Tennis Elbow :(

Chrisuk78

New User
Hi guys,

I've had a frustrating case of tennis elbow for about three months now. It seems to be improving, but very slowly. I dont have any pain now when the elbow is bent, only when I straighten the elbow, and stretch it. Looking for some advice from fellow sufferers and recoverees

1. I've been to my GP who has put me on a waiting list for a cortisone injection. My GP didnt think there would be any ill effects at all,but i'm a bit skeptical. Friends and family have cortisone injections with mixed results. Anyone had this injection? Dont really want to have anything to invasive if I can help it.

2. Im probably going to try out a physio. Do they really help or is it just money down the drain?

3. A friend also mentioned acupuncture for my tennis elbow. Anyone tried this? What are the results like?

Its killing me being off the court. Already had to give up my spot on my club team. Need to get back playing.

Cheers fellas
 

dman72

Hall of Fame
Hi guys,

I've had a frustrating case of tennis elbow for about three months now. It seems to be improving, but very slowly. I dont have any pain now when the elbow is bent, only when I straighten the elbow, and stretch it. Looking for some advice from fellow sufferers and recoverees

1. I've been to my GP who has put me on a waiting list for a cortisone injection. My GP didnt think there would be any ill effects at all,but i'm a bit skeptical. Friends and family have cortisone injections with mixed results. Anyone had this injection? Dont really want to have anything to invasive if I can help it.

2. Im probably going to try out a physio. Do they really help or is it just money down the drain?

3. A friend also mentioned acupuncture for my tennis elbow. Anyone tried this? What are the results like?

Its killing me being off the court. Already had to give up my spot on my club team. Need to get back playing.

Cheers fellas

Have you started the tyler twist with flexbar? If not, order one now, and start doing it, check the videos on youtube. That combined with rest and revaluating your equipment choices are keys.
 

mbm0912

Hall of Fame
I still have arm pain but these have helped me manage it somewhat. I usually hit 4-5 times a week for 1 hr or more.

-Rest ( I know that's hard to do)
-Experiment with different frame/string setups
-Stop mishitting the ball (off center hits/shanks hurt, eyes on the ball through the shot)
-Try do develop relaxed, fluid strokes (watch a lot of videos)
-Ice & Ibuprofen
 

JonC

Banned
I tried everything besides injections (stretching, art ,etc..) - only one thing worked - I went way down in grip size (3/4 to 1/4) and the TE was gone - it was amazing. I really believe it has much more to do with over-gripping the racquet vs strings or racquet stiffness. This over-gripping can be due to bad form or grip size. My case was 8 months. Early on in my TE I read to go up in grip size so I went from 1/2 to 3/4 -big mistake.
 

Chrisuk78

New User
Have you started the tyler twist with flexbar? If not, order one now, and start doing it, check the videos on youtube. That combined with rest and revaluating your equipment choices are keys.

I have the green flexbar, but haven't used it much as it seemed to make the elbow worse :( I recently ordered the red flexbar to see if that's any better.

Also I've haven't so much as hit a ball for three months do equipment isn't an issue right now. When I back a plan to string up my radical ig pro with some babolat xcel (which I heard is pretty elbow friendly).
 

JonC

Banned
I have the green flexbar, but haven't used it much as it seemed to make the elbow worse :( I recently ordered the red flexbar to see if that's any better.

Also I've haven't so much as hit a ball for three months do equipment isn't an issue right now. When I back a plan to string up my radical ig pro with some babolat xcel (which I heard is pretty elbow friendly).

I'd recommend against it - made mine worse. Strengthening should only begin after you've fixed it.
 

tbln

New User
Hi guys,

I've had a frustrating case of tennis elbow for about three months now. It seems to be improving, but very slowly. I dont have any pain now when the elbow is bent, only when I straighten the elbow, and stretch it. Looking for some advice from fellow sufferers and recoverees

1. I've been to my GP who has put me on a waiting list for a cortisone injection. My GP didnt think there would be any ill effects at all,but i'm a bit skeptical. Friends and family have cortisone injections with mixed results. Anyone had this injection? Dont really want to have anything to invasive if I can help it.

2. Im probably going to try out a physio. Do they really help or is it just money down the drain?

3. A friend also mentioned acupuncture for my tennis elbow. Anyone tried this? What are the results like?

Its killing me being off the court. Already had to give up my spot on my club team. Need to get back playing.

Cheers fellas

Sorry to hear about your TE, it sounds very frustrating! I'm a trainee doctor so take my post with a grain of salt (like all online postings :) ) and briefly read up on the literature on TE out of interest. Basically:

1. Cortisone injection *may* help with short term pain levels (6 weeks) but it does not prevent recurrence and there is evidence that it may actually worsen long-term outcome, causing worser pain and even decreased grip strength after 1 year compared to no injection. It sounds like your disposition is to avoid this invasive and relatively higher risk option and save it as a last resort.

2. A meta-analysis (combination of all randomized clinical trials) actually showed no benefit to physiotherapy in treating TE. This may be likely due to varying level of skill, experience, and treatment regimen. Physiotherapy is, basically, individualized guided rehab so if you go this route, shop around for someone with lots of experience dealing with tennis players and this injury. This is a low risk option (other than cost) and probably worth considering a few visits, but is highly dependent on the practitioner.

3. An old (2002) systematic review found little evidence to either support or refute the efficacy of acupuncture for TE. Some small studies report mild short-term benefit, some do not. No study looked at long term benefit. Like physiotherapy, the risk is low (other than cost) so it might be worth trying.

There are other crazy treatment options out there too like autologous blood injections or platelet enriched plasma injections -- all of which look unconvincing and poorly studied.

All in all, the average time to recovery is typically between 6-months and 2 years.

In short, there's no quick fix for this one. :(
 

10sGrinder

New User
It's the racquet?

I know we've gone through this before and there are a lot of threads about tennis elbow, but one of the best fixes is to make sure you have an arm-friendly racquet, like the Kennex 5g or equivalent. Heavy racquet, head light, flexible. Cured me and several other of my friends with tennis elbow.
 
I'm very sorry to hear your problem.

I agree with some of the suggestions about gripping the racquet loosely, smooth and fluid stroke motions, heavier racquet and also looser string setup.

Other factor worth to think about is food. Plenty of healthy fruit and vegetables would help. Also, hot Indian curry is really a good menu to fight inflammation, as it contains yellow turmeric and other good spices. Capsicum and ginger are great too.
 

Gyswandir

Semi-Pro
I still have arm pain but these have helped me manage it somewhat. I usually hit 4-5 times a week for 1 hr or more.

-Rest ( I know that's hard to do)
-Experiment with different frame/string setups
-Stop mishitting the ball (off center hits/shanks hurt, eyes on the ball through the shot)
-Try do develop relaxed, fluid strokes (watch a lot of videos)
-Ice & Ibuprofen

Have you started the tyler twist with flexbar? If not, order one now, and start doing it, check the videos on youtube. That combined with rest and revaluating your equipment choices are keys.

Sorry to hear about your TE, it sounds very frustrating! I'm a trainee doctor so take my post with a grain of salt (like all online postings :) ) and briefly read up on the literature on TE out of interest. Basically:

1. Cortisone injection *may* help with short term pain levels (6 weeks) but it does not prevent recurrence and there is evidence that it may actually worsen long-term outcome, causing worser pain and even decreased grip strength after 1 year compared to no injection. It sounds like your disposition is to avoid this invasive and relatively higher risk option and save it as a last resort.

2. A meta-analysis (combination of all randomized clinical trials) actually showed no benefit to physiotherapy in treating TE. This may be likely due to varying level of skill, experience, and treatment regimen. Physiotherapy is, basically, individualized guided rehab so if you go this route, shop around for someone with lots of experience dealing with tennis players and this injury. This is a low risk option (other than cost) and probably worth considering a few visits, but is highly dependent on the practitioner.

3. An old (2002) systematic review found little evidence to either support or refute the efficacy of acupuncture for TE. Some small studies report mild short-term benefit, some do not. No study looked at long term benefit. Like physiotherapy, the risk is low (other than cost) so it might be worth trying.

There are other crazy treatment options out there too like autologous blood injections or platelet enriched plasma injections -- all of which look unconvincing and poorly studied.

All in all, the average time to recovery is typically between 6-months and 2 years.

In short, there's no quick fix for this one. :(

First, I agree with the above except the bolded.
Second, I've been suffering from TE since last July mainly due to relying on "traditional" methods and not going to an orthopedic doctor. I only started physio 3 weeks ago based on doctor's recommendation. Here is my opinion on what really works, all are recommended by my doctor:
- flexbar Tyler twist (choose the right resistance and go up when you can do the motion without pain)
- active release massage: like mentioned above, really depends on the quality of the therapist. You can do this at home using the flexbar as a roller.
- shockwave therapy: the only thing that will help with a stubborn case, especially if there is old scarring in the tissue. Still depends on the quality of the therapist

For reference on my doctor's background http://www.drbadshamedical.com/our-doctors/william/

According to him, after the SWT, if I still have pain, we will do a course of PRP over 6 weeks of 6 injections. He didn't use it prior to last year, when there was a double blind study on its efficacy and he adopted it as a means of treatment.

There is a great thread by charliefederer about his own case of TE and other contributors
 
If you can switch to gut I would recommend it. I know it's not the same thing but I had wrist tendinitis and went through rehab, anti-inflammatory gels, cortisone shot...you name it but nothing helped. I ditched my poly/syn gut hybrid for a gut/poly hybrid and it went away and hasn't come back.

Best of luck.
 

Chas Tennis

G.O.A.T.
There are many threads on this forum on tennis elbow and golfer's elbow. Unfortunately, the most informative discussions and illustrations stopped when CharlieFedererer stopped posting.

Search; CharlieFedererer Tennis Elbow

Here is a thread that describes the difference between tendinitis (with inflammation) and tendinosis (with defective healing). When you newly tear a tendon you should stop stressing it immediately - in the match when injured. If you don't, the probability of developing chronic tendinosis increases. See the links in this thread to research papers on tendinitis and tendinosis.
http://tt.tennis-warehouse.com/showthread.php?t=442912&highlight=tendon+injury+nuthouse
 
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Shroud

Talk Tennis Guru
Got my first case about a year ago I think.

It wasnt too bad but there were days when it was hard to drink or lift things or shave. Stringing a racket was tough. And I remember thinking I could play left handed and started hitting that way, but man I sucked.

Tried all kind of things and here is ultimately what worked from a racket standpoint

1. Added weight to the racket mostly in the handle, but bunch in the hoop. I know this was a big factor because the TE healed finally. But just last week I started to get a twinge of pain after hitting with a new and lighter racket. Once I added about 4g to the tip of that racket (one in the sig) the pain went away. Though I added too much in my initial round (445g ) and I think gave myself some golfers elbow so dont add too much, go slow. Shocktape is an awesome TE grip IME.

2. Low low tension. I strung some rackets with 15lbs and even though it was a kevlar hybrid it had some flex and really helped. I think this is one of the reasons gut is recommended. Said another way, a stiff string at a low low tension can be like a less stiff string at normal tensions. you will have to adjust. The first time will suck and everything will go long. BUT its possible to hit with a 20-30lb string bed. Long story short I had one strung at 15lbs and brok a string. The only racket I had was strung at 30lbs. The 1st 5 minutes I was hitting in the ground!!! But you can adjust.

From a "rehab" standpoint:

1. Heat. Ice only made mine worse because it tightened up the muscles. Anyhow it all comes down to bloodflow and if you dont have it, then you wont heal. Heat gets the blood flowing. Massage too. Wearing a neopreen sleeve or even wearing a hot gel pack has helped speed things up. Though there might be a time with Ice is what is called for.

2. Band-iT. TW sells it and it locks the muscles without restricting blood flow.

3. Stretching- do it all the time stopping if there is pain.

4. Epsom Salt hot baths. See #1 and the minerals help. I also used magnesium gel

I have 3 flexbars and used them but they never seemed to help and made things worse. Bicep curls with a stretch band really seemed to help but man I just am not in to that kind of working out so I am not religious about that stuff. Though I should be, just so it doesnt come back. I never took any ibuprofen or other things like that. Though I was good about taking a ginger/ tumeric tea most days.

Finally I just started doing this in the last week so I am not 100% sure of its effects, but I stopped arming the ball. That really not the right term because it implies no core. In my case the core was there, but my arm would be "active" or tense. I stopped doing that and just let it swing with the body. So much easier on the arm, once you get the hang of it.

Also realize that your game should change. It might be that there is a technique issue and IMHO its probably better to see a good coach than most doctors.
 

mbm0912

Hall of Fame
First, I agree with the above except the bolded.
Second, I've been suffering from TE since last July mainly due to relying on "traditional" methods and not going to an orthopedic doctor. I only started physio 3 weeks ago based on doctor's recommendation. Here is my opinion on what really works, all are recommended by my doctor:
- flexbar Tyler twist (choose the right resistance and go up when you can do the motion without pain)
- active release massage: like mentioned above, really depends on the quality of the therapist. You can do this at home using the flexbar as a roller.
- shockwave therapy: the only thing that will help with a stubborn case, especially if there is old scarring in the tissue. Still depends on the quality of the therapist

For reference on my doctor's background http://www.drbadshamedical.com/our-doctors/william/

According to him, after the SWT, if I still have pain, we will do a course of PRP over 6 weeks of 6 injections. He didn't use it prior to last year, when there was a double blind study on its efficacy and he adopted it as a means of treatment.

There is a great thread by charliefederer about his own case of TE and other contributors

Why do you disagree with an anti-inflammatory like ibuprofen?
 

mbm0912

Hall of Fame
Index Finger Rule

I tried everything besides injections (stretching, art ,etc..) - only one thing worked - I went way down in grip size (3/4 to 1/4) and the TE was gone - it was amazing. I really believe it has much more to do with over-gripping the racquet vs strings or racquet stiffness. This over-gripping can be due to bad form or grip size. My case was 8 months. Early on in my TE I read to go up in grip size so I went from 1/2 to 3/4 -big mistake.

I have found the exact opposite as far as grip size goes. Going down, even slightly can really strain the forearm, at least it did for me. I wouldn't go much smaller than they recommend here:

http://www.youtube.com/watch?v=0X915ufF5Iw
 

Chas Tennis

G.O.A.T.
One hand backhand issue - avoid flexed wrists because of TE risk.

For an important technique issue use TW search box above.

Search Threads: one hand backhand Knudson tennis elbow

Knudson says that an extended wrist is best for the one hand backhand. A flexed wrist can stress the tendons that are torn in tennis elbow. Google pictures of one hand backhands and you will see that all pros hit with their wrists in an extended position.
https://www.google.com/search?q=ima...dF8jw8QGK5YCwCw&ved=0CCcQsAQ&biw=1113&bih=670

Pros use extended wrists but not all amateurs do. Amateurs experience more TE than pros.

Knudson's book has a full discussion. Biomechanical Principles of Tennis Strokes (2006).
 
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heninfan99

Talk Tennis Guru
I would definitely skip the cortisone injection. Rehab is very helpful and once the physio okay's you to play I would look for a good coach to look at your technique.
 

JonC

Banned
I have found the exact opposite as far as grip size goes. Going down, even slightly can really strain the forearm, at least it did for me. I wouldn't go much smaller than they recommend here:

http://www.youtube.com/watch?v=0X915ufF5Iw

I guess the correct grip size should be the one that allows you to grip the lightest. I would bet money that all 1h bh players that have TE are gripping their racquet too tightly and this is usually due to muscling the shot. Still, I find it hard to understand how a smaller grip (within reason) can increase grip pressure - seems just the opposite. Oscar Wegener recommends a small grip because he says you can manipulate the racquet more easily - it follows that it takes less strength to manipulate a racquet with a smaller grip.
 

tbln

New User
First, I agree with the above except the bolded.
Second, I've been suffering from TE since last July mainly due to relying on "traditional" methods and not going to an orthopedic doctor. I only started physio 3 weeks ago based on doctor's recommendation. Here is my opinion on what really works, all are recommended by my doctor:
- flexbar Tyler twist (choose the right resistance and go up when you can do the motion without pain)
- active release massage: like mentioned above, really depends on the quality of the therapist. You can do this at home using the flexbar as a roller.
- shockwave therapy: the only thing that will help with a stubborn case, especially if there is old scarring in the tissue. Still depends on the quality of the therapist

For reference on my doctor's background http://www.drbadshamedical.com/our-doctors/william/

According to him, after the SWT, if I still have pain, we will do a course of PRP over 6 weeks of 6 injections. He didn't use it prior to last year, when there was a double blind study on its efficacy and he adopted it as a means of treatment.

There is a great thread by charliefederer about his own case of TE and other contributors

The PRP study you are referring to was significantly flawed, misleading, and with notable stated conflicts of interest in which the authors declared that they were paid royalties and owned stock in the sponsoring pharma and biotech companies. The study flaws and rebuttal are published in the journal's letters to the editor, which you can peruse here: http://ajs.sagepub.com/content/42/1/NP1.long

In short, they did not properly follow proper protocols of a double-blind randomized control study, did not properly analyze their data, and only had borderline significant results in a clinically insignificant outcome measure (visual analog pain scale).

In honesty, if I were in your shoes, had exhausted all options to no avail, and had the money, I'd probably try PRP. But I'm not convinced that its as effective treatment as claimed.
 

JonC

Banned
I'll add one more piece of evidence that points to tension in the muscle as the cause for TE. I onece developed TE after lifting 50 bags of 80 lb concrete - I lifted them by the corners which means I was using a lot of prolonged grip pressure and got TE in both elbows. I think this translates to tennis and grip pressure on the 1h bh as the main cause of TE. I also think that the 1 finger test to determine grip size is not appropriate for today's harder hit and wristy backhand. Oscar Wegener says that "smaller grips make the racquet feel lighter and easier to handle. Cumbersome grips make the racquet harder to handle and strain the arm". That has been my experience as well but perhaps it has to do with the types of strokes you have - I hit a lot of top spin.
 

Gyswandir

Semi-Pro
Why do you disagree with an anti-inflammatory like ibuprofen?

Long term effects of NSAID include hazards to gastrointestinal system. In addition, this really doesn't do anything for tennis elbow other than mask your pain for a while, which can be achieved with icing, with the added benefit of encouraging new blood flow.
 

Gyswandir

Semi-Pro
The PRP study you are referring to was significantly flawed, misleading, and with notable stated conflicts of interest in which the authors declared that they were paid royalties and owned stock in the sponsoring pharma and biotech companies. The study flaws and rebuttal are published in the journal's letters to the editor, which you can peruse here: http://ajs.sagepub.com/content/42/1/NP1.long

In short, they did not properly follow proper protocols of a double-blind randomized control study, did not properly analyze their data, and only had borderline significant results in a clinically insignificant outcome measure (visual analog pain scale).

In honesty, if I were in your shoes, had exhausted all options to no avail, and had the money, I'd probably try PRP. But I'm not convinced that its as effective treatment as claimed.

Thanks for the info. I tried the link, but it didn't work for some reason. Will check again later.

As to efficacy, I tend to believe that PRP should work. The concept of increased blood flow to the injury makes sense. In addition, I've had anecdotal evidence of it working including a member here GregG. Nonetheless, as you recommend, I am keeping to as the last option if the rest doesn't work.
 

spun_out

Semi-Pro
Yes, it's a broken record, but massage your arm, hard enough to bruise (triceps, forearm, around the elbow, near the armpit). I wouldn't try to exercise your way out of TE. It's tempting, I admit, but every time I fall to the temptation, I regret it.

The reason the Flexbar doesn't work or makes it worse, I think, is that you need to grip the Flexbar to do the exercises for a condition that you got from gripping too tight. You are simply repeating what got you TE in the first place.
 

comeback

Hall of Fame

I posted this last year in another TE thread


I had the worse case of tennis elbow and couldn't wash my hair or lift a cup into the microwave. But I am playing now pain free. It took 4-6 weeks but worked. Don't squeeze anything like the flexbar or a tennis ball. it will only make it worse
As i have advised in several other threads, the flextend glove www.flextend.com works
Flextend is a proven medical device COVERED BY INSURANCE and actually has an insurance code# so you will get reimbursed. Used by professional golfers, guitar players etc that really works and then will strengthen your entire finger, wrist, forearm, and both sides of the elbow. Here is the video for tennis elbow but there are many other videos next to it on Utube that cover the fingers,wrist, forearm etc..it's also GREAT for carpal tunnel..send me an email at comeback@safe-mail.net if you need further details
https://www.youtube.com/watch?v=AVhlgBDy_F8
__________________
 
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BreakPoint

Bionic Poster
Nothing beats rest for tennis elbow. The torn tendon needs a lot of time to heal. There's really no way around that. I suggest taking 6 months completely off from tennis and see how your elbow feels by then. And then when you come back, stay away from poly strings and use a very flexible racquet. Sorry for the bad news but strong medicine never tastes good.
 

Chrisuk78

New User
Nothing beats rest for tennis elbow. The torn tendon needs a lot of time to heal. There's really no way around that. I suggest taking 6 months completely off from tennis and see how your elbow feels by then. And then when you come back, stay away from poly strings and use a very flexible racquet. Sorry for the bad news but strong medicine never tastes good.

Thanks mate. Was kind of thinking this myself :(
 

Chas Tennis

G.O.A.T.
....................................................................
The reason the Flexbar doesn't work or makes it worse, I think, is that you need to grip the Flexbar to do the exercises for a condition that you got from gripping too tight. You are simply repeating what got you TE in the first place.

The tendon(s) that is torn with a TE injury extends the wrist or extend the fingers (see anatomy Youtube below). Several of these wrist and finger tendons attach at the lateral epicondyle, the TE location.

Gripping involves the finger tendons on the bottom of forearm that flex the fingers. They attach on the medial epicondyle. These tendon attachments are associated with golfer's elbow.

I have to check this some more as when I grip I can feel muscles on the top of my forearm tighten near the TE location and enlarge.....?

This video is very thorough and clear on forearm muscles and their attachments. (it uses the medical terminology but the anatomy is clear with or without the terms). First, there is a discussion of the wrist extensors and finger extenders and later the flexors. At around minute 8, he describes the finger flexors and their attachments. The finger flexors attach on the medial epicondyle - not the TE pain location - and the radius. Maybe the radius attachment is what I feel on the top of the arm when I grip. ?
http://www.youtube.com/watch?v=BjIab-huqgU&list=PLA42AC7FBC0B31765&index=18
 
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RogueFLIP

Professional
There are many different ways to get symptoms that can be classified as tennis elbow.

Thus, there are many different ways to approach treating it.

What works for one person may not work for another. There isn't going to be a universal "one treatment" cures all.

And you can see that with all the different responses on this thread and the many others like this one.

You have to take into consideration a lot of different factors like mechanism of injury, muscle imbalances, palpation of soft tissues, postural imbalances, time frame of symptoms, etc..

If you have a more acute injury and strain of the muscle belly, you may response better to rest and motion with some gentle resistive exercises of say the Flexbar.

A more chronic injury with continued inflammation and tearing may not respond well to resistive exercise.

Generally, for an acute injury you'd want to:

Rest. Stop playing tennis. Seriously.

Most people when they injure themselves, their instinct is to grab and hold the injured area. Follow this intuition. Rub, pressure, massage, trigger point, whatever. Go gently. You don't need to bruise the area. Going too hard while may feel good, may lead to further strain and injury to the area. Gentle is safe. Instead of trying more to rub harder, rub with less force and spend MORE time in the area.

After 24 hours, ice or heat is whatever makes it feel better. Either or isn't going to cure it if that's your only plan of action.

Keep the range of motion in a comfortable range. Move the wrist, elbow, shoulder in a gentle way every which way you can.

Chronic issues are more complex, but generally speaking now you've most likely developed more soft tissue restrictions and compensations besides the symptomatic area that if not addressed, will con't to delay healing.

Remember, if your symptoms are chronic and you keep treating only your symptomatic area, and there's no improvement, you need to look more globally!
 

RogueFLIP

Professional
So if you've determined that your grip is too strong which has lead to your TE, you might want to consider addressing the soft tissue on the flexor side of your forearm.

Even if your symptoms are on the opposite side, the extensor side, too much tightness/overuse on one side or another may lead to an imbalance which can cause TE symptoms.
 

RogueFLIP

Professional
Personal experience:

Last summer, I developed pain and symptoms that could be classified as tennis elbow.

Pain in my extensor belly, difficulty holding a cup, etc...

Now before you all go, well of course you got TE, look at your setup (in my signature)....hold on.

Again, you have to look at the mechanism of injury. I had been using the APD with Blast since 2010 with no symptoms. But on this particular day, I hit an awkward defensive 1 handed shot which was all wrist on a full stretch. I normally hit with a 2HBH. I could feel the belly spasm and tighten. Next day, full on symptoms of pain.

Two weeks of gentle stretching (which I did a lot of beforehand anyways), and soft tissue work in all aspects of my arm....no more pain, haven't had any issues since.

Extensor belly because that's where I could feel the pain and spasm, flexor belly because that probably was overstretched during moment of impact. Triceps, biceps, inside and outside of upper arm....pectorals, shoulders, scapular region because everything is all connected.

Had I followed my own advice and stopped playing tennis, probably would have resolved my symptoms sooner.....but since most of us on this board are addicts....:twisted:
 

Tight Lines

Professional
After suffering through TE for about 9 months, I am just getting over it.

Before you do anything, you must find the cause of your TE. In my case, it was my stroke mechanic (muscling the ball too much) combined with a Babolat APD stick strung with a poly. I changed the swing mechanic so that my wrist is laid back much more than before to allow the wrist to absorb the impact rather than the tendons that attach to the elbow. I went to poly/syn gut combo and lowered the tension to 44/50. That helped.

I have laid off tennis until about a couple of months ago. Theraband helps. I use a green one now.

Don't use cortisone shots. IMO, they hide your pain and will make the TE worse.

When I play now, I use my own version of a "leverage band" that forces your wrist to be laid back so that you don't muscle the shots (google it and you will find it). Another device you should think about is the wrist assist. They all do the same.

Good luck.

Harry
 

Tight Lines

Professional
After suffering through TE for about 9 months, I am just getting over it.

Before you do anything, you must find the cause of your TE. In my case, it was my stroke mechanic (muscling the ball too much) combined with a Babolat APD stick strung with a poly. I changed the swing mechanic so that my wrist is laid back much more than before to allow the wrist to absorb the impact rather than the tendons that attach to the elbow. I went to poly/syn gut combo and lowered the tension to 44/50. That helped.

I have laid off tennis until about a couple of months ago. Theraband helps. I use a green one now.

Don't use cortisone shots. IMO, they hide your pain and will make the TE worse.

When I play now, I use my own version of a "leverage band" that forces your wrist to be laid back so that you don't muscle the shots (google it and you will find it). Another device you should think about is the wrist assist. They all do the same.

Good luck.

Harry

During the nearly nine months that I couldn't play, I did a lot of research into possible training aids that could help with my tight grip and bad stroke mechanics. In the end, I concluded that any training aid that puts your wrist in the laid back position would help. These include WristAssist, RacketBracket Volley Doctor and Leverage Band, to name the popular ones. IMO, they all work to improve your stroke mechanics.

But, I wanted one that was easily adjustable and had a tennis elbow type brace so I could play without worrying about tendon stress. So I developed my own. Since it is not legal to use it in matches, I use it during practice rallies. So far, so good. No more TE issues. So, if you must play while you are recovering from TE (I do not recommend this), I would highly recommend one of the above mentioned devices.

Harry
 

Chas Tennis

G.O.A.T.
......................In the end, I concluded that any training aid that puts your wrist in the laid back position would help. ......................

What does wrist 'laid back' mean? extended, flexed, ulna deviation.... etc.

attachment.php


What stroke caused your Tennis Elbow?

I am very interested in this point. I've posted many times on the only creditable technique issue I've found, the one described by D. Knudson for the one hand backhand. He says that skilled players use their wrists in extension but more amateurs use their wrists in flexion. They attribute some of the increased incidence of TE among amateurs to this wrist issue. Adding to the credibility for me, flexion stretches the tendons injured in TE.

I know another player with a two hand backhand that has tennis elbow. I have not seen information on how TE might be caused with a two hand backhand.
 
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Tight Lines

Professional
What does wrist 'laid back' mean? extended, flexed, ulna deviation.... etc.

attachment.php


What stroke caused your Tennis Elbow?

I am very interested in this point. I've posted many times on the only creditable technique issue I've found, the one described by D. Knudson for the one hand backhand. He says that skilled players use their wrists in extension but more amateurs use their wrists in flexion. They attribute some of the increased incidence of TE among amateurs to this wrist issue. Adding to the credibility for me, flexion stretches the tendons injured in TE.

I know another player with a two hand backhand that has tennis elbow. I have not seen information on how TE might be caused with a two hand backhand.

By laid back, I mean wrist extension. Here is a pic.

il_570xN.631492370_qnbs.jpg


That is one image of a device my son and I made together. If you want more information, you will need to click on my user name and look at my home page.

I used to slice my backhand a lot with heavy spin. That caused a lot of strain on my TE tendon. Also, I reviewed my forehand in slow motion. It made me realize that I was holding on to the racket too tight. With the above devices mentioned, it allows you to relax your fingers since the power is coming essentially from your wrist/palm.

I did read through D. Knudson's article for the one hand topspin backhand. I believe he is correct. If you do not lay back your wrist, you need to grip the racket very tightly as you don't have any leverage. By laying back the wrist, you are letting your palm do the hitting, rather than your fingers.

Harry
 
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Chas Tennis

G.O.A.T.
By laid back, I mean wrist extension. Here is a pic.

il_570xN.631492370_qnbs.jpg


That is one image of a device my son and I made together. If you want more information, you will need to click on my user name and look at my home page.

I used to slice my backhand a lot with heavy spin. That caused a lot of strain on my TE tendon. Also, I reviewed my forehand in slow motion. It made me realize that I was holding on to the racket too tight. With the above devices mentioned, it allows you to relax your fingers since the power is coming essentially from your wrist/palm.

I did read through D. Knudson's article for the one hand topspin backhand. I believe he is correct. If you do not lay back your wrist, you need to grip the racket very tightly as you don't have any leverage. By laying back the wrist, you are letting your palm do the hitting, rather than your fingers.

Harry

It looks as if you are making certain that the wrist cannot get to the flexed position. That would not allow tension to build up on the injured tendon area. Neat work.

You might be very interested in Knudson's book, Biomechanical Principles of Tennis Technique. He has some interesting discussion and a paragraph where he demonstrates the difference in strength between the flexed wrist and the extended wrist. The extended wrist has a good bit stronger grip. The book is a low cost reference with quite a bit of discussion on TE and many other insightful discussions.

He also has in that book or Fundamentals of Biomechanics an interesting discussion that there is some belief that some tendon injuries may occur related to some rapidity of muscle lengthening perhaps due to the automatic controls for the muscle-tendon unit. For example, guessing the content as I don't recall it, the muscle-tendon unit is lengthening very rapidly, very near the end of its range of motion and perhaps the ball is impacted.
 
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hray4clay

Rookie
Hi guys,

I've had a frustrating case of tennis elbow for about three months now. It seems to be improving, but very slowly. I dont have any pain now when the elbow is bent, only when I straighten the elbow, and stretch it. Looking for some advice from fellow sufferers and recoverees

1. I've been to my GP who has put me on a waiting list for a cortisone injection. My GP didnt think there would be any ill effects at all,but i'm a bit skeptical. Friends and family have cortisone injections with mixed results. Anyone had this injection? Dont really want to have anything to invasive if I can help it.

2. Im probably going to try out a physio. Do they really help or is it just money down the drain?

3. A friend also mentioned acupuncture for my tennis elbow. Anyone tried this? What are the results like?

Its killing me being off the court. Already had to give up my spot on my club team. Need to get back playing.

Cheers fellas
I am right there with you, Chrisuk. See my thread on this blog in the Health and Fitness titled Perfect Storm for Arm Destruction. I have been "out of action" now for over 12 weeks with what I thought was tendonitis or evern tendonosis. I saw my Orthopedic surgeon right after I had the bad pain and he did not xray or MRI. Just assumed it was TE and gave me a shot in the painful area and prescribed physical therapy. I was feeling better so I tried to play after 4 weeks of PT....big big mistake. The first blazing ball to my backhand volley blew up my elbow really good this time. I went bact to an arm/hand specialist who again took no MRI and said rest completely for at least 8 to 12 weeks, possibly longer. In the 7th week I finally prevailed upon the doctor to do an MRI to see exactly what was wrong and not just assume it was routine tendonitis. The results of the MRI showed a 75% tear in the forearm muscle near the tendon!
I have had problems before with various injuries and have had bad bad luck with cortisone injections into tendons especially. I had a shot in my right achilles tendon years ago and three days later the tendon completely blew up at the beach in Atlantic City. I had to have surgery to reattach the tendon. These shots CURE NOTHING. They are only used to manage the pain and they CAN be harmful. I have had good success with physical therapy on several of my sports injuries but rest until fully healed is also very highly recommended.
Furthermore, have a pro check your technique.....stiff wristed tennis like in the old days puts all the shock on your elbow and shoulder. Notice how "wristy" many of the best forehands are nowadays with the grip loose and the wrist very supple through impact. That's the way to avoid injuries to the tendons and joints, I think. Also, your equipment could very well be a contributing factor, particularly very stiff frames and those killer poly strings! Talk to a racquet rep at TW for some advice on friendly frames for your arm. Lots of luck with yours. I'm dying to play again too but I am very leary of going back too soon again.
Finally, I have been told there is a surgery to relieve TE which is very effective. Check with your Orthopod.
 

Tight Lines

Professional
. . . Furthermore, have a pro check your technique.....stiff wristed tennis like in the old days puts all the shock on your elbow and shoulder. Notice how "wristy" many of the best forehands are nowadays with the grip loose and the wrist very supple through impact. That's the way to avoid injuries to the tendons and joints, I think. Also, your equipment could very well be a contributing factor, particularly very stiff frames and those killer poly strings! Talk to a racquet rep at TW for some advice on friendly frames for your arm. Lots of luck with yours. I'm dying to play again too but I am very leary of going back too soon again.
Finally, I have been told there is a surgery to relieve TE which is very effective. Check with your Orthopod.

To me, this is one of the best posts on TE. People need to pay attention to their stroke mechanics. If your racket is parallel to your arm at impact, you are holding onto the racket too tight because you have no leverage. Your wrist MUST BE in the laid back position. See the image in post 35 above.

While recovering from TE, if you must play, you should do the following:
1. avoid hitting any backhand volleys and one handed backhand (especially slices), which place a tremendous stress on the tendon (lateral epicondyle).
2. wear one of those wrist lay back devices like wristassist, racketbracket or one that my son is selling (you will need to click on my home page). That will teach you the correct technique and relieve some pressure from the tendon.
3. change your racket to a more arm friendly one. I had a Babolat APD strung with poly, which was too stiff for my arm. I have now switched to Prince Classic Response 97 with a multi.

Harry
 
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vegasgt3

Rookie
You also need to treat the cause of the problem not just the result or it will appear again. For example, body alignment. Check out egoscue.com or get Pete
Egoscue's book Pain Free. Changed my life. I used to have knee, shoulder and elbow issues, now I don't.

I also recommend a heavy, head-light flexy racquet strung with gut.
 

magnut

Hall of Fame
poly did it for me. i had to take one year off and play left handed. kind of sucked but was not the end of the world. i still played almost every day, still worked on my serve, still trained other than a few arm exercises.

in short...your not going to die. commit to lefty play and heal up. work on developing your body.

i wont even be in the same room with poly. string manufacturers a going to get sued if they dont start putting disclaimers on their packaging. i have never seen tennis elbow so common among young players as i do know. they are putting out a product with no warning and injuring consumers. dont be surprised if a class action lawsuit is brought about in the future.
 

Raul_SJ

G.O.A.T.
I am very interested in this point. I've posted many times on the only creditable technique issue I've found, the one described by D. Knudson for the one hand backhand. He says that skilled players use their wrists in extension but more amateurs use their wrists in flexion. They attribute some of the increased incidence of TE among amateurs to this wrist issue. Adding to the credibility for me, flexion stretches the tendons injured in TE.

I know another player with a two hand backhand that has tennis elbow. I have not seen information on how TE might be caused with a two hand backhand.

There was a significant difference between wrist motion speed after ball/racquet impact between the PRO and + TE groups.

While the PRO group extended their wrist after impact (-4.4 radians/second), the + TE group flexed their wrists more slowly (0.42 radians/second) at this point in the stroke​


Not sure what study means by lower level players "flexing their wrists" after impact.

I would think that upon impact, the wrist would either extend (as high level players do) or remain in essentially the same position.

But there would not be any further wrist flexion after impact.


http://assets.usta.com/assets/1/UST..._The One Handed Backhand and Tennis Elbow.pdf
 
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RogueFLIP

Professional
There was a significant difference between wrist motion speed after ball/racquet impact between the PRO and + TE groups.

While the PRO group extended their wrist after impact (-4.4 radians/second), the + TE group flexed their wrists more slowly (0.42 radians/second) at this point in the stroke​


Not sure what study means by lower level players "flexing their wrists" after impact.

I would think that upon impact, the wrist would either extend (as high level players do) or remain in essentially the same position.

But there would not be any further wrist flexion after impact.


http://assets.usta.com/assets/1/UST..._The One Handed Backhand and Tennis Elbow.pdf


I'm not sure what the confusion is on your part. What you think should happen, that the wrist would be in extension or the same position after ball impact was NOT found to be true in +TE group. This group demonstrated a more flexed position of their wrist after ball impact.

Do you think the researchers are wrong with what they found?
 

Chas Tennis

G.O.A.T.
The Knudson book was published about 10 years after the 1997 brief note. I read the book. I don't recall the wrist motion in the book but the wrist position of more extension for the pros and more flexion for the amateurs.

There is always an ambiguity in the use of the terms. The terms may either refer to motion or to a static joint position. I take the book to mean the wrist position. Recommend the book. It is really the only creditable information that I've found on the cause of TE. I'm sure there are many contributing factors, as discussed, but this seems a plausible cause to me.
 
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TennisLogic

Semi-Pro
poly did it for me. i had to take one year off and play left handed. kind of sucked but was not the end of the world. i still played almost every day, still worked on my serve, still trained other than a few arm exercises.

in short...your not going to die. commit to lefty play and heal up. work on developing your body.

i wont even be in the same room with poly. string manufacturers a going to get sued if they dont start putting disclaimers on their packaging. i have never seen tennis elbow so common among young players as i do know. they are putting out a product with no warning and injuring consumers. dont be surprised if a class action lawsuit is brought about in the future.

Same here. I never had any issues in my life until I used Kevlar strings. That was in the early 2000's. From what I've seen, most people who get tennis elbow use stiff equipment...technique is not necessarily the cause.

Since then, I have only used gut and ultra soft multifilament synthetics. while I have had other issues in my older age, TE has not been one.(touch wood)
 

Raul_SJ

G.O.A.T.
I'm not sure what the confusion is on your part. What you think should happen, that the wrist would be in extension or the same position after ball impact was NOT found to be true in +TE group. This group demonstrated a more flexed position of their wrist after ball impact.

Do you think the researchers are wrong with what they found?

Yes, you are correct.

I was just initially somewhat in disbelief that intermediate level players would be flexing their wrists upon impact, as it seems like such an obvious awkward uncomfortable position.
 

Tight Lines

Professional
Same here. I never had any issues in my life until I used Kevlar strings. That was in the early 2000's. From what I've seen, most people who get tennis elbow use stiff equipment...technique is not necessarily the cause.

IMO, it's usually a combination of equipment and not so good tennis stroke mechanics. It is entire possible that your soft string and racket may be hiding the bad stroke mechanics.

How do I know? Pros hit with poly strings all the time and they have no problems with TE. Before someone says yeah but they rip out the poly after a few hours of use, I don't think that matters much IMO.

Harry
 
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