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Interventional Pain & Regenerative Medicine

Specializing in minimally invasive interventions for the treatment of spine and musculoskeletal disorders

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Tennis Elbow

In tennis, the impact between ball and racquet produces a significant amount of force, and how much force reaches the tennis player’s arm depends on how hard the player swings, the speed of the incoming ball, where on the racquet face the ball is struck, the qualities of the racquet, the string tension and the stroke mechanics.

The major factor in the etiology of tennis-related elbow pain is incorrect stroking technique, especially the backhand drive. However, the characteristics of the racquet may also contribute. The older style wooden racquet were heavy and flexible, both of which reduced shock on impact. The modern wide-body racquets are lighter and stiffer in order to generate increased power but these racquets do not absorb the shock of impact as well as wooden racquets.

There are a number of ways of altering the tennis racquet to reduce the shock at impact and lessen the force transmitted to the player’s arm:

  • Lower string tension
  • Increase flexibility of the racquet
  • Increase the size of the racquet head
  • Increase the weight (add lead tape to head and handle)
  • Increase grip size. Optimal racquet grip circumference should equal the distance from the proximal palmar crease to the tip of the ring finger.
  • Grip higher on the handle of the racquet

The tennis player should choose the largest comfortable grip size. A larger grip size prevents the player gripping the racquet too tightly (and decreasing chances of developing carpal tunnel). Players should also be encouraged to loosen their grip on the racquet. It is only necessary to squeeze firmly on the grip during the acceleration phase of the stroke.