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Ask the Lab: Tennis Elbow

PLEASE NOTE: The medical opinions in USTA.com's Ask the High Performance Lab are responses intended for the average player. Please consult with your primary physician before beginning any new exercise program.

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From: David T., Georgetown, DE: I'm sure this question has been posed hundreds of times but I have developed what my doctor describes as tennis elbow. The pain eminates from the top of my elbow. It seems to come from the bone or in close proximity. I have been through three weeks of physical therapy consisting of stretches and small weight exercises. It hurts worse. Some people tell me to rest it completely, some say light exercise. Any advice?

Mary Jo Campbell: David, thanks for your question, it is a great one!  As I read your letter I was reminded of another player who having been treated for his shoulder injury with complete rest noticed that his tennis elbow of 2 years disappeared!!  There is something to be said for listening to your body, and pain is definitely a message that you should heed.

Rest alone will not guarantee that the lateral epicondylitis will not return.  It is sometimes caused by an acute or sudden injury but more often it is related to repetitive stresses and overuse of the wrist extensor muscles.  There are several factors to consider for total treatment of this condition:

1) Check your stroke mechanics. Seek help from a certified professional to find the flaw in your mechanics and to ensure that you have the proper sized racket.  Increasing the size of the racket head can increase the size of the ‘sweet spot’ and hence, decrease the amount of vibration.  Tight strings and even the playing surface can also contribute as stressors.

2) Strengthen the surrounding shoulder and forearm musculature while you are healing and it will help to prevent a recurrence.  If pain persists during exercise, total rest is advised.

3) If symptoms persist, seek medical attention.  You may need to consider more aggressive treatment than the above conservative modes.  Non-steroidal, anti- inflammatory medicines or even cortisone injections may be indicated.

Below are some of my favorite shoulder and wrist exercises that may help to prevent this overuse injury.  Thanks for your question, David and good luck!


 

Wrister Roller - Wrist Flexion and Extension



Ulnar Deviation



Neutral Position




Neutral Position


 

Wrist Pronation




 

Wrist Supination



 

Radial Deviation




 

90/90 Ball Drops




Release and Catch Ask the Lab




Stick Em Ups Starting Position




Ending Position - Scapular Retraction and Depression



All exercises can be performed three times per week.  Two-three sets of 15-20 repetitions, very light weight.

 

About the Author:

The answers to this week's Ask the High Performance Lab are provided by Mary Jo Campbell, MEd, ATC, CSCS. Campbell serves as the USTA Strength and Conditioning Coach/Athletic Trainer at the USTA West Coast Training Center in Carson, CA.


 
 
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