How come pros don't get tennis elbow?

Discussion in 'Health & Fitness' started by jack crack, Apr 29, 2012.

  1. jack crack

    jack crack New User

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    The level of play and training pros need to endure is extreme. They endure all sorts of injuries, especially to knees, ankles and shoulders.

    It's strange to me that one of the most common problems for rec players - tennis elbow - seems rare among pros. Anyone know why this is?
     
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  2. fantom

    fantom Hall of Fame

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    If your technique is correct, you typically don't develop tennis elbow.
     
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  3. Itagaki

    Itagaki Semi-Pro

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    They also likely have exercises in their training tailored to preventing it, and I wouldn't be surprised if they had regular massages on their shoulders and arms
     
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  4. Satch

    Satch Hall of Fame

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    also a heavier frame can save you from getting it because of less vibration (if you technique is right in the first place).
     
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  5. Ramon

    Ramon Hall of Fame

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    I have a very simple answer for that. If your body doesn't have the constitution to endure heavy hitting on your arm, the pounding of hard courts, and the constant punishment of sudden starts, stops, and changes in direction, you're not going to be a pro!
     
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  6. npadreman

    npadreman New User

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    BINGO - well said
     
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  7. heartattack

    heartattack Semi-Pro

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    recreational player should do proper warm up and stretching before playing would be one to prevent TE. Use softer string first before going to full poly. my opinion! whats yours?
     
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  8. Avles

    Avles Hall of Fame

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    Pros get injured all the time. Look at Nadal's knees, Sharapova's shoulder, Del Potro's wrist.

    The OP was asking why tennis elbow doesn't figure prominently among pro injuries, as it does among injuries to rec players. Your post doesn't answer that question.
     
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  9. Avles

    Avles Hall of Fame

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    Along with good technique and natural selection, maybe the relative rarity of 1HBH among pros plays a role? I've read that the 1HBH is associated with tennis elbow.
     
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  10. Robbnc

    Robbnc Rookie

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    Pro tennis players DO get tennis elbow. They may be less likely to get it for most of the reasons already mentioned. But just off the top of my head I remember not too long ago Richard Gasquet had it (I'm sure that was bad form on the backhand, funny).

    Pete Sampras had it, again bad form.

    Richard Krajicek pretty much retired because of it.

    Billy Jean King had it.

    Marat Safin had it and cured it with a whole blood injection into the elbow before PRP became well known.

    Oh and don't let me forget Rod Laver, poor guy just never learned to hit a tennis ball right !

    I am being sarcastic because I believe form is the least likely factor in tennis elbow. NONE of the folks listed above had bad form. In Laver's case I recall it was just because of a racquet change. How many club players have you watched play for years with no problem and then suddenly get TE ? I have seen this a hundred times. Do you really think they just forgot how to hit a tennis ball ?
     
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  11. Limpinhitter

    Limpinhitter G.O.A.T.

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    Here's the correct answer: They keep a loose grip throughout the entire swing, including contact. Rec players tend to play with a death grip on the racquet by comparison to the pros. When your grip is loose, the shock of impact ends at your hand and is not transferred to the arm.

    BTW, I learned this the hard way.
     
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  12. ollinger

    ollinger Legend

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    As Robbnc notes, pros do get TE; Tony Roche had a particularly notorious case, leading him as far as a filipino faith healer to try to treat it, and that was using wood racquets and gut. Also, I suspect many players who had hoped to be pros are winnowed out by TE well before they reach the pro level.
     
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  13. Ramon

    Ramon Hall of Fame

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    We all know pros get hurt, but not to the extent that most of us get hurt from playing tennis. If my body had to endure the kind of pounding that the pros go through, I would be finished in a matter of weeks. Therefore, even if I had the hand-eye coordination, speed, strength, endurance, and mental toughness of the pros, I would still not be a pro because my body would give up before I could go very far. The pros are different from a lot of people because they can endure that pounding for an extended period of time.
     
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  14. Say Chi Sin Lo

    Say Chi Sin Lo G.O.A.T.

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    Who plays with a death grip?! :shock:

    I agree with this, you have to play with a loose grip.

    Also, I think a lot of people choke their grips too. As in, their grip is higher on the handle. I think the higher you hold your grip, the more shock gets to your arm. Like Mardy Fish's grip.

    [​IMG]

    I think the proper grip is loose and towards the butt cap of the handle. My pinkie is at the end and part of my palm is not even on the handle.

    Surely, genetics, technique, and fitness factor into tennis elbows too. But I think a choking death grip definitely increases the chances of one getting tennis elbow.
     
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  15. ollinger

    ollinger Legend

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    Let's not forget that pros generally use heavier racquets with higher swingweights. One can hold such a racquet more loosely, and the racquet will still have some plow and directional stability. Try that with your 11 ounce racquet, with its 312 swingweight, and the racquet will be deflected as much as the ball.
     
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  16. Chas Tennis

    Chas Tennis Legend

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    See Biomechanics of Tennis Technique, D. Knudson

    D. Knudson, author of Biomechanics of Tennis Technique, says that pros most often have their wrist extended for the one hand backhand. He claims that wrist position goes a long way toward avoiding TE. I have looked at some pro videos and viewed single frame on my DVR, etc.,(you press the pause button again to advance a single frame) and tend to agree with his observation that most pros use an extended wrist for the 1HBH.

    He claims that many amateurs hold their wrists in flexion and that increases the chance of TE injury.

    I don't know if this is the reason but in extension the muscle that attaches at the elbow is contracted while if the wrists are flexed that muscle may be stretched - near the end of its range of motion. Hitting a ball with the wrist extensor muscles near the end of their range of motion might cause too much stress and tear the attaching tendon at the elbow. Tendons stretched under tension are also discussed in the above book (has anyone read it?). However, just because things seem, at first, to make sense doesn't make them true but...?....

    Search: wrist extension, wrist extensors, wrist flexors, wrist flexion,
     
    Last edited: Apr 29, 2012
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  17. adventure

    adventure Banned

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    I recall falling backwards off a ladder in my early teens. I literally didn't feel a thing. Had zero ill effects and immediately got up and resumed messing around doing whatever it was I was doing. I was body slammed on my torso a few years before that (on grass); again, basically zero pain and no lingering after effects. What was the source of my amazing recuperative powers? YOUTH.

    The top pros are all in their teens and early twenties for the most part, and a majority begin their careers around 15 or 16, or at least used to. Add to that superior physical genetics, top notch on the spot health care, and masseuses.

    Lesson: don't compare your average to below average middle aged body to that of a top flight athlete who is 18 or 20 year old with health care resources you couldn't even dream of.
     
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  18. Bud

    Bud Bionic Poster

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    They do. I've seen numerous pros with TE straps on their arms.
     
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  19. maggmaster

    maggmaster Hall of Fame

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    Didn't Nishikori have surgery for tennis elbow?
     
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  20. Satch

    Satch Hall of Fame

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    imagine returning Karlovic's serve with 11oz racquet, you would feel like you got an electric shock..
     
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  21. jack crack

    jack crack New User

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    Hmmm. OK, first I really appreciate all the input and expertise, all of which is far greater than my own. Still a bit stuck though. This is what I gather so far:

    -Technique is part of it, but pros techniques varies quite a bit. So maybe it's not that simple.
    -Gear, especially heavy rackets is part of it, but some pros use lighter rackets. Including some hard hitters. Especially WTA players.
    -DNA is part of it, pros are just more durable than the rest of us. But many pros get lots of other injuries.
    -OHBH is part of it, but Roger is a very durable player with a OHBH. Also many rec players with THBH get tennis elbow.
    -Training, massage and other therapies might be part of it, but again, pros get lots of other injuries.
    -Soft strings help, but many pros use full poly.
    -Low tension helps, but pros use a wide variety of tension, including quite high.
    -Flexible rackets help, but lots of pros play with stiff rackets.
    -Some pros do get TE, but it just doesn't seem frequent, especially relative to the time they train and play.

    Maybe it is some combination of all of the above, and I certainly appreciate all the input, but it is still a bit mysterious. Maybe the players using lighter frames lead them up more than public knows.

    One thing is for sure. If we could really nail it down it would be a fantastic for our sport. To many developing players of all ages get sidelined by TE. Equipment manufacturers should really try and make sure what they market will at least not create or worsen TE.

    Again, I appreciate all the input.
     
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  22. r2473

    r2473 Legend

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    Top pros can get pretty much anything they want. I'm sure if they wanted tennis elbow they could get it.

    Maybe it has something to do with the shipping costs? I don't know, I'm just spitting here.
     
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  23. 86golf

    86golf Semi-Pro

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    Finally a correct response. Murray had two cortisone injections last year. They get tendinitis, but your likelihood of developing it goes up with age. How many junior players have tendinitis? Many of which are 3.5 level to 4.0 level, your typical club player. They have swing flaws just like adults.
     
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  24. vegasgt3

    vegasgt3 Rookie

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    Stan Smith had it and famously switched to Fischer racquets
     
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  25. Limpinhitter

    Limpinhitter G.O.A.T.

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    I'M TELLING YOU - Keep your grip loose and relaxed throughout your entire swing, including contact.
     
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  26. OTMPut

    OTMPut Hall of Fame

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    Interesting. Take a look at the fore-arm muscles in these photos. They look pretty flexed to me (can compare them holding a trophy to see the resting state and they don't look this flexed).

    Can you flex your fore-arm as much as this and keep your grip loose?

    [​IMG]

    [​IMG]

    [​IMG]

    [​IMG]
     
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  27. jaybear1909

    jaybear1909 Rookie

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    Roger's actually does look loose :p
     
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  28. Cindysphinx

    Cindysphinx G.O.A.T.

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    No, it seems every pro in every photo has a death grip at contact. I would like to see photos of how they look on takeback. I bet you will still see a death grip.

    I think it is youth + natural selection + correct form.

    Still, it is amazing to me that anyone can play tennis pretty much daily with poly strings and the ball coming as hard as it does and hitting as hard as they do and not have a noodle for an arm.
     
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  29. OTMPut

    OTMPut Hall of Fame

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    Don't think so. Fore-arm muscles are certainly strained and you can see the strain on his thumb as well.
     
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  30. OTMPut

    OTMPut Hall of Fame

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    There is also a bit of survivorship bias. The ones with persistent TE probably have quite playing already. So there is actually a much bigger sample that we do not observe and therefore apparent absence of TE incidence could understate the odds.
     
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  31. r2473

    r2473 Legend

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    Enjoy your "death grip" folks.

    I'll stick with with Limpinhitter.
     
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  32. lvuong

    lvuong Rookie

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    This could be an illusion you have. You can swing with loose grip which in fact recommendable but the grip and wrist at contact has to be firm otherwise your hand will be twisted and wrist problem will be a result.

    Look at the pro pictures. It doesn't look like the grip and hand are loose at contact.
     
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  33. lvuong

    lvuong Rookie

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    The grip shouldn't be tight but certainly need to be firm (at contact). Otherwise, enjoying twisting.
     
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  34. r2473

    r2473 Legend

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    It would be pretty strange for a person to hold the grip so loose that it actually twists at contact. Can you imagine anyone doing that?

    Bollettieri goes over how tight you should hold the racquet in his video. He talks about the "death grip" mistake and then talks about holding it loose. X-Man is in this video and says he holds it just tight enough so it doesn't fall out of his hand (or move, twist undesirably I presume), but no tighter. I think they demonstrate that someone can easily pull the racquet out of your hand when you are holding the "proper" loose grip.

    http://www.amazon.com/Nick-Bolletti...1_1?s=movies-tv&ie=UTF8&qid=1336151039&sr=1-1

    Perhaps you naturally grip it a bit tighter at contact, but it is all just by feel.

    If you grip it too tight, there is no way you can get good spin on the ball. The loose grip facilitates the kinetic chain. And this is the real reason why the loose grip is important for not getting tennis elbow IMO.
     
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  35. adventure

    adventure Banned

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    When we think of 'pros,' we often only think of the top 10-12 players on the men's and women's sides. But, as someone just pointed out, there are hundreds of players on each tour, and the media only discusses maybe 3% of these players' health status (none of the other players are 'newsworthy').

    These top players also have the best resources, meaning they have the best health care and they can also be selective about the events they play at. They can afford to sit out a tournament or two as well as take extended vacations, whereas most players cannot.

    Again, there is little to be learned about how to play tennis or about how to maintain your health from a couple of dozen elite pros.
     
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  36. LeeD

    LeeD Bionic Poster

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    Most tennis players get tennis elbow before they ever turn pro, so they never make the last step. You never hear of them, but if talk to ex college Div1 players, most will own up to at least some sort of physical ailment which stopped their pursuit of tennis exellence.
    Injury is what stops us from being the best.
    The best just didn't get injured early in their careers.
     
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  37. OTMPut

    OTMPut Hall of Fame

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    Check everyone of Nadal's pictures. His fore-arm is pretty flexed and his grip seems pretty firm. Good spin on the ball?

    I think it may not be a firm hold all the way and you need to squeeze the racquet right before the contact to prevent twisting.

    Loose all the way can possibly work at rec level balls.
     
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  38. r2473

    r2473 Legend

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    ^Use a death grip if it works for you. I'm certainly not going to stop you.
     
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  39. kimbahpnam

    kimbahpnam Hall of Fame

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    pros have built up quite an immunity towards TE with the amount of balls they have hit throughout their career.
     
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  40. user92626

    user92626 Legend

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    Well, you don't know if the rec player's TE percentage is higher than Pro's.

    You have that impression because ...well only those with TE speak up and this is the place for it. I play at city courts and I don't see anyone having this issue. Same many people coming and going for years.
     
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  41. jwbarrientos

    jwbarrientos Hall of Fame

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    I do agree,
    I would add that pros are a very few number of human beings ... they are the elite, don't have to wait till doctors give an appointment and so on.
     
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  42. usta2050

    usta2050 Rookie

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    if u have 10nis elbow issues, chances are u can't last as a pro.
     
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  43. Chas Tennis

    Chas Tennis Legend

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    Some data on the incidence of TE

    This discussion involves the incidence of TE among pros and rec players.

    I came across this information in the book Effective Functional Progressions in Sports Rehabilitations, by T. Ellenbecker, M. De Carlo, C. DeRosa. Page 18.

    1) A study of 84 world class men and women (1976) reported 84% of the men and 60% of the women had a history of shoulder or elbow injuries that affected tennis play. Injuries to both elbow & shoulder were reported in 21% of the men & 23% of the women.

    2)A 1980 study of 2,633 recreational tennis players indicated 31% incidence of tennis elbow. There was a 63% greater incidence of shoulder injuries in this 31% with TE compared to those who did not have TE.

    Maybe a search of the incidence of TE would find some more data.
     
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  44. jimanuel12

    jimanuel12 Semi-Pro

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    i have played tennis my entire adult life - only got TE one time when i was young.
    have had it twice in the last 3 years.
    mine was due to the following factors:

    switched from a heavy racquet to a "modern" light weight heavy head stiff racquet
    continued to play even after i hurt the arm
    took me a year to recover
    never really did fully recover
    tried everything - laser treatments, cor-ozone shots - nothing worked - finally just quit and it got better on it's own
    hurt it again this year - but due to not warming up property
    now - i am seeing a physical therapist - took my first treatment yesterday - it is better already.
    will hope for the best.

    word to the wise: stay away from the heavy head, light weight stiff racquets
    use a softer string and make sure you warm up before playing.
    use a heavy light head racquet - stiffness somewhere in the low 60's or even the 50's.

    i would not wish TE on my worst enemy.

    will hope i can play again in a few weeks.
     
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  45. mikeler

    mikeler Moderator

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    Order The Trigger Point Therapy Workbook. I'm currently self treating with massage in the back of my shoulder and it has really helped my TE the last few days.
     
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  46. jimanuel12

    jimanuel12 Semi-Pro

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    thanks for the information, will give it a look see
     
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