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Tennis Elbow


Updated April 16, 2010

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Tennis elbow is an inflammation of the tendons that attach your forearm muscles to your lateral epicondyle, the bony knob on the outside of your arm an inch or two from the bigger knob that you generally think of as your elbow. In tennis elbow, an acute strain, or, more commonly, repeated, smaller strains cause microscopic tears in the tendons where they attach to the bone. The main symptom is pain, which occurs on contact with the ball, especially on one-handed backhands, and often when performing ordinary motions like opening a jar or lifting a heavy bag. Almost half of recreational tennis players suffer from tennis elbow at some point in their lives. Another name for tennis elbow is lateral epicondylitis.

While tennis elbow is the most common elbow injury in tennis players, tennis can cause or exacerbate many other elbow injuries. Of these, the next most common injury--and the one most often confused with tennis elbow--is golfer's elbow, or medial epicondylitis, an inflammation of the tendons that attach to the medial epicondyle, the bony knob on the inside of your elbow. It usually hurts when hitting forehands and serves, twisting the wrist, and of course, playing golf.

Arm-Friendly Equipment

To help prevent tennis elbow, you should start with arm-friendly equipment. Except for a few delicate touch shots, most of tennis involves fairly violent collisions between racquet and ball, and the amount of shock and twisting force transferred to your arm varies significantly with the physical properties of your racquet, strings, and balls. Racquet weight, balance, and stiffness, grip size and traction, string tension and gauge, and ball weight and fluffiness can all make a real difference to the health of your arm, as explained in Choosing Racquets and Strings to Prevent Tennis Elbow and Choosing Grips, Overgrips, and Balls to Prevent Tennis Elbow.

Elbow-Friendly Strokes

Even with the best equipment, you won't be immune to tennis elbow if your strokes are seriously flawed, especially if your one-handed backhand isn't mechanically sound. On the backhand, your grip, origin of the swinging motion, use of your legs, eye and head control, and point of contact are crucial to preventing tennis elbow. Other strokes may also be straining your elbow, and you'll find suggestions that apply to all strokes, as well as to the one-handed backhand specifically, in Modifying Your Strokes to Prevent Tennis Elbow.

Worst and Best Court Surfaces

Most experienced tennis players know that some court surfaces are easier on your legs than others, but as court surfaces determine the trueness, speed, and height of the ball's bounce, they make a real difference to your arm as well. Which Court Surface is Best to Avoid Tennis Elbow? will send you through the right gate.

Off-Court Activities

Tennis elbow doesn't only afflict tennis players, and tennis isn't always the problem for those players who do get tennis elbow. Off-court activities can put repetitive strains on your elbow for many more hours than you spend on a court, especially if they're a part of your work. Construction and factory work are always suspects for arm strains, but the worst culprit may be the computer, where thousands of small motions can add up to a lot of strain. Sleeping habits may also play a role. To make your elbow happier at work and in sleep so that it's ready for the rigors of tennis, see Off-Court Activities That Can Cause Tennis Elbow.

Further Measures

If you already have tennis elbow, changing your equipment, strokes, and off-court activities will help your elbow heal and stay healthy. For suggestions on further measures, including stretches, exercises, and treatment options, see Online help for Tennis Elbow.

Babette Pluim, M.D., Ph.D. and Marc Safran, M.D. From Breakpoint to Advantage: A Practical Guide to Optimal Tennis Health and Performance. Racquet Tech Publishing, 2004.
Howard Brody, Rod Cross, and Lindsey Crawford. The Physics and Technology of Tennis. Racquet Tech Publishing, 2002.

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