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Issue 12: Enjoy Racquet Sports? This one’s for you.

With Wimbledon finished and more racquet lovers getting back on the court, we’ve seen a huge spike in elbow problems so it only felt right to give out some advice.

Like other joints – such as the shoulder, we hear a lot of conditions tossed around like ‘frozen shoulder’ and ‘rotator cuff’. This happens with elbows too.

Although we’ve written about this before, the most frequent conditions are Lateral Epicondylitis (otherwise known as ‘Tennis Elbow’) and Medial Epicondylitis (none as ‘Golfer’s Elbow’).

Lateral Epicondylitis is a condition effecting the common extensor tendons on the lateral elbow, most commonly in the ‘extensor carpi radialis brevis’ tendon as this tendon is particularly chronic in nature/takes the biggest hit with injury.

What causes this?

Overload is the most common cause of this condition – for example, repeated wrist extension against resistance, a sudden increase in wrist extension or repetitive twisting actions (like using a screwdriver).

However, overload isn’t the only cause. Occupational problems can cause irritation too such as; hammering, painting, bricklaying, massage or playing a mistimed tennis shot. Sometimes the cause can be unknown.

For the racquet lovers out there – consider too that if overload isn’t the problem, then it may be due to your technique, a loosened grip on the racquet or even the racquet itself being too heavy.

The symptoms for this condition include a loss of grip strength, pain on wrist extension and pain produced on forearm muscle testing.

Do bear in mind that if the condition isn’t treated sooner rather than later then the extensor tendons of the wrist will begin to degenerate and microscopic tears and scarring can occur.


There’s no single treatment proven to be effective – however research suggests using a combination of isometric/eccentric stretches and soft tissue therapy can be most effective. In the short term – ice can be useful.

Medial Epicondylitis:

Medial Epicondylitis on the other hand effects the common flexor tendons on the medial elbow. Although less common, the mechanism of injury is very similar.

Excessive contraction of the wrist and fingers flexors can lead to this condition, again – occurring within tennis players, golfers, baseballers and climbers.

The symptoms include; increasing medial elbow pain, pain on palpation around or just to the side of the elbow joint, resistance of both wrist and finger flexion is painful, pain on wrist pronation and pain on stretching the wrist flexors.

Although treatment for this condition is very similar to the above, if you’re suspicious of a medial elbow problem then screening for a medial collateral ligament problem or an ulnar nerve entrapment is crucial.

How do I prevent these conditions?

The best piece of advice that we can give you is to be gradual. Like we mentioned above, tendon problems most commonly occur because of an overload issue.

Overload is caused by:

- The frequency of the activity (an example being two sessions to four per week) increasing too quickly.

- The intensity of the activity being out of your ‘norm’. For example; you’re used to playing one singles tennis match twice a week, then suddenly you’re playing two or three singles matches within the same amount of time.

- The time between your sessions, i.e., your rest days!

Ultimately – try to implement a good warm up before exercising, be sensible with your routines! Don’t go from naught to one hundred because that’s how people get injured.


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