HOW TO AVOID TENNIS ELBOW
If you are a frequent visitor to tennis courts, or have just taken up a new found love of tennis, there are some obvious aches and pains that come along with the fast, repetitive motion of this sport. The most common issue that can sideline you for a few months is Tennis Elbow (aka Lateral Epicondylitis).
According to the Cleveland Clinic, “Tennis elbow affects… 10-50% of tennis players during their career. Tennis elbow affects men more than women. It most often affects people between the ages of 30 and 50…” The ”itis” in Lateral Epicondylitis refers to inflammation, however, research is finding that it should be called Lateral Epicondylosis. This means that instead of one move irritating the elbow, it’s caused by repetitive strain. This constant motion slowly breaks down the tendon connecting the forearm muscles to the elbow.
Think of the rope in every movie that is used to hold up the main character. It gradually frays one fiber at a time, until it loses the ability to function. This is what you should think of when discussing the mechanism of tennis elbow. Enough introduction… let’s talk about 3 common ways to address this issue and help prevent it by addressing these areas: upper back mobility, shoulder stability and elbow strengthening.
UPPER BACK MOBILITY
What does this even mean? All it means is we need to address your upper back movement. Due to sitting at work, standing for prolonged periods in lines all while we look down at our devices (computer, phone, ipad, etc.) this area gets extremely stiff and immobile. We all know about the neck tension that comes from these activities but the other spot is the upper back. It gets ignored like the German Ice Hockey team in this years Olympics. However, it’s key that we address this area because where does the arm and neck connect into the body at? That’s right the upper back.
Proper movement here means less pressure and more optimal position of the joints in the arm during tennis. This means less change of tennis elbow. How do you do thoracic rotation? Simply watch the below video. Perform 20 reps total (10 to each side), 3x/day to ensure that when you go to play in the evening or on the weekend your keeping the pressure on the elbow at a minimum. A beard like the one shown in this video won’t hurt, in fact we recommend it. 😉
The next thing we should address is the ability of the shoulder and arms to go overhead. So each of you are planning to serve or volley overhead correct? You can just forfeit those points if you want. Why are these so hard for people’s joints to handle? Think about your previous few days for a second. How many times have you reached overhead? Maybe a few times for a glass here, or a book on a shelf there? Even if you are on the high end and have done maybe 25 reps over the past 3 days, think about how many times you reach overhead during one match or practice on the tennis court. 50? No. 100? No. At least 150 times. Not just that, but you are trying to swing your arm as hard as possible while going into a position that you never really take your arm through consistently. Talk about strain and lack of stability that will be present in this movement.
So how do we remedy this? That’s right! We practice reaching overhead with an exercise we call the overhead reach! Watch below and see how to perform this exercise to allow your joints and soft tissue to become accustomed to going into this position so that we reduce the stress going through the elbow to limit tennis elbow development. You will perform this 20 reps, at least twice per day. If you are practicing a few hours a day, you need to up this a little.
ELBOW STRENGTH & CONTROL
Lastly, we go directly to the site of interest – the elbow. We need to decrease pain and strengthen the tissue at the tendon. Research has found that in tennis elbow (or in any tendinosis) movement is key. Movement not only helps decrease pain, but encourages rebuilding of damaged tissue. We will focus on the eccentric contraction for the purposes of tennis elbow in this article.
Eccentric control or contraction is a fancy term that means controlling the muscle and tendon as it lengthens. Everyone does a great job at the concentric (or shortening) portion of a movement, but the problems arise commonly during the eccentric (or lengthening) portion of the movement. If we train the eccentric portion then we will have a better ability at the elbow to handle excessive force that comes with saying yes to a few too many sets. The device of choice to train this move is the flexbar made by Theraband. This tool and exercise shown below will help you not only in strengthening the current tissue but decreasing tennis elbow pain so that you can get back to play or keep playing. Perform this at least 3 times per day with the goal of perform 10-15 reps each time.
One thing to mention with the flexbar – there are 4 levels of resistance. They are colored yellow (extra-light, 6lbs resistance), red (light, 10 lbs resistance), green (medium, 15lbs resistance) and blue (heavy, 25 lbs resistance). Just as a guide – in our experience most people in either intense acute pain or just generally weaker need to start with the red (light) colored bar. If pain is mild or you are pretty strong and haven’t had too many elbow problems in the past then you will probably do good starting with the green (medium) bar. Only if you have no pain should you consider the blue (heavy) bar. Best case scenario you buy red, green and blue so that you can work your way through the set.
AVOIDING TENNIS ELBOW PLAN
Let’s recap our plan. In order to address or avoid tennis elbow pain we need to consider: upper back mobility, shoulder stability and elbow strength & control. For upper back mobility you will utilize the thoracic rotation exercise to decrease stress going down the arm and into the elbow. With shoulder stability, you will perform the overhead reach to teach the body how to safely enter this upper end range of motion under control. To strengthen and promote elbow control we have you perform the flexbar exercise (sold by Theraband). Remember, these altered mechanics are just part of the stresses involved in our everyday lives.
In order to offset these repetitive strains and enable our body to handle the additional stress on the court, we need to have a specific plan to reduce tension going through the elbow. The road map above will guide you to this goal. That’s all for today, if you want anymore specifics you can check out our Instagram for future posts that will accompany the article and we will also provide helpful tips for all the most common sports related injuries. Thanks for tuning in!