then start the Flexbar exercises gradually. I am confidently hitting those one handed backhands again.

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Tennisnerd October 26, 2019 - 06:10 - 06:10

Sounds great, thanks for the tip!

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Paul October 26, 2019 - 02:17 - 02:17

Jonas,

I feel for you. I went through this a few years ago. Went to an Orthopedic surgeon who put me in carpel tunnel brace and gave me wrist exercises. No relief and wasn’t getting better. I couldn’t lift my briefcase or shake hands. Eventually one of the pros at my club told me to call this masseuse who works a lot of east coast US tennis tournaments and areas college teams. I made an appointment and found out that the masseuse was Michael Phelps’ personal masseuse for five years when he was swimming competitively. He said a lot of interesting things — swimmers and tennis players deal with similar injuries (repetitive overhead). He said he’s treated many, many cases of tennis elbow and rarely does he see the cause emanating from an injury to the elbow. He had me lie on my stomach and he started to work my upper back. He started on the left (I’m right handed) and said you’re pretty loose. then went to the right side deep in the shoulder and said “ah ha, you’re tight as a drum.” He went on to say that this is what he sees as the cause of most tennis elbow. The repetitive overhead motion causes a muscle deep in the shoulder to tighten and basically pulls on the tendon that runs from the shoulder all the way to the wrist. He said it often manifests in elbow and wrist pain.

It’s a little hard to get at because it’s deep in the shoulder, but he worked me for an hour and literally after about 45/50 minutes my whole arm just relaxed and my elbow felt dramatically better. He said “you’ll feel a bit beat up for a day or two but after a few days you should feel a lot, lot better.” He was right. I did one more half hour session and he said the muscle responded great and loosed right up. Very soon I was back on the courts.

I’m not saying it’s the cure for all, but it worked for me (dramatically) and according to the masseuse, for many other tennis players and swimmers as well. I keep a platform tennis ball in my office and put it behind my chair or roll on it on the wall if my elbow starts to act up. I can find the spot deep in the shoulder and roll it out with the ball so far with no problem.

PS – I have several different flexbands and do those exercises as well and like them. But the real cause of my tennis elbow was the muscle deep in my shoulder. According to the masseuse, it’s the most common cause of tennis elbow he sees.

Let me know if you want more details and thanks for what you do,

Paul

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Tennisnerd October 26, 2019 - 06:08 - 06:08

Hi Paul,
Thanks! Great advice. Will see my massage therapist next week.

Regards / Jonas

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Ed October 27, 2019 - 13:14 - 13:14

HI Jonas
I have had this and not to do with tennis as you have said.
My Physio is getting me from the lying sideways on floor to lift a kettlebell (up in the air -straight up)and then when shoulder on the floor downward twist both ways as far as comfortable and do this 8 times x 3 sets.
I suggest you get your back- shoulder muscles-posture checked out.( posture is 90% of the problem)
So far it doesnt hurt if I accidently bump my elbow area.
This together with my prokennex ionic 10.6 with loose strings works to date – may pay you to get a physio that is switched on to sports like tennis. Many just seem to me average with their advice.

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Boris October 31, 2019 - 08:07 - 08:07

Hi Jonas,
Really sorry to hear about the TE. Seeing how passionate you are about the sport, this must be a real ordeal.
I had one about 3 years ago, that I didn’t even get through playing tennis, but hoovering my flat! Still it was pretty bad, and took the best part of 4 months to resolve.

Here is what I found really help me heal it and avoid causing further injury:
– electroacupuncture worked extremely well for me. After 3 session, I barely had any residual pain, whereas before I could hardly open a door or give a handshake. I highly recommend giving it a try
– once pain has receded, strengthen your forearm. There is a very simple exercise where you extend your arm in front of you, with your hand at the same level of your hand, palm out, as if you were telling someone to stop. From this position, open and close your fingers at a pace of 2 per second for as long as you can. At first, it will be difficult to make it past 50 before it burns too much, but after a few days you should be able to go past 100 reps. Do this 2-3 times a day for a few weeks and your arm strength will improve considerably
– systematically warm up your arm before going on the court. There are a few videos on youtube on this, showing you how to roll your wrist. Just a minute or two is enough

I hope this will help.

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Johnson November 1, 2019 - 17:22 - 17:22

In addition to all of the great comments above I have two suggestions.

One is grips & overgrips – one can get additional dampening and vibration reduction by having more padding here. Also, a tacky overgrip helps you hold the racquet without squeezing. Despite trying many others, my longtime favourite overgrip is the Volkl Super Grip II. It’s a matter of personal taste, some people do not like padded grips nor tacky overgrips but perhaps while one has this condition they are a good idea anyway.

Second, it is useful to know that lateral epicondylitis is a problem of the outside of the elbow/arm and has more to do with the [especially one-handed] backhand than the forehand shot. Hence when you are coming back, [at first] don’t hit any backhands! When playing a match this might not be practical, but when rallying with a friend it is, and of course you can ask your friend not to hit any wide shots to your backhand. You can consider it to be an extended practice of running around your forehand! In the worst case, one can pass the racquet over to the left hand and hit a left-handed forehand. At first it feels weird, but eventually you might be surprised at some of your shots!

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TennisLion January 24, 2020 - 17:56 - 17:56

I noticed that Wilson is expanding it’s range of hybrid string combinations (with Luxilon), and there’s one called Duo Feel that is Luxilon Element and NXT. The former being apparently a relatively soft poly (20% softer than Alu-Power for example). Wilson also states that for all their hybrids the poly should be strung ‘at least 10% lower tension’ than the multi, which means at least a 5lb or 2.5kg difference on average. Given that that guidance is a minimum, it might be interesting to so whether stringing with 7-8lb difference also helps the arm issues.

Polys definitely seem to be bad for your arm, just compare the vibration noises you get when bouncing a ball without an absorber, with the more muted sound with a bed of multi. So it would be quite interesting if you could give a full bed of multi a trial as well, to inform us all.

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Mark August 8, 2021 - 20:43 - 20:43

This mix worked best:
1. rest & time – no way around it, but it works its magic
2. shoulder strengthening – especially one-arm hangs (search: How to Fix Elbow Pain (ONE SIMPLE EXERCISE!)
3. heavier racket & lead in hoop

Avoided/gave up:
1. Flexbar – helped early, but started causing pain in other elbow!
2. Lighter rackets – need the racket to absorb the shock not my elbow
3. Massage – helped early (possibly still could be aiding in long-term healing, dunno)
4. Never used brace – felt like if it hurt that much, shouldn’t be playing but resting

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