Tennis Elbow Guide

[roger is the king]

Tennis Elbow


Tennis elbow is a condition where the outer part of the elbow becomes painful and tender.

The condition is also know as lateral epicondylitis, lateral epicondylosis, or simply lateral elbow pain.

According to the best available scientific evidence, tennis elbow is an idiopathic, self-limiting, enthesopathy of middle age.

Symptoms:

* Pain on the outer part of elbow (lateral epicondyle).
* Point tenderness over the lateral epicondyle--a prominent part of the bone on the outside of the elbow.
* Gripping and movements of the wrist hurt, especially wrist extension and lifting movements.
* Activities that uses the muscles that extend the wrist (e.g. pouring a pitcher or gallon of milk, lifting with the palm down)are characteristically painful.
* Morning stiffness is common.

" Medical Treatment":

Non-specific palliative treatments include:

* Non-steroidal anti-inflammatory drugs (NSAIDs): ibuprofen, naproxen or aspirin
* A counter-force brace or "tennis elbow strap".
* Heat or ice


Specific treatments with limited scientific support include:

* Local injection of cortisone and a numbing medicine
* Using a splint to keep the forearm and elbow still for 2 to 3 weeks
* Heat therapy
* Physical therapy
* Occupational therapy. Primarily for stretching and strengthening of the wrist extensor musculature.
* Pulsed ultrasound to break up scar tissue, promote healing, and increase blood flow in the area
* Extra-corporeal shock wave therapy. (lithotriptor)
* Botulinum Toxin
* Blood injection
* Sclerotherapy
* Acupuncture- very good method...different people have many different opinions on this

The Equipment keep this equipment for now!!)

1. Make sure that your racket for now is a heavy weight one, but not something you cant handle preferably something with less stress to arm (head light rackets)

2. The racket head size would be good 98-whatever.

3. Strings: Go to tennis-warehouse.com..then click String Finder!
Then click the button soft(arm friendly)
Some include: From Expensive to low-
Natural Gut (babolat,Wilson)
Multis-NXT,Babolat xcel
synthetic gut-gosen og micro, gamma
My opinion-Babolat Super Fine Play

There you will find a wide variety of strings that you can choose from
I technically prefer at the middle of the healing process you use babolat super fine play

NEVER USE POLY NEVER USE POLY WITH TENNIS ELBOW make this a promise or your recovery is no more

4. Buy dumbells and use them:

1-5 pounds for 10-14years of age
5-10 for 14-99

Activites that can be done with dumbells:
PHASE 1
Goals: decrease inflammation and pain, promote tissue healing, and retard muscle atrophy. During the acute stage of your injury, whether the medial or lateral elbow is affected, follow the RICE principle:

* Rest - this means avoiding further overuse not absence of activity. You should maintain as high an activity level as possible while avoiding activities that aggravate the injury. Absolute rest should be avoided as it encourages muscle atrophy, deconditions tissue, and decreases blood supply to the area, all of which is detrimental to the healing process. Pain is the best guide to determine the appropriate type and level of activity.
* Ice - is recommended as long as inflammation is present. This may mean throughout the entire rehabilitation process and return to sports. Ice decreases the inflammatory process slows local metabolism and helps relieve pain and muscle spasm.
* Compress and Elevate if appropriate to assist venous return and minimize swelling.

PHASE 2
Goals: Improve flexibility, increase strength and endurance, increase functional activities and return to function.

[Stretch Image] Stretching
Gentle stretching exercises including wrist flexion, extension and rotation. The elbow should be extended and not flexed to increase the amount of stretch as required. These stretches should be held for 20-30 seconds and repeated 5-10 times, at least twice a day. Vigorous stretching should be avoided - do not stretch to the point of pain that reproduces your symptoms.

Strengthening
With the elbow bent and the wrist supported perform the following exercises:

1. Wrist Extension. Place 1 lb. weight in hand with palm facing downward (pronated); support forearm at the edge of a table or on your knee so that only your hand can move. Raise wrist/hand up slowly (concentric contraction), and lower slowly (eccentric contraction).

[Extension Image 1] [Extension Image 2]

2. Wrist Flexion. Place 1 lb. weight in hand with palm facing upward (supinated); support forearm at the edge of a table or on your knee so that only your hand can move. Bend wrist up slowly (concentric), and then lower slowly (eccentric)(similar to exercise above).
3. Combined Flexion/Extension. Attach one end of a string to a cut broom stick or similar device, attach the other end to a weight. In standing, extend your arms and elbows straight out in front of you. Roll the weight up from the ground by turning the wrists. Flexors are worked with the palms facing upward. Extensors are worked with the palms facing downward.
4. Forearm Pronation/Supination. Grasp hammer (wrench, or some similar device) in hand with forearm supported. Rotate hand to palm down position, return to start position (hammer perpendicular to floor), rotate to palm up position, repeat. To increase or decrease resistance, by move hand farther away or closer towards the head of the hammer.

[Pronation Image 1] [Pronation Image 2] [Pronation Image 3] [Finger Ext Image]
5. Finger Extension. Place a rubber band around all five finger tips. Spread fingers 25 times, repeat 3 times. If resistance is not enough, add a second rubber band or use a rubber band of greater thickness which will provide more resistance.
[Ball Squeeze Image]
6. Ball Squeeze. Place rubber ball or tennis ball in palm of hand, squeeze 25 times, repeat 3 times. If pain is reproduced squeeze a folded sponge or piece of foam.

For all of the exercises (except combined flexion\extension) perform 10 repetitions 3-5 times a day. With the combined flexion/extension perform until you feel fatigue. With all exercises use pain as your guide - all exercises should be pain free.

When to progress. Begin with a 1 lb. weight and perform 3 sets of 10 repetitions. When this becomes easy, work up to 15 repetitions. Increase the weight only when you can complete 15 repetitions 3 times without difficulty. The axiom "No Pain No Gain" does NOT apply here.
After exercising, massage across the area of tenderness with an ice cube for about 5 minutes. You might also try filling a paper cup half-full with water and freeze; peel back a portion of the paper cup to expose the ice.

PHASE 3
Goals: Improve muscular strength and endurance, maintain and improve flexibility, and gradually return to prior level of sport or high level activity.

Continue the stretching and strengthening exercises emphasizing the eccentric contractions of wrist flexion and extension. In this regard, since the eccentric contractions are movements with gravity, do not let the weight drop too quickly; lower the weight in a controlled fashion. With the combined wrist flexion/extension exercise, work on increasing speed when rolling up the string with the attached weight as this will improve endurance.

When your symptoms are resolved and have regained full range of motion and strength, you may gradually increase your level of playing activity. An example of one gradual progressive return to tennis is as follows:

Lateral Epicondylitis Medial Epicondylitis
15 minutes forehand only 15 minutes backhand and lobs
30 minutes forehand only 30 minutes backhand and lobs
30 minutes forehand and two handed backhand 30 minutes backhand, lobs, forehand (no top spin)
45 minutes forehand and backhand 45 minutes backhand, lobs, forehand
45 minutes all strokes 45 minutes all stokes
Serve Serve
Full play Full play
Competitive play Competitive play

5. Buy icy hot or theragesic ( note: this will give temporary relief)

6. Arm strap (gelled)

7.ICe pack
Process:

1. Rest 1-3 days

2. Dumbbells 15 minutes 2 times a day 1-2 weeks and until elbow recovers

3. wear arm strap while you can always 1-2 weeks after elbow recovers

4. DO nice soft rally baseline with racket* no serve hard hits..1 week

5. Play and increase power and etc gradually no more play than 1 hour first month and 2 hours 2nd etc etc etc.

6. Please don't push...1% push can lead you back to 100% pain

7.Seek a physician at extremes. ( which shouldn't happen if you follow)

Do all these and you'll be relaxed..but maintaining a good timing and schedule is important after little bit of recovery don't play 6 hours it'll be back!!


Well comments would be nice and more things that I can add.











Chris Thanks to many people and sources

[roger is the king]

completed and will be appreciated if people would give tips that i can add.

MODS PLZ DONT DELETE I WANT TO HELP PPL

[roger is the king]

~~ Reserved For info ~~

[roger is the king]

~~ Reserved ~~ for info and adding to guide

[bronco_mba]

MODS: sticky this one fast!

[roger is the king]

ya mods plz hey bronco im gonna be adding more i thought this would help ppl

[roger is the king]

bronco alpha revo's own

[BORISK]

"1. Make sure that your racket for now is a light weight one preferably Less than 10 oz"
Are you serious ? Less then 10? I would say at least 12 !!!

[Gantz]

you don't specify what to do with the dumbells...

mentioning wrist curls and reverse wrist curls, along with pronation and supination would be good.

[roger is the king]

k gantz will dont like i said adivce..please give and its under construction

[roger is the king]

Originally Posted by BORISK

"1. Make sure that your racket for now is a light weight one preferably Less than 10 oz"
Are you serious ? Less then 10? I would say at least 12 !!!

dude think about the overall conceptual shock that can be transmitted to the arm

[psYcon]

I use Poly on my Prokennex Ki5. namely the Luxilon Big Banger. Are you sure it can contribute to tennis elbow?

[tennisdad65]

Heavier rackets are better for Tennis Elbow.
Less than 10 oz are the worst rackets for Tennis Elbow.
You should use the heaviest racket that you can use effortlessly. If you can handle 11oz - 13 oz easily, then use it. I use 12.4 - 13.4 range.

Flex ratings below 60-62 are recommended.

[Mr. Blond]

As I know it, heavy, but head light racquets are the key to recovery.

Heavy racquets are better for the vibration transmitted to the body and head light to lessen the impact of the heft while swinging. I know head light heavy has made a world of difference in my recovery time.

[IceNineTX]

The best thread I have read is this one regarding tennis elbow:

http://tt.tennis-warehouse.com/showthread.php?t=58089

Light racquets are death on the elbow. I can not stress enough what others have said. Heavy, but head light balance is a huge factor. You can find my reply to in that thread where my wife was suffering very badly. She could not reach into our cupboards to get things without wincing. I took her head heavy Wilson Hammer and sold it on **** and bought a Prince O3 White. Within days, she was better and has been pain free for 18 months or so.

ice

[seb85]

Yes. A 10oz racket is more likely to LEAD TO tennis elbow that cure it.

Racket should be: -

Flexible
Heavy
Head light

and have
soft strings, preferably natural gut.
the right size of grip.

In practice this means NO GRANNY STICKS

The bit about middle age is not true. People can get tennis elbow for all sorts of reasons at any age. Don't lead people down the wrong track by suggesting that only middle age people can get it.

Add "deep tissue massage" to treatments.

Some mention of technique would be helpful. A significant number of TE injuries are due to technique issues esp on the backhand side (but by no means all- it can also be caused by technique issues on the forehand, serve or volleys). TE can also be caused by overuse.

Some mention of RSI might be helpful- too much use of a computer can lead to TE or other pains in the area.

A small section of other possibilities would be good- nerve impingement in the neck/shoulder. Radial tunnel syndrome.

Also, unless you are a qualified doctor or PT, i would suggest a disclaimer in the original post making it absolutely clear that this advice is not given by a doctor or PT.

[roger is the king]

thank you all for all your advice more will be appreciated

[roger is the king]

Originally Posted by psYcon

I use Poly on my Prokennex Ki5. namely the Luxilon Big Banger. Are you sure it can contribute to tennis elbow?

Yes poly is a factor if you have tennis elbow it will kill your arm...but it is very stiff and uncomfortable for players

[roger is the king]

need more advice guys

[waves2ya]

There's a *lot* of elbow tips already in this forum - and a number of good round-ups if you use the 'search' function - so here's a little perhaps contrarians advice.

Besides all the ez stuff like avoiding 'poly' strings and light racquets, technique is a critical part of the problem. Folks spend years hitting the ball a certain way and because they are on one side of the genetic age equation they can get away with it. Until they get on the other side; compensation patterns break down and suddenly the weak link is staring at you in the face... er arm.

You'll find many good lifting tips. And almost all of them can *give* you tennis elbow/golfer's elbow. Lifting like a madman can exacerbate things significantly.

The tincture of time is nature's most powerful weapon (that, and for the tennis player, learning proper technique...!).