Tennis/Golfer Elbow and Tennis Rackets/Strings

My 10 year old son had an elbow injury about two years ago which seemed to have been related to a tennis racket-Babolat Drive. When my son switched to Wilson Pro Staff (about the same weight), he was just fine.

Now, my son has been alright for 2 years since the time he was hurt on his elbow, and he has done great given the enormous workload that I have assigned for him this year. However, he began complaining about his elbow last week after 3 days-9 hours' practice with a pro coach (for the first time in about a year and a half or so). Hard to blame the coach whom i personally know well enough so i do not know in which direction to point my fingers in. The boy's been using the same racket and strings. Could it be that the tennis racket is too light (270 grams Wilson Pro Staff) for the balls are coming at him faster/harder than before?

recovering time is as important as training - you need to let him rest too.

Find a flexible racquet and a softer string.

Stop stressing his arm immediately and see a well qualified Dr for a firm diagnosis.

Tendons are a commonly injured tissue. But he is undiagnosed, it may not be a tendon injury. ? There are special adolesent injuries involving growth plates that require a specialist.

Torn tendons heal defectively if stressed while healing. This bad path to healing can cause defective healing in a very short time - the first publications says within 2 to 3 weeks of new tendon injury for animal studies. For defectively healed tendon research tendinosis. The term tendinitis involves inflammation and tendinosis involves defective healing.

There is a very short window when first injured to stop stressing the torn tendon and have have a chance at better healing. You lose that by stressing the elbow, especially with tennis stresses that caused the injury in the first place.

I collected some publications on tendinitis and tendinosis in a thread:

Tendinitis (with inflammation) and tendinosis (with defective healing).
https://tt.tennis-warehouse.com/index.php?threads/tendon-injury-nuthouse.442912/#post-6953489

Tendinosis. Permanent chronic condition?
https://tt.tennis-warehouse.com/index.php?threads/tendon-injury-nuthouse.442912/#post-6956819

charliefedererer comments. He is a Dr.
https://tt.tennis-warehouse.com/index.php?threads/tendon-injury-nuthouse.442912/#post-6956506

Complete healing of tendons takes many months. Stop the stress and see a well qualified Dr.

9 hours seems extreme

Hmgraphite1 said:

9 hours seems extreme

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Yup agree.

dnguyen said:

Find a flexible racquet and a softer string.

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It could also be a matter of technique, e.g. even some advanced players arm the ball and don't prepare early.

Forums are fun and can be helpful places for information, but don't come here for medical advice and especially for a kid. See a doctor.

Fintft said:

It could also be a matter of technique, e.g. even some advanced players arm the ball and don't prepare early.

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I am quite certain that this is the case with my son. His 3-day coach instructed my boy to serve differently than I have taught him for a long time.

Chas Tennis said:

Stop the stress and see a well qualified Dr

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I thank you for the suggestion and links you have offered above. I'll have a look what you're talking about here and I've immediately stopped the stress with adjusted practice on the court. Believe it or not but there are varieties of treatments (unknown to the west) on mainland China and i've got help before that I don't think I would've gotten back home. Now, my boy seems fine, says he's fine; however, volleys and top spin high baseline balls may still hurt on and off a bit. All in all, i'll see which doc could take a look at my kid here.

If Nadal is TE or GE then a larger handle and heavier racquet would be Dustin Brown...

TennisBro said:

My 10 year old son had an elbow injury about two years ago which seemed to have been related to a tennis racket-Babolat Drive. When my son switched to Wilson Pro Staff (about the same weight), he was just fine.

Now, my son has been alright for 2 years since the time he was hurt on his elbow, and he has done great given the enormous workload that I have assigned for him this year. However, he began complaining about his elbow last week after 3 days-9 hours' practice with a pro coach (for the first time in about a year and a half or so). Hard to blame the coach whom i personally know well enough so i do not know in which direction to point my fingers in. The boy's been using the same racket and strings. Could it be that the tennis racket is too light (270 grams Wilson Pro Staff) for the balls are coming at him faster/harder than before?

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I would let him rest for few weeks and try different rackets with softer strings. String tensions also contribute to tennis elbow.

Light of Star said:

I would let him rest for few weeks and try different rackets with softer strings. String tensions also contribute to tennis elbow.

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I think we just had a scare and that's all. He complained right after the first practice with the coach but I was not around (was in Hong Kong). My wife didn't want to listen to my son as she was pushy and wanted him to go on with the pro coach that I paid (that I know well). Three days later and after the three practices that I couldn't be there for, he complained to me. I treated him with a couple of accupuntrure (traditional) sessions after which he well recovered last week.

However, I agree with you that such injuries take time and require full attention. My kid really was hurt two years ago (not now); and, we took a good care of that injury then too. Not a few weeks but two months of agony, I remember, we experienced. We went through a lot of frustration but with a lot of patience everything worked out in the end.

Different rackets are out of question for I am quite sure he's got the right one now. The softer string that you're suggesting though, is something to think about. We've been using a fairly good Yonex string but at wee bit dangerous tension (55 lbs). Whenever the racket is newly strung it may have an affect but afte a few times...ok. This time, this case of my son's little scare, it was a combination of newly strung racket and another (than me) coach who found my son challenging in sense of the service and net work. So, I'll have to address those issues in future should I have someone else take over my position there.

Chas Tennis said:

Stop stressing his arm immediately and see a well qualified Dr for a firm diagnosis.

Tendons are a commonly injured tissue. But he is undiagnosed, it may not be a tendon injury. ? There are special adolesent injuries involving growth plates that require a specialist.

Torn tendons heal defectively if stressed while healing. This bad path to healing can cause defective healing in a very short time - the first publications says within 2 to 3 weeks of new tendon injury for animal studies. For defectively healed tendon research tendinosis. The term tendinitis involves inflammation and tendinosis involves defective healing.

There is a very short window when first injured to stop stressing the torn tendon and have have a chance at better healing. You lose that by stressing the elbow, especially with tennis stresses that caused the injury in the first place.

I collected some publications on tendinitis and tendinosis in a thread:

Tendinitis (with inflammation) and tendinosis (with defective healing).
https://tt.tennis-warehouse.com/index.php?threads/tendon-injury-nuthouse.442912/#post-6953489

Tendinosis. Permanent chronic condition?
https://tt.tennis-warehouse.com/index.php?threads/tendon-injury-nuthouse.442912/#post-6956819

charliefedererer comments. He is a Dr.
https://tt.tennis-warehouse.com/index.php?threads/tendon-injury-nuthouse.442912/#post-6956506

Complete healing of tendons takes many months. Stop the stress and see a well qualified Dr.

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It's sports, injuries happen. I don't think you have to rush to a doctor every time something hurts. And I'm a doctor saying this.

The best advice is rest and ice and gradual return to activity. If the injury doesn't settle within a couple weeks, see a doctor. Most kids tissues are far more resilient than adults so it absolutely doesn't take months to heal a tendon at that age.

Dartagnan64 said:

It's sports, injuries happen. I don't think you have to rush to a doctor every time something hurts. And I'm a doctor saying this.

The best advice is rest and ice and gradual return to activity. If the injury doesn't settle within a couple weeks, see a doctor. Most kids tissues are far more resilient than adults so it absolutely doesn't take months to heal a tendon at that age.

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1122566/

What are your thoughts on this if the tendon actually has some torn tissue?

"Animal studies show that within two to three weeks of tendon insult tendinosis is present and inflammatory cells are absent.7"

What percentage of tennis players rest?

Chas Tennis said:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1122566/

What are your thoughts on this if the tendon actually has some torn tissue?

"Animal studies show that within two to three weeks of tendon insult tendinosis is present and inflammatory cells are absent.7"

What percentage of tennis players rest?

Click to expand...

I believe tendons are as fragile as they are resilient which is why the topic is subjective and so may be the MRI or X-Ray or any trained doc. There's plenty to study about the tissues of the issues. Many pros, wanna be pros or non pros have dealt with the elbow injury in varieties of ways as some have continued through the pain, some took breaks or treatments and some opted for surgeries (after they could not sustain the pain or warnings from their docs).

From my experience, the pain can be excruciating for I have played through tears. My love for the sport overrode the calls of the nature when my elbow pain began 10 years ago. I had kept on going for a couple years, with a month of rest which had made no difference; and, I gradually realized that getting used to the physical suffering I actually recovered with my elbow (two years later). Then, the very same injury can be heart breaking when someone whom you love gets it too. At that point, you have the love for the sport as well as for the person in your life which in my case was/has been my son. About 2 and a half years ago, my little pumpkin went down with the elbow injury and had to rest and be treated for a couple months. With the break, therapies and switching to another tennis racket, he has been able to come out of the trouble very well. The scary tennis elbow days that he has had a few weeks ago, are most definitely not related to any injury worth attending, since my 10 year old little bull is kicking (and hitting). Should there be a doubt back in my mind whether there's any damage in my son's joint (or wherever else there) I would most likely be told and/or let you know here as my boy is no dog from the "animal studies" that we've been fed with.

TennisBro said:

I believe tendons are as fragile as they are resilient which is why the topic is subjective and so may be the MRI or X-Ray or any trained doc. There's plenty to study about the tissues of the issues. Many pros, wanna be pros or non pros have dealt with the elbow injury in varieties of ways as some have continued through the pain, some took breaks or treatments and some opted for surgeries (after they could not sustain the pain or warnings from their docs).

From my experience, the pain can be excruciating for I have played through tears. My love for the sport overrode the calls of the nature when my elbow pain began 10 years ago. I had kept on going for a couple years, with a month of rest which had made no difference; and, I gradually realized that getting used to the physical suffering I actually recovered with my elbow (two years later). Then, the very same injury can be heart breaking when someone whom you love gets it too. At that point, you have the love for the sport as well as for the person in your life which in my case was/has been my son. About 2 and a half years ago, my little pumpkin went down with the elbow injury and had to rest and be treated for a couple months. With the break, therapies and switching to another tennis racket, he has been able to come out of the trouble very well. The scary tennis elbow days that he has had a few weeks ago, are most definitely not related to any injury worth attending, since my 10 year old little bull is kicking (and hitting). Should there be a doubt back in my mind whether there's any damage in my son's joint (or wherever else there) I would most likely be told and/or let you know here as my boy is no dog from the "animal studies" that we've been fed with.

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Confidence and evidence. You are using your medical understandings to make important decisions. Much greater knowledge is available.

The typical argument between two forum posters has opposing points expressed with 100% confidence but little evidence. That is why it is so difficult to determine the credibility of forum and internet information.

For my point of view, I presented several publications in the thread Tendon Injury Nuthouse. And some of the publications do not agree with others. For tendon injuries, I did not originate my view but believe that what I have read is reasonable. The recommendation would be a firm diagnosis by a well qualified Dr, a long healing time and no stress especially from tennis. Additional publications can be searched on the subject. My point of view is never 100% confident and medical issues always have some degree of uncertainty. In your son's case, the injury is undiagnosed.

There are a great number of chronic injuries in tennis. Many of them were made worse by continuing tennis and were preventable.

TennisBro said:

I believe tendons are as fragile as they are resilient which is why the topic is subjective and so may be the MRI or X-Ray or any trained doc. There's plenty to study about the tissues of the issues. Many pros, wanna be pros or non pros have dealt with the elbow injury in varieties of ways as some have continued through the pain, some took breaks or treatments and some opted for surgeries (after they could not sustain the pain or warnings from their docs).

From my experience, the pain can be excruciating for I have played through tears. My love for the sport overrode the calls of the nature when my elbow pain began 10 years ago. I had kept on going for a couple years, with a month of rest which had made no difference; and, I gradually realized that getting used to the physical suffering I actually recovered with my elbow (two years later). Then, the very same injury can be heart breaking when someone whom you love gets it too. At that point, you have the love for the sport as well as for the person in your life which in my case was/has been my son. About 2 and a half years ago, my little pumpkin went down with the elbow injury and had to rest and be treated for a couple months. With the break, therapies and switching to another tennis racket, he has been able to come out of the trouble very well. The scary tennis elbow days that he has had a few weeks ago, are most definitely not related to any injury worth attending, since my 10 year old little bull is kicking (and hitting). Should there be a doubt back in my mind whether there's any damage in my son's joint (or wherever else there) I would most likely be told and/or let you know here as my boy is no dog from the "animal studies" that we've been fed with.

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Impossible for me to accurately know what's going on with your son's arm and I'm not out to make any sort of diagnosis. But my strong encouragement is to scrutinize the string setup that he has in his racquets now. If he's using a poly or a poly hybrid, cut that stuff out immediately and switch to either a synthetic gut or a multifiber.

It sounds to me as though the action is speeding up and he's trying to deal with faster, heavier incoming shots with what I'd consider to be a relative fly swatter of a racquet. A poly string in a frame like that will only rob him of some power and also transmit a little extra impact shock into his arm.

No guarantees that this will work any miracles, but I've been teaching and coaching (and also stringing racquets) for enough years to believe that a string switch can be a simple step to bring substantial relief to an ailing arm or elbow in short order. Even if your son takes a break to cool things down, a softer string will stack the odds for success more in his favor when he gets back to it. Sometimes a string switch is the one difference maker that steers a player back to health... and occasionally it does work a bit of a miracle.

TennisBro said:

My 10 year old son had an elbow injury about two years ago which seemed to have been related to a tennis racket-Babolat Drive. When my son switched to Wilson Pro Staff (about the same weight), he was just fine.

Now, my son has been alright for 2 years since the time he was hurt on his elbow, and he has done great given the enormous workload that I have assigned for him this year. However, he began complaining about his elbow last week after 3 days-9 hours' practice with a pro coach (for the first time in about a year and a half or so). Hard to blame the coach whom i personally know well enough so i do not know in which direction to point my fingers in. The boy's been using the same racket and strings. Could it be that the tennis racket is too light (270 grams Wilson Pro Staff) for the balls are coming at him faster/harder than before?

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Pro Staff 270g? Is it a PS97ULS? I think they were only around for like 1 or 2 years?

In any case, my son used a PS97LS (303g) for about a year as he was transitioning from a "lite" racquet to more of a flagship racquet.
I had him on full poly, then poly/sgut hybrid, then poly/multi hybrid, then back to a thin gauge full poly. The 97LS had an 18x16 string pattern than seemed to eat strings. So it was like a safety fuse so strings wouldn't stay in his racquet too long.

Once we moved to a 16x19 racquet, he experienced poly strings going dead.

How's your son's arm now? What changes, if any, have you made?

Are you nuts? He's 10! Let him grow up healthy! No tennis until he's 13 at least! And then have him use a much heavier racquet with natural gut!

Chas Tennis said:

What are your thoughts on this if the tendon actually has some torn tissue?

"Animal studies show that within two to three weeks of tendon insult tendinosis is present and inflammatory cells are absent.7"

What percentage of tennis players rest?

Click to expand...

Traffic said:

Pro Staff 270g? Is it a PS97ULS? I think they were only around for like 1 or 2 years?

In any case, my son used a PS97LS (303g) for about a year as he was transitioning from a "lite" racquet to more of a flagship racquet.
I had him on full poly, then poly/sgut hybrid, then poly/multi hybrid, then back to a thin gauge full poly. The 97LS had an 18x16 string pattern than seemed to eat strings. So it was like a safety fuse so strings wouldn't stay in his racquet too long.

Once we moved to a 16x19 racquet, he experienced poly strings going dead.

How's your son's arm now? What changes, if any, have you made?

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My son's racket is the 97 ULS which we're really happy with. Poly Yonex (120 and 125 mm) string fits well in and my boy loves it, especially the "fire" (120 mm) one. The string does not give him much of a shock as i've tested it too. This is why we/I suspected the coach's instruction to diverse serving technique which I now really believe has been the issue. My son's arm is more than fine now but we have not been to a doc for DIAGNOSIS that we considered for unnecessary given the little pain he had. Yes, my boy was the judge to tell what to do for he felt his elbow was not threatening his game. After taking a few days off and a few days of traditional therapy, he felt absolutely no pain then. All in all, there'll always be a doubt whether it is in his (or anyone's) elbow or in the eyes of forums users.

fuzz nation said:

Impossible for me to accurately know what's going on with your son's arm and I'm not out to make any sort of diagnosis. But my strong encouragement is to scrutinize the string setup that he has in his racquets now. If he's using a poly or a poly hybrid, cut that stuff out immediately and switch to either a synthetic gut or a multifiber.

It sounds to me as though the action is speeding up and he's trying to deal with faster, heavier incoming shots with what I'd consider to be a relative fly swatter of a racquet. A poly string in a frame like that will only rob him of some power and also transmit a little extra impact shock into his arm.

Click to expand...

Chas Tennis said:

Confidence and evidence. You are using your medical understandings to make important decisions. Much greater knowledge is available.

The typical argument between two forum posters has opposing points expressed with 100% confidence but little evidence. That is why it is so difficult to determine the credibility of forum and internet information.

Click to expand...

Yes, it is IMPOSSIBLE for all of us to precisely say what's up with any injury, especially the one that involves a joint that is crucial for the game. As you say strings truly are to be looked at closely as well as the rackets but that we have well considered. I'd say pay attention to diversity in your training sessions for they more often are the culprits to changes in your life; some of them may be positive and some negative which appears to have been with my son's service practice about a month ago now.

Chas Tennis said:

For my point of view, I presented several publications in the thread Tendon Injury Nuthouse. And some of the publications do not agree with others. For tendon injuries, I did not originate my view but believe that what I have read is reasonable. The recommendation would be a firm diagnosis by a well qualified Dr, a long healing time and no stress especially from tennis. Additional publications can be searched on the subject. My point of view is never 100% confident and medical issues always have some degree of uncertainty. In your son's case, the injury is undiagnosed.

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I am glad to see the knowledge that comes forward on this topic. Professionals really are the people to consider most of all. In the case of elbow injuries, decisions to see docs are most likely the wisest ones. Yes, we could have seen a pro to determine any possible damages in the elbow but we did not. We sometimes make decisions based on varieties of circumstances. Going to see a doc for every pain may be painful too.

Chas Tennis said:

There are a great number of chronic injuries in tennis. Many of them were made worse by continuing tennis and were preventable.

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Oh yes! I am the living example of exactly that. My hips speak volumes (especially when I go to sleep). Many tennis players could get treated by pro docs in varieties of way to avoid such injuries; some of the athletes could make their decisions to just stop playing. Yes! Perhaps, Ivan Lendl wouldn't have to suffer at 50 and see a doc, had he taken care of himself when he was a teenager.

Wise one said:

Are you nuts? He's 10! Let him grow up healthy! No tennis until he's 13 at least! And then have him use a much heavier racquet with natural gut!

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No, I am not and neither is my kid. He's growing well. Imagine all kids started playing at the age you propagate here. The world would be a better place to live in, wouldn't it? Yeah! I'd stick a hammer in his hand, the first thing on the court then. Anyhow, I think that both of us are a bit of nuts here.

@TennisBro , any updates? How's the boy's arm doing? What racquet strings did you guys settle on?

Traffic said:

@TennisBro , any updates? How's the boy's arm doing? What racquet strings did you guys settle on?

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His elbow only hurt a little and for a few days after practicing with the coach then. So, I've arrived to the conclusion that the way the coach instructed my son to serve was the issue. As for the string, we've been using the Yonnex poly for over a year now, and we are very happy with it. There's no problem using it for my boy's elbow is just fine. Anyhow, great racket, string and ways we do it without any interfering instructions that change the way the kid should serve at this point. Sure that when/if I sign my kid into the ITF in a couple years, we'll consider some aspects of the service which seems to be great in my son's game anyway.

Thanks for asking
Bro

TennisBro said:

His elbow only hurt a little and for a few days after practicing with the coach then. So, I've arrived to the conclusion that the way the coach instructed my son to serve was the issue. As for the string, we've been using the Yonnex poly for over a year now, and we are very happy with it. There's no problem using it for my boy's elbow is just fine. Anyhow, great racket, string and ways we do it without any interfering instructions that change the way the kid should serve at this point. Sure that when/if I sign my kid into the ITF in a couple years, we'll consider some aspects of the service which seems to be great in my son's game anyway.

Thanks for asking
Bro

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What part of the serve motion do you think was the issue?

Curious said:

What part of the serve motion do you think was the issue?

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The stance, ball toss and swing. The coach's overemphasis on top spin and slice in my boy's service has most likely been the reason behind the strained elbow. The toss of balls overhead rather than slightly in front must have put a degree of stress on my son's elbow for he's not so used to bend his knees and back backwards enough prior to hitting the ball on his service. What my kid's used to is lightly jumping forward with the ball toss a bit in front of him which doesn't require such a leap back and a bend of knees. I'd say my son's hitting more of a Pete Sampras service

Anyhow, the coach's my friend so no sweat there. He's done a great job on varieties of other issues I have had with my son Jay before. I use him once in a while for a couple hours here and there. What somewhat s*cks is that many coaches in tennis are just so proud and they don't listen when their are told not to do something with the kids. I've warned my friend (the tennis coach) before not to teach Jay how to serve for we've got our standard for the game; however, he's not followed. Stubborn man!

TennisBro said:

The stance, ball toss and swing. The coach's overemphasis on top spin and slice in my boy's service has most likely been the reason behind the strained elbow. The toss of balls overhead rather than slightly in front must have put a degree of stress on my son's elbow for he's not so used to bend his knees and back backwards enough prior to hitting the ball on his service. What my kid's used to is lightly jumping forward with the ball toss a bit in front of him which doesn't require such a leap back and a bend of knees. I'd say my son's hitting more of a Pete Sampras service

Anyhow, the coach's my friend so no sweat there. He's done a great job on varieties of other issues I have had with my son Jay before. I use him once in a while for a couple hours here and there. What somewhat s*cks is that many coaches in tennis are just so proud and they don't listen when their are told not to do something with the kids. I've warned my friend (the tennis coach) before not to teach Jay how to serve for we've got our standard for the game; however, he's not followed. Stubborn man!

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I’m guessing it’s the inner side(closer to torso) of the elbow aka golfers elbow.

Heavy, flexy racquet. If you must use poly string it 50# or lower.
Stay away from Pure Drive...work on timing and hitting out in front.

Curious said:

I’m guessing it’s the inner side(closer to torso) of the elbow aka golfers elbow

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Yap, it was (few days). Good guess!

heninfan99 said:

Heavy, flexy racquet. If you must use poly string it 50# or lower.
Stay away from Pure Drive...work on timing and hitting out in front.

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Racket not heavy at all. If fact, I've been thinking it's too light and it needs to be replaced with a bit heavier one. He's been hitting with 270 grams; he could get one of those 298 g ones. Some strong 10 year olds do that now.

Your "timing and hitting" comment is right on. I've been working on that with my son a lot now. He's somewhat either early or late for that tossed ball in front of him; and, when he's timed well, his toss is off. We've been working on the the toss for that service ball quite a bit. Thanks.

TennisBro said:

My son's racket is the 97 ULS which we're really happy with. Poly Yonex (120 and 125 mm) string fits well in and my boy loves it, especially the "fire" (120 mm) one.

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Oh goodness. I play with poly usually in a frame that is almost 13oz strung and my latest stringing was 45/32. Please don't be stringing poly up at 50lbs + in a super light frame for a 10yr old. Not a good idea at all in my opinion.

Kevo said:

Oh goodness. I play with poly usually in a frame that is almost 13oz strung and my latest stringing was 45/32. Please don't be stringing poly up at 50lbs + in a super light frame for a 10yr old. Not a good idea at all in my opinion.

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Yes, this has been my concern. I am about to go from 270 grams up and get the 298 gram racket (Wilson) that's the same he's having now. I believe, given that he's strong and playing with the high level kids, that my boy will adjust this winter to the high level the top U12 competition. I guess I'll let you all know how that's worked out by the spring time.