SAN FRANCISCO — Modifications to equipment and playing style can be combined to decrease the chances of acquiring tennis elbow, a troublesome and painful disorder most commonly seen in the casual player, Dr. Marc R. Safran said at a meeting on sports medicine sponsored by the University of California, San Francisco.
Tennis elbow has been known more formally as lateral epicondylitis, but this is actually a misnomer, said Dr. Safran of the university, because the condition is not caused by inflammation, but rather by a degenerative process. So sports medicine experts are beginning to switch to the term “epicondylosis” or “tendinosis.”
It commonly affects weekend warriors aged 35–50 years, men more than women, and the dominant arm twice as often as the nondominant arm. The prevalence among tennis players is as high as 40%–50%.
Elite tennis players tend to develop medial epicondylitis (or epicondylosis), commonly called “golfer's elbow.” The casual tennis players (and others) who are most at risk of developing lateral epicondylosis are those who have inadequate conditioning, particularly weak wrist extensors; tight, inflexible muscles (which can be alleviated somewhat by stretching); and weak posterior shoulder muscles. The condition is caused by overuse in both time and intensity of play.
Poor technique also plays an important role. The one-handed backhand is a particular offender, said Dr. Safran, who advocates the two-handed backhand, which keeps the wrist steady and straight.
Choosing the correct racket can prevent a player from gripping too tightly. The grip should be neither too small nor too large. Cushioned grips can decrease vibration. And players should always use new balls to reduce stress on the elbow, he said.
The racket should be made of composite materials with good dampening characteristics. It should have a stiff head and a flexible shaft; large heads are better than small heads because there will be fewer off-center hits and less vibration.
The head should be relatively light to decrease the chances that the player will become fatigued, though it should have at least some weight so the player gets an assist from momentum, Dr. Safran advised, adding that regular-length rackets are better than longer rackets, which require more strength to swing.