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  • Hand Therapists Serve Up Advice to Avoid Injury

  • Game, Set, Match: Preventing Tennis Elbow

    Hand Therapists Serve Up Advice to Avoid Injury

    Lateral epicondylitis, or “tennis elbow,” is a type of tendonitis that causes pain in the elbow and arm. It affects approximately one-third of the tennis population, from beginners to professionals.

    Though it is the most common injury among those who play tennis, tennis elbow can be brought on by other repetitive wrist extension tasks such as gardening, golfing and overuse of computer keyboards.

    Individuals suffering from tennis elbow may report that they have pain at the outer side of the elbow while performing activities using the hand or wrist. As a result, daily activities such as typing, ironing, vacuuming, writing or even lifting a coffee cup may become too painful to perform. For tennis players, some of the causes of tennis elbow can be playing too long or too frequently, poor stroke mechanics with the back hand swing, improper equipment relating to grip size, string tension, racket weight, frame rigidity or the length of the racket.

    The following can help you avoid tennis elbow:

    When Playing Your Game

    • Avoid poor body positioning with the elbow leading the racquet.

    • Avoid “wrist flick” motions when striking the ball. Especially during the serve, do not turn the palm down and flick the wrist at impact.

    • Avoid striking the ball late. Especially during backhand, strike the ball when it is beside your body and keep your wrist in neutral to slight extension.

    • In order to correct poor body positioning and stroke mechanics, request instruction or advice from a tennis professional.

    • Strengthen your core muscles, shoulder stabilizers, rotator cuff muscles and leg muscles to increase the power of your hit using your trunk, shoulders and lower body.

    • Try a two-handed backhand to relieve stress placed on the forearm extensor musculature that originates at the elbow. These are the muscles that are contributing to the pain.

    • Stretch and warm up before your match and then ice the elbow area well after your match. This will help decrease the chances of inflammation and re-injury.

    • Try playing on a clay court rather than asphalt. The slower court surface helps to slow the ball down and lessen the impact on your racquet. Replacing tennis balls regularly also decreases impact related stresses to the arm.

    When Choosing and Maintaining Equipment

    • A smaller head racquet and/or a tightly strung racquet may require more exertion from the forearm musculature. Try a mid-size to larger head racquet in order to provide a larger impact area or “sweet spot” for the ball. A lighter racquet may decrease stress on the arm as well.

    • Make sure your grip is not too small. Avoid gripping your racquet too tightly.

    • Grip size should be chosen by measuring the distance from the crease of the palm to the tip of the ring finger.

    • Professionals suggest string tension be at the manufacturer's lowest recommendation. Also, the string on the frame should be replaced approximately every six months.

    • Wear a counterforce brace while playing your match. The counterforce brace gives external support to the involved muscles and relieves stress on the area.
    Treatment for tennis elbow involves a combination of rest, change of activity, ice, massage and a rehabilitation program that will include instruction in appropriate stretching and strengthening exercises.

    Professional hand therapists are highly specialized physical or occupational therapists with expertise in the delicate and essential functions of the hands, wrists, arms and shoulders.

    Call 444-5178 for more information about hand therapy at Rhode Island Hospital.

    Source: American Society of Hand Therapists