What is Tennis Elbow?

Understanding the mechanics behind tennis elbow and how to reduce strain

Tennis elbow, or “lateral epicondylitis”, refers to inflammation of the common extensor tendon and its attachment to the lateral epicondyle (bony bump on the outside of the elbow). The tendon is the attachment of all the muscles in the forearm that extend (raise) the wrist and fingers.

These muscles are critical for the grip that is needed to hold the racquet: fun fact, make a strong fist and note your wrist immediately extends to improve the strength and mechanics of the flexor muscles on the other side. Try gripping tightly without that extension of the wrist and your power immediately drops off.

Tennis elbow may be caused by several factors, including sustained forceful gripping, and the sudden stretch transferred to the muscles on impact with the ball. Racquet design and stringing of the racquet can be important considerations in avoiding or overcoming tennis elbow.

Changing grips often is another key consideration: if the grip is slippery or worn out, you will need to grip tighter to maintain control of the racquet, thereby increasing the risk of causing or exacerbating tennis elbow. A new, “sticky” grip allows you to loosen your grip, thereby reducing this risk.

Tennis elbow is seldom caused by weakness in the forearm muscles. However, eccentric strengthening can help you avoid or overcome tennis elbow. Eccentric strengthening implies that the muscle is lengthening as it contracts, as opposed to being static or shortening during the contraction.

To do this, rest your forearm on a table with your hand, palm down, extending past the edge of the table. Put the wrist in extension (wrist bent backwards) and place a weight (3 to 8 lbs.) in the hand; lower the weight towards the floor then release the weight. Repeat to the point of fatigue. This results in lengthening the extensor muscles and is preferable to static stretching.