When I’m not with my personal training clients, I’m on the tennis court. Like thousands of people in London, I love playing tennis, but back in 2005 I got a bad case of tennis elbow. Here’s my story:
The Andy Roddick Serve
Impressed with the speed and power of Andy Roddick’s serve, I thought I would try to reproduce it myself. The next day I experienced really painful twinges in the elbow of my hitting arm. As a personal trainer with clients all over London to train, this was a real nuisance, as it meant I was inhibited in my ability to demonstrate certain exercises.
Tennis Elbow: Lateral Elbow Tendinosis
I had dynamically overstretched the tendons in the lateral aspect of my elbow. The Andy Roddick serve is a rapid whiplike action, and if you dive in at the deep end with this action, tennis elbow is the likely result.
I felt the pain most when I entered and left full extension of the elbow, where the radius (one of the two bones of the forearm) meets the humerus (the bone of the upper arm). Strangely, rotation of my forearm felt fine. The pain was worse when I clenched my fist while extending and flexing my elbow, and when I dorsiflexed my wrist against resistance. The pain radiated down the outside of my forearm.
The tendon I had injured was the ECRB: extensor carpi radialis brevis, the most common tennis elbow injury caused by actually playing tennis. The other tendon often injured is the extensor digitorum communis, diagnosed by experiencing pain when raising your middle finger against resistance.
One of my personal training clients in north London who was a keen tennis player, had experienced a similar tennis elbow injury some years previously, and had several sessions with his physiotherapist. These were his recommendations:
Treatment of tennis elbow
- rest the elbow until you are pain-free (this can take several months
- ice the area twice a day for 20 minutes per session, using a bag of frozen peas (wrapped in a dry tea towel to avoid ice-burn) during the acute inflammation phase
- Gently massage the area after the acute pain has subsided, using massage oil and your other hand, to help stimulate blood flow to the area, dispel waste products, and to stretch the muscles gently.
- Stay active and exercise regularly, but avoid straining the elbow. There are so many exercises you can do which do not impact the tennis elbow, so don’t use it as an excuse to stop exercising.
- Start rehab exercises as soon as pain has significantly reduced, to stretch and strengthen the muscles and tendons round the wrist and elbow
Rehab exercises for tennis elbow
- strengthen wrist extensors with wrist extension against resistance: palm downwards, sit with forearm resting on knee with hand hanging over knee, grip light dumbbell, and raise upwards for 15 reps.
- stretch wrist extensors: (straight arm, push wrist forwards, hold 20 secs, feel stretch along top of forearm) – this targets the tennis elbow tendons.
- Elastic band round fingers, stretch fingers apart under resistance
Change your tennis technique
There are many ways you can improve your technique to prevent tennis elbow:
- hit the ball more out in front, so your elbow takes less of the impact and strain
- don’t ‘muscle’ the ball, but make your swing more relaxed and use the kinetic chain of energy to generate power ,ie use your whole body optimally
- improve your footwork so you’re better set-up for taking each shot
Equipment changes to reduce risk of tennis elbow
- looser strung racket
- racket with larger sweet spot
- don’t play with wet tennis balls
Dominic Londesborough is a personal trainer in London and keen tennis player