Why Do Some People Seem More Prone to Tennis Elbow Than Others?

I'm trying to figure out what the root cause of my tennis elbow is. I seem to be exceptionally sensitive to racquets/strings compared to others and I'm trying to figure out why. It's quite literally painful that I cannot use stiffer frames that really improve my game, like the Pure Aero or Head Boom, because of these tennis elbow and shoulder issues. I'm not saying that I have a godly physique or perfect technique, but I certainly think I'm much more strong/fit than the typical rec player and have decent timing for my level. That said, these same guys are able to play with a Pure Drive for hours while my shoulder starts howling in pain when I play with even an Ezone 100, which isn't that stiff.

I've basically figured out from all my demoing that I cannot play with frames stiffer than 63 RFA, which feels extremely limiting. I'm just trying to figure out what else I could be doing that's causing these issues. I know I can still get better at hitting the sweet spot, but I also don't think the standard for being able to use a stiffer frame should be hitting the ball as cleanly as Jannik Sinner or something. That's just not realistic. I strength train, stretch, ice, etc., so what else can I do to fix my ailing arm?
 

Rosstour

G.O.A.T.
How old are you and what ethnicity? lol

Some ppl are more prone to soft tissue injuries than others.
 
34 and Asian. I've had these issues forever - even when I was playing as a junior. I don't think it's purely an age thing in my case

Just to add - I understand that genetics can be wild and some people win the lottery while others don't. Since I can't control my genes, I'm just wondering if there's anything else I could be doing that's giving me so much problems so I can fix it. I don't want to have to quit playing tennis again, but I'm fearing I may have to since I'm not getting younger and my shoulder and arm pain seem to be chronic issues.
 

socallefty

G.O.A.T.
I assume you don’t play with dead poly - if not sure, search for and read my PSA thread.

I would suggest having a good coach look at your BH in case you always get pain on the outside of your elbow which is tennis elbow. If you get pain on the inside which is golfers elbow, it is your serve that should be looked at. If you have a 1HBH, this research paper might be interesting.

 

Rosstour

G.O.A.T.
34 and Asian.

Dude this is a hard subject but as soon as I read your post I thought so and that is why I asked. For whatever reason I have noticed a higher susceptibility to soft tissue injuries in this group. I could be totally wrong but look at the pros. Injuries galore and aside from Yao's stress fractures, all soft tissue injuries. Maybe a coincidence but maybe not.

If you can't play with higher than 63RA, you know what to do. Also thinner strings at lower tension, bigger grip, and use a shock absorber.

I play with a Clash v1, Volkl Cyclone Tour 17@40lb, grip size 3 with an overgrip. I still get pain in my shoulder and biceps but it's not getting worse and I can whack the ball again.
 
I assume you don’t play with dead poly - if not sure, search for and read my PSA thread.

I would suggest having a good coach look at your BH in case you always get pain on the outside of your elbow which is tennis elbow. If you get pain on the inside which is golfers elbow, it is your serve that should be looked at. If you have a 1HBH, this research paper might be interesting.


What constitutes dead poly? I guess I am using the wrong term - sounds more like golfer's elbow. My main is mainly in the shoulder and biceps that leaks down to the elbow and wrist if it's really bad.

Dude this is a hard subject but as soon as I read your post I thought so and that is why I asked. For whatever reason I have noticed a higher susceptibility to soft tissue injuries in this group. I could be totally wrong but look at the pros. Injuries galore and aside from Yao's stress fractures, all soft tissue injuries. Maybe a coincidence but maybe not.

If you can't play with higher than 63RA, you know what to do. Also thinner strings at lower tension, bigger grip, and use a shock absorber.

I play with a Clash v1, Volkl Cyclone Tour 17@40lb, grip size 3 with an overgrip. I still get pain in my shoulder and biceps but it's not getting worse and I can whack the ball again.
I play with full poly, but I'm guessing I need to change that. That also sucks because I'm a string breaker and polys save me a lot of stringing cost. I'm wondering if there's durable, spin-friendly, and affordable multis or softer strings out there since I've never really researched them...
 

Rosstour

G.O.A.T.
What constitutes dead poly? I guess I am using the wrong term - sounds more like golfer's elbow. My main is mainly in the shoulder and biceps that leaks down to the elbow and wrist if it's really bad.


I play with full poly, but I'm guessing I need to change that. That also sucks because I'm a string breaker and polys save me a lot of stringing cost. I'm wondering if there's durable, spin-friendly, and affordable multis or softer strings out there since I've never really researched them...

I play with full poly too. Just thin, shaped, low tension poly in soft flexy frames.

Maybe look into poly mains and gut crosses. Low tension for both. Zverev does this I think

Edit--just read the first part and you don't have TE. You have biceps tendonitis, maybe tendonosis. Stop playing for a while and strengthen your lats and forearms. This is exactly what happened to me, and I ended up tearing my rotator cuff.
 

socallefty

G.O.A.T.
What constitutes dead poly? I guess I am using the wrong term - sounds more like golfer's elbow. My main is mainly in the shoulder and biceps that leaks down to the elbow and wrist if it's really bad.


I play with full poly, but I'm guessing I need to change that. That also sucks because I'm a string breaker and polys save me a lot of stringing cost. I'm wondering if there's durable, spin-friendly, and affordable multis or softer strings out there since I've never really researched them...
You just have to cut out poly - it is not a long-lasting string. Also have a coach look at your serve. If you bring up your racquet head too vertically, you’ll be prone to shoulder/elbow/arm issues. The racquet head tip has to be bent inwards tilted towards your head and then you swing outwards and up when you execute a serve motion properly.

I see a lot of players post that they got elbow/wrist/arm injuries and are debating whether to change their racquet - go lighter/heavier/more flexible etc. If they mention their string is poly, they get a litany of people saying they should not use poly. They rarely mention if they cut out their poly before it goes dead while I think playing with dead poly is a major cause for injuries. So, I wanted to post this Public Service Announcement (PSA) and am intentionally posting it in the racquet section as if you follow it, you won’t need to change your racquet.

PSA - Cut out your poly before it goes dead. Very few players are high level enough to break their poly before it goes dead and this includes 95% of rec players because stiff old-school poly goes dead in 5-10 hours and softer polys go dead in 10-25 hours (shorter duration the harder/heavier you hit or if you play only singles). If you play with dead poly, it WILL injure you and control will be erratic in addition to feel being ‘crappy’ so that it also compromises your performance - this is not the way to save money as medical/PT bills cost a lot.

How to know if your poly is dead? If you feel any tightness (even before pain) in your wrist/arm/elbow, the poly is dead. Cut it out before you develop any soreness/pain. If you play with the same string and tension, make sure you make a note of how many playing hours you played with it and cut it out in advance of that for future stringjobs. You should also be seeing erratic control and a worsening in feel, but this may be harder to spot if you are low-level or don’t play often - surest sign of dead poly is your body talking to you and telling you it feels tight or sore. This rule still applies in a hybrid stringjob as poly goes dead in hybrids also and you should cut it out if your wrist/arm feels tight even before you develop pain. If you get any pain, please ‘for the love of God’ cut out your strings and don’t try to coax a few more hours out of your stringjob. If you strung your poly many months ago and didn’t play with it much, be extra wary as poly can go dead quicker just from being under tension (strung in a racquet) for a long time - so you might feel tightness in your wrist/arm quicker and need to cut out an old stringjob sooner than normal. Don’t keep your backup racquet strung with poly in your bag without playing with it for many weeks and months as you are wasting the stringjob.

Other causes of injury:
  • Playing poly at high tension. Most polys (especially newer soft polys) play well at tensions in the low-mid-high forties (lbs) of tension and there is no reason to go higher. Most players below college level who play with higher tensions do so because they were used to stringing in the fifties with soft strings and think dropping 4-6 lbs is enough with poly. If you try lower tensions, you will see that comfort goes up a lot, control doesn't go down too much and you can play many hours longer with a poly stringjob before you feel discomfort. Be bold and try 40-44 lbs before you knock it or go back to higher tensions.
  • Racquets weighing below 10 ozs and above 12 ozs unstrung (as printed on the racquet) should be avoided as you have to be very small/weak or very big/strong to need racquets outside the weight range of 10-12 ozs to play well.
  • Racquets with RA stiffness above 70 unstrung or VF above 155Hz might be good to avoid if you have a history of injury. But if you string poly properly (low tension, cut it out before it goes dead), you might be fine anyway.
Some other points to reduce the risk of injury.
  • If you don’t hit too many winners on serves/groundstrokes and play (bunt) at a low level, you probably could play with soft strings and avoid poly as you have to hit hard to get the effects of increased spin/control. Please don’t play with poly because you don’t break it for a long time or because it doesn’t move when you play with it unlike soft strings - you should cut it out before you feel tightness/pain and then it doesn’t last long either. Play with poly only if you like the extra control and spin.
  • Try thin gauges of poly also as they have more comfort and power compared to thick gauges. Only high level players who break poly before it goes dead need to think about playing with 15g poly.
  • Change your tennis balls often and understand that if you play with low pressure balls for multiple matches or practices, this can contribute to injury. Serve practice with very old balls is bad for the shoulder.
  • If you are currently injured, rest long enough to not feel ANY pain before you start playing again. When you restart, you might not need to change your racquet or strings except possibly the gauge and tension as long as you follow the PSA.
  • Lastly, change your shoes often too if you are feeling knee/foot/calf pain or Achilles tightness that you did not feel when the shoes were new. These days, shoe soles last a long time and don’t wear out before the shoe support wears out. Also if you tighten your shoe laces too much to make old shoes that have loosened up ‘fit’ better, you run the risk of plantar fascitis injury. If your lower body is talking to you in the form of pain, listen to it and replace your shoes. If you get leg/knee pain just after you switched to a new shoe model, change back to a shoe model you are used to and see if the pain goes away. Some shoe designs (especially heel drop, arch support) might not be suitable for your feet. Also in some shoe models, you might need to size up half a size and wear thick socks to have a good fit.
Enjoy pain-free tennis by following the PSA. Then you can ignore the ’witch doctors’ who don’t follow the PSA and tell you to avoid heavy racquets, medium-stiff racquets, poly strings etc. that you like to play with. I‘ve played everyday for almost fifteen years with Babolat racquets/poly hybrids on hard courts in my forties/fifties (when I’m not traveling) without repetitive/overuse injuries by following my equipment guidelines although it took me a few years to figure out that some shoe models/old shoes can cause injury.

This message is not sponsored by your local orthopedic surgeon or physical therapist, but should be sponsored by your local stringer who hopefully strings for you more often.
 
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ey039524

Hall of Fame
Ditch the full poly. Look up monogut zx, if you want the same string snapback spin. Most people don't like it as a full bed. I use it as a cross.

Also, not sure what tension you're using, but lower it.

There are a world of frames <63 ra. At 34, and if you have good technique, you don't need a lot of power from your frame.
 

jxs653

Professional
"... these same guys are able to play with a Pure Drive for hours while my shoulder starts howling in pain when I play with even an Ezone 100, which isn't that stiff."

I developed shoulder problem first time in my life when I began to use 29 inch frame, again first and only time in my life, which taught me shoulder health is related with swingweight rather than stiffness. That was my case anyway.
 

PKorda

Professional
So you have both tennis elbow and shoulder issues, that's not great. Sounds like you do some strength training but I'd schedule an appointment with a physical therapist to get advice on how to make it more effective to address your issues, need to focus on strengthening your tendons. Also get a theraband (green one, 15 bucks on amazon). Technique prob has something to do with it. Changing string/tension can help as mentioned above.
 
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I'm trying to figure out what the root cause of my tennis elbow is. I seem to be exceptionally sensitive to racquets/strings compared to others and I'm trying to figure out why. It's quite literally painful that I cannot use stiffer frames that really improve my game, like the Pure Aero or Head Boom, because of these tennis elbow and shoulder issues. I'm not saying that I have a godly physique or perfect technique, but I certainly think I'm much more strong/fit than the typical rec player and have decent timing for my level. That said, these same guys are able to play with a Pure Drive for hours while my shoulder starts howling in pain when I play with even an Ezone 100, which isn't that stiff.

I've basically figured out from all my demoing that I cannot play with frames stiffer than 63 RFA, which feels extremely limiting. I'm just trying to figure out what else I could be doing that's causing these issues. I know I can still get better at hitting the sweet spot, but I also don't think the standard for being able to use a stiffer frame should be hitting the ball as cleanly as Jannik Sinner or something. That's just not realistic. I strength train, stretch, ice, etc., so what else can I do to fix my ailing arm?

heard ppl said 'tennis played by legs' n it's absolutely true ie arm/wrist/hand only being there to pass on the power generated by legs/hips n retaining the rkt for the next shot or let the rkt go if u'r sure the ball's not coming back lololololol.........

go get some rkt length sticks to throw as far as u can then find an old rkt to throw it away as far as u can forehandly/backhandly n u'l feel it8-B8-B8-B8-B8-B8-B8-B8-B8-B8-B8-B8-B8-B8-B8-B8-B.................
 

SystemicAnomaly

Bionic Poster
What constitutes dead poly? I guess I am using the wrong term - sounds more like golfer's elbow. My main is mainly in the shoulder and biceps that leaks down to the elbow and wrist if it's really bad.


I play with full poly, but I'm guessing I need to change that. That also sucks because I'm a string breaker and polys save me a lot of stringing cost. I'm wondering if there's durable, spin-friendly, and affordable multis or softer strings out there since I've never really researched them...
Golfers Elbow typically occurs when your grip force is too high -- particularly when employing a lot of wrist actions.

To minimize GE your grip force should be RELAXED most of the time. Your perceived grip effort should not be much more that 2 out of a max of 10 (full grip effort) most of the time. Grip force naturally increases very shortly (~50 ms) prior to contact. Even then, grip effort should normally not be much higher than 5 or 6 out of 10 -- that's about 1/2 of max grip force.

Immediately after hearing your contact, your grip pressure should be relaxed again.
 
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