Wrist Tendonitis: form, grip, & braces Questions

[jmmhc4]

Hello, I'm pretty sure I have wrist tendonitis. I'm 21 now (ntrp 4.5), but I had the same pain in high school when I was 17, and had it diagnosed by an orthopedic. My pain occurs on the back of the hand on the ulna side. When the hand is straight, in the nuetral, relaxed position, I have pretty much no pain. Daily I have basically no or very little pain. However, when the hand is supinated, I feel the pain. For example, a push up would hurt very much: Supinating my hand back, and then adding my body's weight to my supinated hand is exactly where it hurts... which is similar to the way I think I hit the ball on a forehand. I think the wrist is still supinated when I strike the ball. My wrist does not hurt on backhands at all. Furthermore, my wrist does not hurt much on low ball forehands either. My wrist mainly hurts alot on medium-high forehand balls. It also hurts a bit on serve. I think I use a semi-western grip. I have zero pain in my elbow.

1. Frist off, what is considered your palm? I have been trying to figure out what grip i have. However, I imagine my palm as being the area from my thump to my fingers. However, this is too big of an area to identify my grip. When, identifying your grip, is the palm the area right in the middle of the hand, where the middle crease of the hand is? Or is it the area right under the knuckles?

2. I know this is a very hard question without seeing my form in person or video, but do you think maybe i'm using my wrist too much. I have problems putting power into high balls. Usually I just whip through the ball generating a lot of top spin on high balls. However, I think my wrist is supinated more on high balls.

3. Also, even though I have little or no pain through the day, I have been considering getting a brace, that will pretty much prevent my wrist from moving throughout the day. Would this increase the healing? I have heard that activity that does not hurt the wrist is good. However, it also seems that immobolizing my wrist, would help the tendons heal faster?

4. Also ,I have done wrist stretches before, I have little luck with making my wrist more flexibile. It's frustrating. I rarely do push-ups period, because it pretty much always gives me discomfort in my wrist. Same with wall push-ups. Any ideas?


I've already read through the forums a bit, and they have informed me alot. I have been playing with luxilion Alu Power for about the last 3 months, sometimes as much as 5 times a week, and I think that has helped contribute to my wrist pain. I use the Wilson ncode nsix-one 95. I played in pain for about 3 weeks. I finally wised up and decided to stop until the pain ceases. However, when I can resume playing, I'm going to demo the PK 5G or Ki and perhaps Wilson Sensation strings. (I'm open to recommendations on other racquets as well). I have been doing RICE laterly (rest, ice, compression, elevation).

I would appreciate any help that you could give me. Thanks alot.

[slewisoh]

I've been dealing with wrist pain, and in my opinion you MUST do 3 things:

1) have the wrist evaluated by a sports-oriented orthopedic. Rather than just tendonitis you could have a tear or other injury. Dumb to guess.

2) have a pro evaluate your technique and commit to changing the technique that is contributing to your pain. Again, you are wasting valuable time (and perhaps doing harm to your body) by guessing what the problem is.

3) follow the guidelines Marius and others have laid out and find an arm friendly racquet and use arm friendly strings.

For me, the racquet was the problem but I could not have known if injury and/or technique were the culprits without seeking professional help.

I did these three things over the last month, and I now have no wrist pain. Good luck!

[jmmhc4]

Alright, I will do those things. I have been watching some videos I took previously of my form, and I do need to see a coach. Using my wrist too much, and my wrist is supinated slightly when I strike the ball. I will post a video on here soon. I am going to try to find a sports orthopedic like you say.

[Marius_Hancu]

don't let the racquet drop too much under the ball

play topspin a la Federer, not a la Nadal ...

play flatter trajectories

have a moderate and controlled "educated wrist release"

[Marius_Hancu]

Federer's and Hewitt's FH (high-speed camera clip):
http://www.araf72.dsl.pipex.com/1000FPS.mpg
Federer (warmup)
http://geocities.com/ma12k408/Federer_FH.mov
http://video.google.com/videoplay?docid=1273724609613333533&q=Roger+FEderer

[amcgula]

I had the same problem some years ago, and I'm going to say something that's not on the books, but was part of the solution to that problem.
Nearly allways thouse simptoms begins after some equipment, technique or surface change, so check it, but it's not the main problem (as it's in your history as it was in mine and it's allways).
It's used to accur on players with extrem western grips, who hits with tons of spin, and use the wrist a lot. But there are a lot of exceptions and I think you're one of thouse (as I was).
I'm not sure of which is your forehand grip, but considering your simptoms I think you're probably using an eastern grip (that was my grip) or even a mild eastern or continental. That's a great grip to hit low balls, but if you want to add spin you need to use your wrist a lot (particularly to add spin to a high balls, it's very difficult). And it's also a difficult grip for high balls, you have to flex your wrist a lot to face the ball.
I think you should consider two moments on this. 1) during the tendonitis
and 2) after it.
1) During, you should use a wrist band (tape it, so it will be more stable), and play with soft strings hiting more flat, low and with big relaxed swings. That was part of the treatment for me and it was very helpful. Don't play to much, and also you should use a wrist band when your're sleeping (you don't know what you do with your wrist while sleeping). All of that have really help me to recover, so I recomend you to do that. Don't try to make any technique change during the tendonitis, your ill and you have to get better first.
2) When you're feeling better, you can begin to work on technique and other aspects. About this I'll say something that's not conventional, and many people may disagree, but it was a solution for me. Your forehand grip depends on your playing style. And if you want to hit high balls with spin, a semi-western or even a full western is much more healthy than an eastern or a continental. I've changed my grip to a strong semi-western and since then (4 years ago) I'd never had a wrist problem (that was my karma in all my previous 15 years of tennis). I'm a clay court player, I hit with tons of spin, and I'm used to hit the ball high. I've being doing that for all my life and it's much more easyer with my actual grip than with an eastern. But of course that's my opinion, and I made all the changes after being fully recovered. The grip change was, for me,the natural consecuence of trying to minimize my wrist function (the tape helps to do that). And of course, everything have changed in my game since that moment. After that it's been a time when my forehand (my historic more powerfull weapon) landed allways short (but with more spin)(new better short angle), and i had very big problems to hit low fast slice balls (I need much more leg flexion). I've need some time to adjust, but after that everything finished in a new balance that was prety similar to the previous (in results and playing style) but with almost any wrist pain.
That's my story, think about it.

[SCSI]

Hmm... Mine started with about the time when I switched to longer less powerful racket with smaller grip size. Of course, I play with poly strings too... I am going to switch to see if it helps.

[jmmhc4]

Thanks alot for the advice. I think you may be right about my grip. I used to think I use a semi-western to western grip, but I think I'm actually using somewhere between a eastern to semi-western. I'm not playing at all right now, but it's starting to feel better. May try next week. I won't play in pain though, so no posts need to warn me about that. I will post a picture of my grip, and a video of my hitting soon. Thanks alot though.

[jmmhc4]

FYI, I have been keeping my wrist wrapped day and night, for the last 2 days, and I really think that is speeding up the healing. Although, I need to go buy a brace, as it would be more comfortable and support it better than wrap too.

[Marius_Hancu]

this is a good one:

http://www.tennisserver.com/set/set_04_05.html
Returning To Play After Tennis Elbow

Contributed by Babette Pluim, M.D., President of the Society for Tennis Medicine and Science, Physician for the Royal Netherlands Lawn Tennis Association, Member International Tennis Federation Medical Commission and Wheelchair Tennis Medical Commission

"When hitting backhands, try to hit the ball in front of the body, so it is easier to fully use the shoulder and trunk and to stabilize the wrist. When the ball impacts the racquet, the wrist should be straight. The forearm extensor muscles are better able to handle the shock when the wrist is straight than when it is flexed. Try to use the forearm for control instead of strength. The application of strength should come mainly from the shoulder and trunk muscles, which are much stronger than the forearm muscles."

[misterg]

I had the same problem some years ago, and I'm going to say something that's not on the books, but was part of the solution to that problem.
Nearly allways thouse simptoms begins after some equipment, technique or surface change, so check it, but it's not the main problem (as it's in your history as it was in mine and it's allways).
It's used to accur on players with extrem western grips, who hits with tons of spin, and use the wrist a lot. But there are a lot of exceptions and I think you're one of thouse (as I was).
I'm not sure of which is your forehand grip, but considering your simptoms I think you're probably using an eastern grip (that was my grip) or even a mild eastern or continental. That's a great grip to hit low balls, but if you want to add spin you need to use your wrist a lot (particularly to add spin to a high balls, it's very difficult). And it's also a difficult grip for high balls, you have to flex your wrist a lot to face the ball.
I think you should consider two moments on this. 1) during the tendonitis
and 2) after it.
1) During, you should use a wrist band (tape it, so it will be more stable), and play with soft strings hiting more flat, low and with big relaxed swings. That was part of the treatment for me and it was very helpful. Don't play to much, and also you should use a wrist band when your're sleeping (you don't know what you do with your wrist while sleeping). All of that have really help me to recover, so I recomend you to do that. Don't try to make any technique change during the tendonitis, your ill and you have to get better first.
2) When you're feeling better, you can begin to work on technique and other aspects. About this I'll say something that's not conventional, and many people may disagree, but it was a solution for me. Your forehand grip depends on your playing style. And if you want to hit high balls with spin, a semi-western or even a full western is much more healthy than an eastern or a continental. I've changed my grip to a strong semi-western and since then (4 years ago) I'd never had a wrist problem (that was my karma in all my previous 15 years of tennis). I'm a clay court player, I hit with tons of spin, and I'm used to hit the ball high. I've being doing that for all my life and it's much more easyer with my actual grip than with an eastern. But of course that's my opinion, and I made all the changes after being fully recovered. The grip change was, for me,the natural consecuence of trying to minimize my wrist function (the tape helps to do that). And of course, everything have changed in my game since that moment. After that it's been a time when my forehand (my historic more powerfull weapon) landed allways short (but with more spin)(new better short angle), and i had very big problems to hit low fast slice balls (I need much more leg flexion). I've need some time to adjust, but after that everything finished in a new balance that was prety similar to the previous (in results and playing style) but with almost any wrist pain.
That's my story, think about it.


Amcgula, it make a lot of sense to me! I have wrist problems and I'm totally out of tennis for about 7 months. I feel pain on the ulnar side only on high forehands, and yes, I played on clay with a estern grip.