Tennis elbow — causes and solutions — a personal story

I don’t claim for this to be a definitive guide on the tennis elbow problems and solutions. Contrary, it is a personal testament, based on my (pretty methodical) self-observation, data collection and isolated cause-effect analysis.

For impatient (tl;dr; ) — the main culprits were a) pressurless tennis balls in a tennis ball machine, fired as “heavy balls”, b) poor contact point, too close to the body, c) too much repetition of the same stroke, and d) once elbow was hurt, any stiff frame (65+).

Now, a bit more details, presented as itemized lessons learned, and in an order of criticality:

1) Pressure-less tennis balls in a ball machine - they are elbow killers. Walls are made of thicker rubber. Balls are heavier. Trying to hit them, especially if fired at the higher speed, requires more effort, and they shock the arm. Pressureless tennis balls in a ball machine, for a significantly repetitive practice, are a killer. My tennis elbow fix: don’t use pressure-less tennis balls in a ball machine, for repetitive and frequent practice.

2) “Heavy balls” fired repetitively from a ball machine - this is obvious. Most players don’t hit such hard balls, at such rate consistently at you. Ball machine does. This is especially severe if you combine with (1). My tennis elbow fix: mix and match. Space out shot types. Don’t use pressureless tennis balls for “heavy balls”.

3) “Jammed” shots / a close contact point - this one is a real killer, with or without tennis ball machine. Hitting forehands (and especially backhands), where the ball is hit closer to the hip or chest is BAD. It aggravates lateral epicondyle QUICKLY. My tennis elbow fix: ALWAYS hit the ball somewhat diagonally away from the hip/chest and at a comfortable contact point. I simply let the ball go if I cannot hit it at the right contact point. This applies to any shots (slow, warmup, points, etc.).

4) Using wrist to generate spin - hitting serve and trying to slice it by a scooping wrist motion. Hitting backhand or even forehand with a continental grip and using wrist to create a top spin “angle”. Doing this repetitively (50-100+ shots in a practice) is a quick way to inflame lateral epicondyle. My tennis elbow fix: Use racket path to generate spin. Use appropriate grips. Don’t use wrist to create a racquet face angle or a scoping effect.

5) Over-hitting one handed backhand - even with a good one handed backhanded technique, as you get tired, and have to hit a variety of shot types to return on a backhand, in lots of repetitions (50-100+), the lateral epicondyle can get aggravated. Sometimes badly. My tennis elbow fix: I switched to two handed backhand and that made me and my elbow very happy. Powerful and controlled shots. I can hit a lot.

6) “Arming” the ball - i.e. hitting forehand or backhand without proper body rotation, using only arm and especially swinging from the elbow. Add tight grip hold and you are toast. My tennis elbow fix: Work on a proper full body, or at least, an upper body swing — kinetic chain (I.e. putting full body into a shot - from the legs, to hip and shoulder rotation, or at least coiling and using hips and shoulders on lighter shots).

7) Stiff, tightly strung polyester strings - my pro strung my Blade, mistakenly, with Solinco Hyper G at somewhere around 56 or 58 lbs. It was like hitting with a metal surface instead of string bed. Aggravated my elbow and shoulder after one heavy hitting session. My tennis elbow fix: NEVER again stringing poly that tight. Happily switched to Triax and Velocity MLT. Played with Luxilon Smart in the 40s and was OK.

8) Equipment - this is tied to all previous points. Using stiff racquet hurts already aggravated elbow (or shoulder). Using stiff racquet with stiff poly can also be aggravating on its own, but I did not find this to be as critical to getting tennis elbow as some earlier points. With a good technique and a consistent sweet spot hits, it can be fine. My tennis elbow fix: Clash Tour and then switch to Clash 98 with Triax, Wilson Natural Gut and Velocity MLT.
Clash 98 is a fantastic, easy to play, reasonably advanced frame with orthopedic / therapeutic properties.

9) Right vs. wrong treatment - this is tricky. You first need to understand if you have a tendinitis vs. tendinosis (see this). Then, you need to possibly follow a very different regimen. My tennis elbow fix: 4-6 weeks rest over the winter first. Then gentle massage of the tendon. Hot and cold therapy. Now after play, I do cold and hot therapy and try to move the arm until the soreness goes away. It is still tender and can get aggravated but with fixing 1-9 and the proper therapy that works for me, it is the night and day than what it was in 2020. I still play daily - hitting, points, practice or a machine with normal balls.

So, that is my story and a summary.

Feel free to contribute your points, using similar format, so that others can use this thread to get players’ testimonies.
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Deleted member 776614

I feel like grip/squeeze could be It’s own topic. Tennis elbow is strain or tear of the tendon that holds your forearm muscle to your bone. When you grip the handle too tight, there muscle is in tension and there’s little to no extra length left to stretch at impact. Arguably a relaxed grip could be the remedy for most of 1-9.

This is from a lot of conversation with my PT. My tendons hurt way too much - shins, calves, fingers...I even gave myself Tennis Elbow to my left arm doing exercises to prevent it in my right arm. I’m 43, went from never playing tennis to playing 5 days a week, and my right arm is fine.

My solution is to use a grip that fits - that doesn’t cause you to squeeze too tightly, and that also doesn’t force you to spread your hands open to hold; the hand should be perfectly relaxed and the racquet supported by the butt when at rest. Also, use a racquet that’s heavy enough to not overly deflect when supported with a relatively loose grip.


New User
Yes, I get pain really quick when blocking orange dot balls to my son. Switched him to pressurized balls just to save my arm.

For me, what works is a relatively heavy and arm-friendly frame (Gravity Pro at 336g) with a smallish grip. I can even tolerate gut/poly which gives you the best of both worlds: easy power, feel, and plush but also spin and touch. However, I found the Clash 98 to be too much of a launcher so I had to look at more rackets. I now have a recovery racket (Prince Phantom) and a competitive racket (Gravity Pro).

One more thing on racquets: I find that the RA number is just a necessary but not sufficient condition. Some very soft and plush rackets light me on fire. Others don't. So demo racquets with multi for a week playing a real match and only then buy. Once again, the GPro is just right for me, but others (Tecnofiber TF40, Yinex HD97) are not.


You mention not using pressureless balls.

Have you found that one ball (i.e. the Penn Championship) is harder than another ball (i.e. PennPro)? I'd be curious if there is a rating of ball softness or arm friendliness.
I use any of these in my tennis ball machine.

I didn’t observe any difference on my elbow, but I do find Wilson Championship the most comfortable.

Overall, good contact point, NO pressurless balls and limiting number of consecutive shots on a machine (or serves) in a row is the best prevention for me.


I use any of these in my tennis ball machine.

I didn’t observe any difference on my elbow, but I do find Wilson Championship the most comfortable.

Overall, good contact point, NO pressurless balls and limiting number of consecutive shots on a machine (or serves) in a row is the best prevention for me.

I haven't played with that many different kinds of balls since I started paying attention.

Pro Penn Marathon, Penn Championship Xtra Duty, and Wilson Championship Xtra Duty are the three. I feel like the Penn Champs are the hardest of those 3. Only played with the ProPenn once. It was noticeably softer than the Penn Champ.


Regarding strings, how better is multi for the arm in general compared to SG or low tension poly?

In my limited experience, syn-gut feels pretty similar to multi in terms of elbow pain....both seems pretty low impact to me. I don't have a ton of experience with full bed poly, but the poly that I have tried has been noticeably stiffer.

Check the string comparison tool on TWU to look at specific strings.

Babolat Syn Gut registers 169 vs Xalt at 165 vs Xcel at 151 (lb/in).

Just a for reference, Babolat RPM Soft is 155 lb/in. So maybe that is an option...

The two softest (edit: poly strings) that I have tried are Luxilon Element Rough and ECO Power (195 and 198 respectively).

Luxilon Natural Gut registers at 82 lb/in.
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Yes a sudden increase in intensity, frequency and Volume in any activities that stress the lateral epicondyle will do it, I,ve been very lucky to have only had TE twice and also GE twice in over 40 years and I work in the industry 6 days a week.
Honestly I think polyester is a major culprit - you have to go low in the 40’s tension wise if you really want to use it. Racquet wise Pro Kennex kinetic frames are the king of arm safety,

From my experience the key to rehab is to get through the inflammation phase and don’t stir things up. Then do the 3 or 4 main exercises once a day but first check to see how you pull up.
Once you have no negative outcomes after strengthening, keep going and you will get better. Consistency of self care is the way to go.
Some people say that without much intervention it may take over a year to get better but those who do all the right things can get it done earlier.
Happy to share ideas with people as required.


Dont ever m@sturbate, It totally gets It worse, remember, if you wanna take care of your arm for It to be ready to compete in a match, be a monk and dont wank