Preventing and Treating Tennis Elbow in Tennis players (Part-IV)

Prevention of Injury: Methods

Certain measures need to be undertaken in order to prevent Tennis Elbow from occurring in those whom are novice, intermediate or expert tennis players.  These measures involve the following principals, and all should be considered important in preventing overuse and direct impact injuries:

A)     Preparation

1)      Warm up the muscles before you practice or play a match.  Warm muscles are much more            
 flexible, and flexible muscles are less likely to be injured. Utilizing a heating pad for 5-10 minutes before playing tennis, performing Flextend stretches and exercises or calisthenics exercises for 10-minutes  to warm up the body and get the blood flowing will help improve flexibility, dexterity and pliability of the muscles, thus reducing the chances of injury or re-injury if you have been affected with Tennis Elbow before.  For those that have suffered a previous injury, it is even more important to warm up before playing.

2)      Following the warm-up, practice for 5-10 minutes before actual play begins.  Doing so will further increase blood-flow to the muscles and reduce the likelihood of injury or re-injury.

B)      Muscle Strength and Length

1)      Strength.  A person can never be too strong when it comes to preventing injuries from occurring.  Upper extremity and grip strength are the most critical aspects of preventing Tennis Elbow or other injuries.  Even if someone has the greatest technique in the world, they are still highly susceptible to injury if the muscles being used are weak.  Activation of the hand extensors is essential to the power grip(7), and the power grip is the key to many sports activities, but is especially critical in the tennis backhand.
If a person strengthens their finger, wrist and elbow extensors to withstand 200 lbs. of force times fifty (50x) and they are only subject to 150 lbs. of force times twenty (20x), they will not become injured.  But, if these same muscles can only withstand 100 lbs. of force times ten (10x) and are subject to 150 lbs. of force one (1) time or 100lbs. of force twenty-one times (21x), they will become injured, and Tennis Elbow will result.  Properly strengthened muscles do not become injured; plus strong muscles can provide room for error where technique or equipment falls short.

a)      Strengthen Finger and Wrist extensor muscles

b)      Strengthen wrist /forearm Supinators

2)      Length is equally important. Short, tight restrictive muscles not only hinder range-of-motion (ROM), but are high risk for injury due to a lack of flexibility, dexterity and pliability. In short, stiff muscles tear at their weakest points, which are either at the musculotendinous junction or the tenoperiosteal junction. Less common, but can still happen, is that the tissues on either side of the muscle restriction can be affected with partial or micro tears.  

Those suffering with Tennis Elbow most often have short restrictive finger and wrist flexor muscles which put an undue tensile strain the extensor muscles, causing them to spasm, so it is important to be sure that the finger and wrist flexor and wrist pronator muscles are of adequate length.

Long, strong muscles provide for greater motion and a higher level of strength.  The longer a muscle is, the further it can contract and move, and the further it can move the greater the velocity and strength of the muscle contraction.

a)      Stretch finger and wrist flexors

b)      Stretch wrist/forearm pronators

C)      Modifications(8)

1)      Improve your technique.  No matter your level of tennis expertise, everyone can improve their backhand technique, such as; to stop leading with the elbow and/or switching from a one-handed backhand to a two-handed backhand.  Both of these greatly reduce stress to the wrist extensor and supinator muscle groups.

2)      Strength your muscles.  You can never be too strong!  Strong muscles are far less likely to become injured.  Make sure that all of your upper extremity muscles are strong and healthy, especially the finger, wrist and elbow extensors and wrist/forearm supinators, as these are the muscles that are usually weak and become injured in tennis players.

3)      Handle size.  A smaller handle is better than a larger handle, but it is best to pick a handle size that suites the size of your hand.   

4)      Use better equipment.  Choose a racquet that is light in weight and has a larger face in order to help hit the ball more “centered”, which reduces vibration and twisting of the racquet.

5)      Ball Speed.  As in golf, you can buy balls that are very fast or are very slow.  Choose the type of ball that matches your level of expertise.  If you are a novice, choose a slower ball.  If you are an expert, choose whichever ball you like to suit your purpose.

6)      Racquet Strings. For novice to intermediate players, it is important to use a racquet that is properly strung with the appropriate string gauge and tightness. Strings that are too tight can cause a lot of hand and arm vibration when the ball is hit off-center, so it is better to have strings that are more “loosely” strung, and leave the professional tennis racquets to advanced players.

(…to be continued.)

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