Golfer's elbow from pronation on serves

[DoubleB123]

Has anyone here dealt with golfer's elbow pain from serving? A couple years ago, I tried to rebuild my serve from scratch because I didn't pronate much and had very little power. My serve got a lot better, but I started getting golfers elbow. I then stopped playing regularly for a couple years, but now I'm getting back into it.

A few days ago I went hit a couple baskets of serves and my elbow felt fine but I could feel a bit of a tingle there that something wasn't quite right. I then hit a basket of serves this morning and my elbow now feels noticeably sore on the inside just like it did a few years ago. Because the pain came on so quickly I'm wondering if the issue is less of a chronic issue caused by my racquet and strings and more with my technique. I'm going to take a few weeks off of serving and I also ordered a Theraband flexbar and plan to do some exercises with that so hopefully that will help, but I would rather fix the root of the issue.

Here is a video of me serving

I only notice pain on flat serves when I have to pronate a lot, kick serves feel fine. Also, I noticed more pain when I toss the ball more to the right.

I've read some of the threads on here about pronation and I think I've been approaching it wrong the whole time. I've been thinking of pronating my wrist but it seems like the rotation is actually supposed to come from the shoulder. Is that correct? Anyone have any drills to learn to get internal shoulder rotation?

(Also, if anyone has any tips for my serve that aren't necessarily related to golfer's elbow, I would appreciate some tips!)

 

[Dragy]

Do you feel pain at impact, or shadow swinging as well?

You have internal shoulder rotation coming into contact, but not through, seems like tightening to hit flat and through - don’t try too hard, it’s timing/trajectory rather than straight-through effort. Aim for post-contact extension rather than contact instance:

Tuck your off-arm elbow for more balanced posture.

 

[DoubleB123]

Do you feel pain at impact, or shadow swinging as well?

I feel pain in both right now, but I bet tomorrow after I've had some rest I would only feel it if I were to actually serve.

I think you are right about tightening at the end. My follow through has always felt a bit stiff, sometimes it feels like my elbow is snapping straight and then suddenly stopping which can't be good for my elbow.

 

[vectorthurm]

What I see for what it’s worth is at the point you strike the ball your arm just comes down and your wrist flexes. I share this problem and it’s been a bear for me to fix. It’s all about stopping your elbow from going forward and allowing ISR to happen. This is one thing I tried with an elastic band (for doing shoulder warmup stretching).
It seems like it helps but I’m still working on it.

https://go.coachseye.com/retirement/

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[vectorthurm]

Do you feel pain at impact, or shadow swinging as well?

You have internal shoulder rotation coming into contact, but not through, seems like tightening to hit flat and through - don’t try too hard, it’s timing/trajectory rather than straight-through effort. Aim for post-contact extension rather than contact instance:

Tuck your off-arm elbow for more balanced posture.

Good point Dragy..this can help me as well! Thank you!


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[Dragy]

I feel pain in both right now, but I bet tomorrow after I've had some rest I would only feel it if I were to actually serve.

I think you are right about tightening at the end. My follow through has always felt a bit stiff, sometimes it feels like my elbow is snapping straight and then suddenly stopping which can't be good for my elbow.

Golfer's elbow is primarily associated with gripping and forceful wrist curling overuse (as well as external impact in the opposite direction). I'd look into whether you try to use/force racquet over-the-top pivot to direct the ball into the box. How deep is your toss into the court?
To get rid of such a habit, you should swing onto the ball up and never think of directing it down with any effort. If you start hitting out, toss more in front and swing through more tilted, yet upward swing. Wrist may stay more or less relaxed in such a case and slightly extended by contact, as you reach up and a bit forward with your arm (and whole body actually):

Roger's raqcuet is not actually vertical, but tilted to the left (away from camera). But not tilted forward, not even in line with the arm, just coming out of "lagging".

 

[Chas Tennis]

I gave myself a Golfer's Elbow injury with an experimental volleying technique. I was using internal shoulder rotation (ISR) before I understood what ISR was. I read a book that said a tendon tear could become defectively healed in a very short time, like 2 to 3 weeks. I quit playing. My volley technique had a 90 degree bent elbow and did ISR forcefully. On the first or second hard volley attempt, I got a GE injury. I recovered but since that time I get brief pains when serving or doing a reverse slice serve especially in platform tennis. Later, I got the same injury with sharp pain on my inner left elbow moving heavy logs around the yard.

While I'm 90% sure of my self diagnosis, there is another injury at the location of GE that involves a ligament and pitching. Research that injury at the location of GE.

I have been very interested in how serving aggravates my old injury. I don't understand how the injury occurs. I have read that GE is associated with forehands and serving.

If you might have Golfer's Elbow or Tennis Elbow, stop stressing your arm immediately especially with any tennis and see a well qualified Dr.

For healing a new tendon injury, a few weeks is nothing. Research the healing time for new tendon injuries.

I believe I gave myself GE using the full force of ISR with a bent elbow and extended racket and then the ball impacted the racket head. The bent elbow with racket extended increases the moment of inertia, also know as 'resistance to rotation'. So ISR gets more resistance with the bent elbow.

I played after that and hurt my arm during warm up and played the match. Then the pain made me stop. Fortunately, I stopped about 3 weeks after the initial injury and defective healing to any extent did not occur.

See thread Tendon Injury Nuthouse
Tendinitis (with inflammation) Post #1
Tendinosis (with defective healing) Post #15

Your technique is a likely cause. See videos of your serve. Compare to high level servers and list the differences.

 

[Curious]

Yes, either over use of pronation or a wristy forehand. They are the culprits.
Both the tendons of pronator muscles and the wrist flexors attach almost the same spot on the inner side of elbow. And yes I suffered from it for about 2 years.

 

[Chas Tennis]

To compare serves in this post for Youtube use the period & comma. To select the video use the Alt + Left Mouse Click otherwise the video starts playing. You can go full screen and back down and the frame stays the same. Use similar camera angles for most accurate comparisons. Place your camera on a tripod as no pro Youtubes have the camera.

Looks pretty good.
1) Your arm may be too vertical. ? For the behind camera view usually the arm tilts right and racket tilts left at impact for flat and slice. Your forearm-to-racket angle at impact is 149 d. vs 134 d. for the pro. Change camera angle to more look along the ball's trajectory.
2) Your ISR does not seem to rotate the racket head as much leading to impact. Some pronation?
3) Do you have more of a close up. ? To see ISR by how the elbow shadows rotate. Camera angles make a difference ?
4) Compare your video to the one above it (with "134" degrees). Look at the frames leading back from impact to when the racket handle is about horizontal. It looks as if the pro's racket moves to the side more than yours and the shadows at his elbow rotate more distinctly and quickly. That side movement of the racket indicates ISR especially when the forearm-to-racket-shaft angle is smaller (racket shaft horizontal). This is were a careful comparison is necessary with the same camera angles. Your racket goes up more and to the side less. ? Does that indicate less effective ISR? I am not used to that camera angle with the camera on the ground.

A method to directly observe ISR with video. Camera closer to observe elbow shadows.

How to Directly Video Internal Shoulder Rotation on the Tennis Serve

The shoulder joint with humerus doing internal shoulder rotation (ISR). I don't see any pronation. Slow playback. Go full screen. For single frame on Youtube use the period & comma keys. The humerus is rotated by ISR during the high level serve. ISR is the joint motion that provides the...

tt.tennis-warehouse.com

Don't serve with an injured arm.

 

[DoubleB123]

Golfer's elbow is primarily associated with gripping and forceful wrist curling overuse (as well as external impact in the opposite direction). I'd look into whether you try to use/force racquet over-the-top pivot to direct the ball into the box. How deep is your toss into the court?
To get rid of such a habit, you should swing onto the ball up and never think of directing it down with any effort. If you start hitting out, toss more in front and swing through more tilted, yet upward swing. Wrist may stay more or less relaxed in such a case and slightly extended by contact, as you reach up and a bit forward with your arm (and whole body actually):

Wow I do exactly what you mentioned, I think about directing the ball down into the box and I don't toss it very far into the court right now. I'll try changing that next time I try serving. I really appreciate the advice.

 

[vectorthurm]

I went out tonight and experimenting a bit and I feel no pain when I’m using ISR to smack balls in downward at ground but it starts when I raise the ball up. For me it may be tension related as I brace for contact with ball or get tense at contact. It may be a situation where after you take enough time to rehab the elbow, while you are working on drills to improve ISR through and after contact, that you make sure you slow the motion down going through the motion smoothly and relaxed and gradually ramp it up. This is my challenge though..me impatient [emoji38]


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[golden chicken]

Try this to help with the follow through.

Two other things I noticed, one has been pointed out already:

Your tossing arm sort of goes dead and flies off in space, instead of being pulled down towards your core. If you can be mindful of pulling your arm down and in you can increase your rotation and get a few extra mph.

Also, and this could be an artifact of the slow motion, but it looks to me like your racket arm starts to swing up to the ball slightly ahead of your leg drive. Use your leg drive to get more racket drop and stretch your chest muscles. Then swing up to the ball.

 

[elee3]

I'm still recovering from golfer's elbow and it happened exactly like what Dragy mentioned. I noticed curling of my wrist at the end of my server motion. Been adding extra sauce on my serves for a while and it eventually led to curling of my wrist.

 

[vectorthurm]

Might be a useful tip here...

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[SystemicAnomaly]

Don't know that forearm pronation alone will result in GE. Golfer's elbow is usually / primarily a result of excessive grip force... gripping too tightly, too often. Certain wrist actions can be secondary factors. Perhaps forearm actions can contribute as well but it is doubtful that this is the primary cause of GE.

 

[Chas Tennis]

Old thread with some more recent posts.

https://tt.tennis-warehouse.com/index.php?threads/serve-pronation-golfers-elbow.211256/

The Health and Fitness Forum usually has many posts on injuries.

 

[fuzz nation]

Has anyone here dealt with golfer's elbow pain from serving? A couple years ago, I tried to rebuild my serve from scratch because I didn't pronate much and had very little power. My serve got a lot better, but I started getting golfers elbow. I then stopped playing regularly for a couple years, but now I'm getting back into it.

A few days ago I went hit a couple baskets of serves and my elbow felt fine but I could feel a bit of a tingle there that something wasn't quite right. I then hit a basket of serves this morning and my elbow now feels noticeably sore on the inside just like it did a few years ago. Because the pain came on so quickly I'm wondering if the issue is less of a chronic issue caused by my racquet and strings and more with my technique. I'm going to take a few weeks off of serving and I also ordered a Theraband flexbar and plan to do some exercises with that so hopefully that will help, but I would rather fix the root of the issue.

Here is a video of me serving

I only notice pain on flat serves when I have to pronate a lot, kick serves feel fine. Also, I noticed more pain when I toss the ball more to the right.

I've read some of the threads on here about pronation and I think I've been approaching it wrong the whole time. I've been thinking of pronating my wrist but it seems like the rotation is actually supposed to come from the shoulder. Is that correct? Anyone have any drills to learn to get internal shoulder rotation?

(Also, if anyone has any tips for my serve that aren't necessarily related to golfer's elbow, I would appreciate some tips!)

I can't tell from your video - thanks for posting - but I'm curious what you're using for a racquet and string layout. If that string is a poly, I'd say get away from that for at least a little while and jump over to a substantially softer alternative. I'm not generally too wild about multifibers, but I seem to get really good bang for my buck from Prince Premier Control among the locals who have me stringing their frames.

A couple of locals I've coached or maybe done stringing for through recent years had to deal with pretty significant cases of tennis elbow. Lots of harder serving can often light the fuse on that gremlin. Switching into softer string brought a lot of help to these locals in a pretty big hurry. Even if you have a technique issue to sort out, I'd expect softer string to be able to help you out right now.