Elbow pain while using Prestige S
 

Hello guys. Well I've been playing with the prestige for a couple of months now... The problem is i've been experiencing some pain in the elbow and i've stopped 3 times for 1/2 weeks each time. Right now is the third and I've been resting for 4 weeks. What can it be?

It likely is "tennis elbow" or "golfer's elbow". [Yes, golfer's elbow is quite common in tennis players.]

Which tendon insertions have the small tears determines whether it is tennis or golfer's elbow.

With the palm up, "tennis elbow" occurs from tears in the tendons on the outside (lateral aspect) of the elbow, while golfer's elbow occurs on the inside (medial aspect) of the elbow.






Tendons are the strong fibrous tissue at the ends of muscle that attach a muscle to bone.


Tennis and golfer's elbow are overuse injuries.

Bashing a tennis ball involves extraordinary force being exerted to the tendons inserting to the bones at the elbow.

Tiny tears develop in the tendons.

The body is busy healing these tiny tears by laying down protein fibers to fill in the defects.

But if you play too much, especially if you use a stiff racquet and/or strings, the body can't keep pace with filling in the small tears with new protein strands.

More and more tears occur.

Your tendon looks like this:





Inflammation is the first stage in healing.

Inflammation gets our attention because pain is involved, but pain is just a byproduct of the chemicals (cytokines) being released to stimulate new protein strands to be made.


The main job of inflammation is to stimulate those new protein strands to be made to plug the tears.




Stopping to play for a few days often makes the pain somewhat better.

But a few ways is way to short for any real healing to occur.


The new protein strands being laid down look under the microscope a lot like the strands in spider's web.




It is only after these strands become cross linked and remodeled by the body do they form enough strength to withstand the forces involved in bashing the fuzzy yellow ball.



[Collagen is the name we give to the protein strands when they are organized to look more like rope or cable, and tendons are made up of bands of collagen.]





So do yourself a favor and rest from tennis for a few weeks to let the process become started.

Buy a red Flexbar and do the "Tyler Twist" exercise to slowly start to rehab, and to invoke the very light mechanical load on the tendon that will help to orient the direction the protein strands will become organized into.

Thera-Band FlexBar Video Demonstration http://www.youtube.com/watch?v=zB3TVb8a5mk

If it hurts using the Flexbar, wait longer for more healing to begin before starting the exercises again.


Only after you have been doing the exercises for a few weeks without pain should you consider returning to tennis.

Otherwise you will tear asunder all the healing that has already happened, the tears will reopen, and you will have to go through the whole process all over again.


I hope this helps.

Good luck!


[By the way, what type of strings do you use? Do you do off court conditioning of any kind? The Prestige S has a fairly good flex rating (63), so I doubt this is the main problem. Still, there are even softer frames out there if the problem persists, like the ProKennex Heritage Type C Redondo Mid with a flex rating of 56. And are you sure there are no problems in your technique leading to undo stress at the elbow?]

It could be your form, but nowadays, more and more elbow problems are happening because of the newest equipment. If you're an advanced player, and you haven't had elbow problems in the past, then your form is ok. Your racquet is probably not the problem. If you are using dead poly strings, that's very likely to be the problem.

I doubt that the racquet is a problem too. I did find an interesting list of arm friendly racquets from another tennis blog. I won't link it because it's probably against board rules, but here's the list:

GOLD STANDARD

Head LM Radical OS
Pacific X Feel Tour
Head Microgel Radical OS
Head YOUTEK Radical OS & Pro
Volkl DNX 10 Mid
ProKennex Redondo Mid & MP
Avery A5 OS
ProKennex Black Ace 93 & 98
Donnay X Black 94
Donnay X Blue 99
Donnay XP Dual
ProKennex Ki5
ProKennex Heritage Type R
Pacific X Force
Pacific X Force Pro
ProKennex Heritage Type C
Prince EX03 Tour

SILVER STANDARD

Prince Original Graphite OS
Wilson BLX Blade Team
Head Microgel Radical MP
Head YOUTEK Radical MP
Prince OZone Tour MP
Boris Becker 11
Avery M3 Control
ProKennex Kinetic Pro 5G Classic
Babolat Pure Storm Ltd. GT
Prince EX03 Rebel 95 & Rebel Team
Dunlop Aerogel 4D 200
Yonex RDiS200
Yonex RD Ti80
Donnay Platinum 99
Donnay Silver 99
Donnay Black 99
Donnay XP Dual Lite

BRONZE STANDARD

Wilson nTour Two nCode
ProKennex Ki 10 PSE
Babolat Pure Storm Tour
Babolat Pure Storm & Pure Storm Ltd.
Yonex RQ1s1 Tour
Head Microgel Prestige Mid & Pro
Volkl PB 10 & 10 MP
Prince EX03 Graphite 93 & 100
Yonex RD is 100 MP
Tecnifibre TFlash 315VO2 Max
Volkl Quantum Scorcher
Boris Becker Delta Core Legend
Volkl C10 Pro
Dunlop Aerogel 4D 100
Prince EX03 Hybrid 100 & 104
Wilson BLX Tour & Tour Pro
Wilson BLX six.one Team
Head YOUTEK Mojo
Head YOUTEK Prestige Mid
Donnay X Dual Bronze & Silver Lite
Donnay X Blue & Red 94
Donnay X 99 Black & Yellow
Head YOUTEK IG Speed
Dunlop Aerogel 4D 300 & 200
Pacific X Force Comp

what strings and what tension are you running?

thanks for the answers guys. i have on the website a video of me playing so you can check it out. i'm doing an MRI tomorrow and i'll see exactly what's wrong with me... i haven't played for two and a half months which sucks but i've been working out in the gym 3 times a week. my strings vary from black code 1.24 at 26/25 and sonic pro 1.25 at 26/25. sometimes i reduce to 25/24 and 24/23 (rarely)
btw: I really appreciate all the work you've put in to answer my problem!

if anyone could tell me what could have caused this, i would appreciate...

Dude, after using for so long an arm friendly Prince EXO, I could not switch to using using my Prestige mid Youtek with polyester strings without developing an elbow injury that would nag me for six months. I could not figure out why suddenly my elbow was perpetually sore until I restrung the Prestige finally not with another poly but with a simple tourney nylon. After that, it has played like heaven in my hands--but I swear to you, these newer Prestiges when combined with poly (yes, I used to own a Prestige Pro as well) were very unfriendly to my elbow, which was strange because I could not recall ever before experiencing that type of injury...So, I would recommend strongly that you either listen to what Charliefederer said, or get yourself away from the polys immediately (and after all, polys are such a pain in the arse because they are playable for just a fews hours of hitting, and then they sort of shade--properties wise--into becoming actually dangerous to your health, and so, they are nothing to me anymore but a huge pain in the arse, because nobody who plays only for exercise and fun wants to have to restring so frequently); even if I own a stringer a have half an unused reel of poly I don't want that crap infecting my arm anymore.

Where is the pain?

Does lifting weights aggravate your elbow? I had to stop lifting a few months ago and my tennis elbow is finally gone. Now I just need to shake this latest wrist issue I'm having. Always something...

first of all i am sorry to hear that and hope you recover quickly ;)
i normally lift nowadays but didnt' when i stopped (i haven't been playing since november 1st), so i can't tell you if it aggravates...
BTW, i did the MRI and the doctor says he can't be sure cause he has to wait for the report from the radiologist but he says it might be TE... bumper :(

in my elbow, speciefiecaly i can't tell you exactly cause i haven't been playing for two months

how long do you really need to stop playing tennis normally to heal TE? and if i do what recovery can i do to make sure this doesn't happen again?

You don't know if the pain is on the top (palm downward) or bottom as indicated in reply #2 and many other TW Health & Fitness TE threads?

Research also the difference between tendinitis (with inflammation) and tendinosis (with defective healing). See
http://tt.tennis-warehouse.com/showthread.php?t=442912

You are under the care of a doctor who has examined you, and will soon have the MRI report, so he would be the best person to ask.


But in general, a period of rehab to build up strength (and test out the injury in a less demanding way than tennis) is the way to go.

Many have found using the Theraband Flexbar as suggested in my post above to be very helpful in returning from tennis elbow without an early recurrence. (The radial motion of the Tyler Twist seems to be a particularly helpful exercise.)


Once one is able to exercise without pain a gradual return to tennis is recommended - start with short hitting sessions without serving, and gradually lengthen the sessions.

Returning with a soft (multifilament or gut) in your frame also lessens the chances for an early recovery. Many find they actually like this set up. Others find that they eventually can play with a hybrid. Trying to get back to a full poly set up too soon (if ever) gives the highest chance for an early recurrence.

Two words... "Natural Gut"

I used to hit with a stiff light weight racquet with old nylon and/or poly for 30-45 min at a time and my elbow hurt so bad I could barely put it on the steering wheel to drive home. After giving proper time off to heal and switching to natural gut (even in a Bab PD strung at 62#) plus a vibration dampner I have no issues at all.

A friend who is a PT with a PHd says some cases of TE can take 6 months (of no tennis) to heal.

Hope you feel better soon!

If your doc determines it is TE and you want to speed up the healing process, try ultrasound treatment. It really accelerates the healing process. A former co-worker of mine got TE from repairing his roof after a hurricane. He did no treatment and it took 6 months to go away on its own.

It really depends on how bad the TE or GE is. I knew some guys that could not even turn their car key without pain. The important thing is to do the strengthening and stretching excercises, and be sure to put ice on it for 10 min afterwards, and also after you play, once you start playing again. Also, you should not weight lift if you can feel any pain in your elbow, and avoid doing things that will aggravate it-like trying to open an overly hard jar lid even. When you start to recover you can train again starting with lighter weights until you get better and can progress to heavier ones.
Good luck.

Skimming the last few posts I see other posters' remarks corroborating my own experience with TE--it took me about 6 months of never playing before the symptoms finally went away on their own. That's how long it took my body to heal itself of the TE that I am positively convinced I acquired solely by using polyester strings in my newer Prestige. Same frame a year later only this time it has a full be soft nylon instead of even just half a bed of poly and, voila, I have had no arm issues whatsoever since making the switch.

hey guys. thanks for the answers. i experience no pain and never have unless when i played tennis... since i haven't been playing since 1 november, i haven't had any pain.
my doctor will tell me what i have for sure next week.