Which stroke is worst for tennis elbow?

TypeRx

Rookie
Traditional tennis elbow:
1. One-handed backhand (esp. if arming the ball and hitting late)
2. Backhand volley
3. Two-handed backhand (with particularly bad form)

Traditional golfer's elbow:
1. Forehand (esp. if arming the ball and hitting late)
2. Serve (flat for sure)
3. Forehand volley
4. Overhead (only because it is similar to the serve)

Really, I think it is ground strokes that contribute directly to both of these tendon over-use injuries. Serves/volleys/overheads just tend to hurt when you are already injured.
 
So, ironically, most players hit FH more than any other shot, particularly guys who just baseline rally for an hour.
Yet, the FH is least likely to cause TE.
 

TypeRx

Rookie
So, ironically, most players hit FH more than any other shot, particularly guys who just baseline rally for an hour.
Yet, the FH is least likely to cause TE.
Please don't take my response as definitive!! o_O

The most important thing is that you don't get TE or GE from a single bad shot (even though you might think that one mishit caused it...). It is a repetitive strain injury. I had moderate+ GE that developed a couple months after coming back to tennis (after a 20 year hiatus). It took 6-7 months to resolve and I kept playing through it. I worked hard to improve my technique and emphasized warmup, cooldown, stretching, strenghtening, anti-inflammatories, and equipment changes. I've been GE free for almost a year now and play 5-7 times/week.

On a side note, I also developed GE years back from washing/detailing cars and intense household cleaning. It is the "wax on, wax off" scrubbing that did me in....
 

dxrysiko

New User
  • FH
  • BH (2HBH? 1HBH?)
  • Volley
  • Serve (Flat? Kick?)
  • Overhead
Rank em!
For me what caused it was clearly bad form 1HBH along with a PD+polly at high tension.
Stroke hurting the most during TE was the BH-volley and OH
Stopped playing for 3 months, took PT's
Changed to a 2HBH with coach, sold the PD bought an Angell (matching specs of the PD, except stifness). That was November 2018
All good now.

If you need ranking:
1. BH Volley
2. Overhead
3. BH (1HBH)
4. FH Volley
5. Serve (Flat, Kick)
 

Cawlin

Semi-Pro
When my TE was flaring up, 1HBH TS was the worst, then BH volley - then flat serve, then kick serve, then BH slice, then slice serve seemed not so bad - but probably only because I could get decent pace and movement on it even with an easy swing. FH didn't hurt much at all relative to anything else.
 

MisterP

Hall of Fame
Please don't take my response as definitive!! o_O

The most important thing is that you don't get TE or GE from a single bad shot (even though you might think that one mishit caused it...). It is a repetitive strain injury. I had moderate+ GE that developed a couple months after coming back to tennis (after a 20 year hiatus). It took 6-7 months to resolve and I kept playing through it. I worked hard to improve my technique and emphasized warmup, cooldown, stretching, strenghtening, anti-inflammatories, and equipment changes. I've been GE free for almost a year now and play 5-7 times/week.

On a side note, I also developed GE years back from washing/detailing cars and intense household cleaning. It is the "wax on, wax off" scrubbing that did me in....
I got GE when I was learning the serve. The way I understood pronation was that it should be a deliberate, violent action. I took that to the extreme to the point that I was finishing all of my serves on the right side of my body (I'm a righty).

It's better now. Looser with more power, spin and control. Now, if I could just get my legs working a little better.
 

tennishabit

Professional
  • FH
  • BH (2HBH? 1HBH?)
  • Volley
  • Serve (Flat? Kick?)
  • Overhead
Rank em!
funny survey man:)))..........it varies from none to some n all to some....lolololol man. u can't do the survey like which brand cars'r more prone to road accident:)))............it's all depending on the drivers ie their driving skills:))).................
 

ollinger

G.O.A.T.
Tennis elbow is most often the result of gripping tightly while the elbow is bent. It's most often seen in people who write (with a pen or pencil) a large amount of time, bicyclists who grip the handlebars too tightly with bent elbows, construction workers who grip tools tightly with bent elbows a good part of the day, and occasionally tennis players. Technique is problematic if one hits the backhand with a very bent elbow. But any tennis stroke in which tight grip and bent elbow occur simultaneously will increase the risk.
 

Crocodile

Hall of Fame
Backhand volley and one handed backhand followed by serve.
Not having balanced kinetic chain and physiology will do this and the real big factors is this:
1. Suddenly increasing Volume, intensity and frequency in activity will give you an injury as will:
2. Light, stiff, head heavy racquets with small grips and poly strings.
 
Traditional tennis elbow:
1. One-handed backhand (esp. if arming the ball and hitting late)
2. Backhand volley
3. Two-handed backhand (with particularly bad form)

Traditional golfer's elbow:
1. Forehand (esp. if arming the ball and hitting late)
2. Serve (flat for sure)
3. Forehand volley
4. Overhead (only because it is similar to the serve)

Really, I think it is ground strokes that contribute directly to both of these tendon over-use injuries. Serves/volleys/overheads just tend to hurt when you are already injured.
I kind of agree (y) Hitting late 1HBH kind of is difficult habit for people to get out of, which is compounded by it being the longest groundstroke. So often people will go for more and more, stop even using their legs while holding the racket tighter and tighter - eventually that has to result in a bad condition :(:(
 

sredna42

Hall of Fame
Traditional tennis elbow:
1. One-handed backhand (esp. if arming the ball and hitting late)
2. Backhand volley
3. Two-handed backhand (with particularly bad form)

Traditional golfer's elbow:
1. Forehand (esp. if arming the ball and hitting late)
2. Serve (flat for sure)
3. Forehand volley
4. Overhead (only because it is similar to the serve)

Really, I think it is ground strokes that contribute directly to both of these tendon over-use injuries. Serves/volleys/overheads just tend to hurt when you are already injured.
Good post.
1hbh was killing my TE, so switched to a 2hbh (mostly left hand)

Now i have murderous GE. Really bad. 100% it is late/armed forehand and serve.
 

tennishabit

Professional
Tooo small grip or big grip?
Which is worse?
whatever tighten ur hand/finger muscles/joints ie 'death grip'. most likely te won't haunt u if u hit 000s everyday n rkt flying often n smashed/cracked, ie extremely loose grip:))).......personal experience:)))
 
Last edited:
Now i have murderous GE. Really bad. 100% it is late/armed forehand and serve.
I had GE from a mishit when I first started playing.
It went away fast, and is nothing like TE
Just give it a month or two of rest, and I bet you'll be ok.
TE is more the forearm muscle, while GE felt like the elbow joint itself.
 

TypeRx

Rookie
I had GE from a mishit when I first started playing.
It went away fast, and is nothing like TE
Just give it a month or two of rest, and I bet you'll be ok.
TE is more the forearm muscle, while GE felt like the elbow joint itself.
While everyone's presentation/severity/recovery experience is different, GE and TE are absolutely very similar. Both are caused by injury to the tendons near the elbow, usually at insertion points that impact the wrist/hand/forearm and less commonly the triceps/biceps. Both are usually the result of overworking a muscle or muscle group that then causes micro-tears to the tendon that connects that muscle group to bone. And they are not typically caused by a single insult - these are repetitive strain injuries. I think it is easiest to describe TE kind of like when you hit your funny bone (outer elbow point\/lateral epicondyle) whereas GE is like a sore inner elbow point (medial epicondyle). Sometimes TE and GE are confused for injuries to other tendons (e.g. triceps tendonitis).

GE can be very bad as can TE. In my case with GE, I had difficulty at times with basic activities. For instance, I couldn't comfortably rest my elbow on my chair armrest. I couldn't vacuum the floors because of the forward-backward motion. I couldn't hold a shopping bag that weighed more than 10 lbs without discomfort. I couldn't participate in the batting cages or hit pop flys with my son because the vibration of ball-bat was killer. It sucked royally.

Resting through injury is generally good advice, but with tendon injuries you have to make sure to keep blood flow as high as possible to the affected area. So, regular and simple stretching/exercises, heat when possible, etc. are important if you choose not to continue with whatever activity contributed to it first. Like I mentioned above it took 6-7 mos for my GE to heal completely but I chose to keep playing while also working really hard on technique, equipment, rehab/strengthening, etc. I do wonder if I could have shortened my healing time by not continuing to play, but to be honest, I am not sure it would have mattered. My fundamental change in forehand technique, intense work with the Flexbar, and equipment changes really helped.
 

sredna42

Hall of Fame
I had GE from a mishit when I first started playing.
It went away fast, and is nothing like TE
Just give it a month or two of rest, and I bet you'll be ok.
TE is more the forearm muscle, while GE felt like the elbow joint itself.
I didn't play from late September til recently and the bloody GE is still there. I am going to try dry needling and a few other things to try relieve it. I had savage TE too when i started and took 6 months off tennis. From tennis and work. That pain was insane. Had no strength in my arm. Soft racquet, gut hybrid, 2hbh, green theraband, and endless arm stretching turned it around and its gone now.
 

atp2015

Hall of Fame
I didn't play from late September til recently and the bloody GE is still there. I am going to try dry needling and a few other things to try relieve it. I had savage TE too when i started and took 6 months off tennis. From tennis and work. That pain was insane. Had no strength in my arm. Soft racquet, gut hybrid, 2hbh, green theraband, and endless arm stretching turned it around and its gone now.
I think you will need to start doing strengthening exercises, it's very difficult to get it healed without regular treatment (self administered) and localized exercises.
 

atp2015

Hall of Fame
While everyone's presentation/severity/recovery experience is different, GE and TE are absolutely very similar. Both are caused by injury to the tendons near the elbow, usually at insertion points that impact the wrist/hand/forearm and less commonly the triceps/biceps. Both are usually the result of overworking a muscle or muscle group that then causes micro-tears to the tendon that connects that muscle group to bone. And they are not typically caused by a single insult - these are repetitive strain injuries. I think it is easiest to describe TE kind of like when you hit your funny bone (outer elbow point\/lateral epicondyle) whereas GE is like a sore inner elbow point (medial epicondyle). Sometimes TE and GE are confused for injuries to other tendons (e.g. triceps tendonitis).

GE can be very bad as can TE. In my case with GE, I had difficulty at times with basic activities. For instance, I couldn't comfortably rest my elbow on my chair armrest. I couldn't vacuum the floors because of the forward-backward motion. I couldn't hold a shopping bag that weighed more than 10 lbs without discomfort. I couldn't participate in the batting cages or hit pop flys with my son because the vibration of ball-bat was killer. It sucked royally.

Resting through injury is generally good advice, but with tendon injuries you have to make sure to keep blood flow as high as possible to the affected area. So, regular and simple stretching/exercises, heat when possible, etc. are important if you choose not to continue with whatever activity contributed to it first. Like I mentioned above it took 6-7 mos for my GE to heal completely but I chose to keep playing while also working really hard on technique, equipment, rehab/strengthening, etc. I do wonder if I could have shortened my healing time by not continuing to play, but to be honest, I am not sure it would have mattered. My fundamental change in forehand technique, intense work with the Flexbar, and equipment changes really helped.
Wow, small world - exactly my experience (without continuing to play part)and my thinking at this point on te and ge.
 

TypeRx

Rookie
What strengthening did you do for GE mate?
A gazillion reverse tyler twists and other exercises using the Flexbar. I would also use a spinning hand gyroscope thing to warm my elbow up in the car prior to mini-tennis, regular stretching with bands and without.
 
While everyone's presentation/severity/recovery experience is different, GE and TE are absolutely very similar. .
If that is the case, I don't think I had GE.
My TE is strain along the entire big forearm muscle, not just the elbow joint.

The inner elbow thing I had was almost like the inner "funny bone"
I had pain ONLY at the ground zero in the diagram,
and was localized to the joint, not the surrounding muscle, like with TE

So, I probably did not have GE at all, if GE is like TE (inner forearm muscle)
And it went away pretty quickly, unlike TE or real GE.

 

TypeRx

Rookie
This looks silly
Haha, I do it in the privacy of my car while driving to the courts. It definitely gets blood flowing to your flexors, extensors, and forearm muscles. However, there are other ways to accomplish this if you don’t like this method.

PS - my kids (13 and 10) find it fun to play with the gyro ball as well. I am okay with that - it improves grip strength for sure


Sent from my iPhone using Tapatalk
 

TypeRx

Rookie
If that is the case, I don't think I had GE.
My TE is strain along the entire big forearm muscle, not just the elbow joint.

The inner elbow thing I had was almost like the inner "funny bone"
I had pain ONLY at the ground zero in the diagram,
and was localized to the joint, not the surrounding muscle, like with TE

So, I probably did not have GE at all, if GE is like TE (inner forearm muscle)
And it went away pretty quickly, unlike TE or real GE.

It probably wasn’t a tendon tear if it resolved quickly - maybe just transient inflammation. GE is nearly identical to TE, just on the opposite side of the joint. And just remember, while TE and GE are both due to muscle overuse, it is the damaged tendon (micro tears) that causes the prolonged pain and healing time.


Sent from my iPhone using Tapatalk
 

sredna42

Hall of Fame
Is your GE aggravated from daily work? I feel bad for a workman who can't rest his injury due to working. That really sucks.
My GE isn't. I can actually get by through the day and not notice it much, until I play tennis or go to the gym or indoor climbing. TE though got so bad i couldn't sleep.
 

antonmartin

New User
The only stroke I feel it on during play is serve. Unfortunately my serve is probably my best shot, so it’s also painful to have to scale it back for the sake of my arm and I have trouble making myself do that. I would say too much volley work is also bad for the elbow. I grip the racket tight for volleys which probably doesn’t help.
 

Raul_SJ

Legend
I use a very flexible heavy racquet with low power to help prevent TE. Not gripping tight on volleys.
But sometimes I will be at net and opponent hits a bullet and I hit off-center, (backhand volley I think), and I feel the vibrations go straight up my arm to the elbow.
:(
 

antonmartin

New User
I use a very flexible heavy racquet with low power to help prevent TE. Not gripping tight on volleys.
But sometimes I will be at net and opponent hits a bullet and I hit off-center, (backhand volley I think), and I feel the vibrations go straight up my arm to the elbow.
:(
what's you advice for how to not suck while hitting volleys with a loose grip
 

tennishabit

Professional
Tennis elbow is most often the result of gripping tightly while the elbow is bent. It's most often seen in people who write (with a pen or pencil) a large amount of time, bicyclists who grip the handlebars too tightly with bent elbows, construction workers who grip tools tightly with bent elbows a good part of the day, and occasionally tennis players. Technique is problematic if one hits the backhand with a very bent elbow. But any tennis stroke in which tight grip and bent elbow occur simultaneously will increase the risk.
problems i had:
1. rackets flew away, smashed/cracked due to fast swing (circular acceleration), my loose grip n sweat in summer
2. calluses on the fingers
3. kept wasting time to ask myself why spent time/$ to re-grip, to protect the stick instead of my hand/fingers:?)))

my solution:
https://www.facebook.com/photo.php?fbid=2026509460945345&set=g.2369373923&type=1&theater&ifg=1

https://www.facebook.com/photo.php?fbid=2026509390945352&set=g.2369373923&type=1&theater&ifg=1

pro:
1. rkt never flew again
2. never re-overgrip or any grip at all n save time/$ to re-grip n $2 spent on gloves instead of grips
3. sweat absorbed very well by cotton glove, much better than wrist band
4. most of calluses gone, though the last 3 calluses seem very hard to get rid off:(((............

con:
1. cheap garden gloves look ugly.....but, hey...who cares:?)))
2. my dominant hand has less exposure to sunshine n bit 'white'.....a bit weird:)))..........
 

jhick

Professional
When I had bad TE, I could not hit a 1 HBH slice, I had to scrap it completely and only hit 2 HBH. That was probably the worst, followed by the serve. Also, any mishits were really bad.
 

antonmartin

New User
Played at a two-hour group clinic this morning. Observations:

1) discomfort on forehands at first, but overall not bad
2) volleys are problems, maybe backhand volley especially but not sure. the clinics include a good deal of volley work and I inevitably hit the frame a few times during them.
3) two-handed backhand is maybe the only problem-free stroke
4) I very intentionally restrained my serve and as such did not have much irritation from it. this is usually where i can feel it most

But I won't really know how much damage I've done until 48-72 hours later, usually the way it works.... though I don't feel like I over did it today.
 
Every mechanically incorrect and inefficient stroke.
I'm not too sure about that.
People play for decades with garbage strokes and don't get TE.
Kids who never took a lesson play with junk strokes and don't TE
I played for 2 years, and my form was the best once I got TE.

I personally think its an overuse injury.
I will be taking more rest days this season, and staggering drills across days.
 

FiReFTW

Legend
I'm not too sure about that.
People play for decades with garbage strokes and don't get TE.
Kids who never took a lesson play with junk strokes and don't TE
I played for 2 years, and my form was the best once I got TE.

I personally think its an overuse injury.
I will be taking more rest days this season, and staggering drills across days.
Yes its an overuse injury i agree completely.

Im just saying that if your technique is so that ur really stressing that part of the muscle then it can happen with less usage.
 

tennishabit

Professional
Yes its an overuse injury i agree completely.

Im just saying that if your technique is so that ur really stressing that part of the muscle then it can happen with less usage.
absolutely ture. i've been playing with a lot of different players of all levels n most of them got te/ge. most of them only play once or twice a wk n due to their comp/matches ofc they have to do whatever takes to win so quite tense with stiff arm/wrist muscle/joints which directly contribute to the te/ge.......for me personally my arm/wrist/hand most of time only function like guiding/sensor system which directing the power, already generated mainly by legs drive, body weight shifting n pivot/shoulder rotation, properly onto the ball to make the shots.

ie don't try to use the radar/sensor/guiding batt ps system to taxi ur jet to the run way poising 'taking off' n 'flying' as they're not ur jet-engine n ur jet will never ever take off from the ground if u don't use ur jet-engine n cause instant damage if u try to use full power of the radar/sensor/guiding system to move ur jet........lolololol man oh man:)))).................
 
Last edited:

antonmartin

New User
I'm 29 and got TE and I think GE from playing like twice a week, on average less. You can get it from having sticks for arms and returning to the game after 12 years. I have no doubt that form is involved too. After about 2 months of flexbar, I have much more defined muscles near my elbow on my forearm (seriously!). I hope this ends up making some kind of difference.
 

antonmartin

New User
Played at a two-hour group clinic this morning. Observations:

1) discomfort on forehands at first, but overall not bad
2) volleys are problems, maybe backhand volley especially but not sure. the clinics include a good deal of volley work and I inevitably hit the frame a few times during them.
3) two-handed backhand is maybe the only problem-free stroke
4) I very intentionally restrained my serve and as such did not have much irritation from it. this is usually where i can feel it most

But I won't really know how much damage I've done until 48-72 hours later, usually the way it works.... though I don't feel like I over did it today.
....annnddddd I'm sore! This is so lame. I'm at work right now with an ice pack strapped to my arm. I'm not in pain but that could kick in tonight or tomorrow night even.
 

tennishabit

Professional
....annnddddd I'm sore! This is so lame. I'm at work right now with an ice pack strapped to my arm. I'm not in pain but that could kick in tonight or tomorrow night even.
lololol man, 'an ice pack strapped to my arm' for what:?)) stop blood circulation:?)))........
 
Top