Preventing Tennis Elbow: Equipment and Technique Tips

Tennis elbow, medically known as lateral epicondylitis, affects countless tennis players from beginners to professionals. This painful condition can sideline you for months if not addressed properly. The good news is that with the right equipment choices and technique modifications, many cases can be prevented or significantly reduced. This guide explores how your gear and playing style affect arm health.

Understanding Tennis Elbow

Tennis elbow is an overuse injury affecting the tendons that connect the forearm muscles to the outside of the elbow. Despite its name, only about 5% of tennis elbow cases actually come from tennis—but tennis players remain at significant risk due to the repetitive nature of the sport.

Common Symptoms

• Pain on the outside of the elbow, sometimes radiating into the forearm
• Weakness in grip strength
• Pain when lifting objects or gripping a racket
• Tenderness when pressing the outer elbow
• Pain that worsens during or after playing

Equipment Factors That Affect Arm Health

Frame Stiffness

Frame stiffness, measured in RA units, is perhaps the most significant equipment factor for arm health. Stiffer frames transmit more shock to your arm, especially on off-centre hits.

• Arm-friendly range: Below 65 RA
• Moderate risk: 65-68 RA
• Higher risk: Above 68 RA

If you're experiencing arm discomfort, consider moving to a more flexible frame. Modern technology allows flexible rackets to still provide adequate power and performance.

Racket Weight and Balance

The relationship between weight, balance, and arm stress is complex:

• Too light: Forces you to generate all power through arm acceleration, increasing strain.
• Too heavy: Exhausts muscles, leading to technique breakdown and compensatory movements.
• Head-heavy: Creates more torque through the arm, especially on mishits.
• Optimal: Medium weight (300-315g strung) with even or slightly head-light balance provides stability without excessive strain.

String Type and Tension

Strings significantly impact how much shock reaches your arm:

• Polyester strings: Stiffer, harsher on arms. Not recommended for players with arm issues unless using softer poly at low tension.
• Multifilament strings: Soft, arm-friendly, excellent for sensitive arms.
• Natural gut: The most arm-friendly option available, with excellent playability.
• Hybrid setups: Multifilament or gut mains with poly crosses offer a good compromise.

String Tension Recommendations

Lower tensions are generally easier on the arm:

• String at the lower end of your racket's recommended range
• Drop tension by 2-4 lbs if experiencing arm discomfort
• Accept slight loss of control for improved comfort
• Keep strings fresh—dead strings lose their shock absorption

Grip Size

Incorrect grip size forces you to grip tighter, increasing forearm muscle tension:

• A grip that's too small is particularly problematic
• Verify your grip size using the measurement methods in our grip guide
• When in doubt, go slightly larger rather than smaller
• Keep your grip fresh—worn grips require tighter holding

Arm-Friendly Equipment Setup

For players with arm concerns, consider this optimised setup:

• Frame: Stiffness under 65 RA, 100 sq in head, 300-315g strung weight
• Balance: Even to slightly head-light (under 325mm)
• Strings: Multifilament or natural gut (or hybrid with arm-friendly mains)
• Tension: Lower end of recommended range
• Grip: Correct size, fresh overgrip, adequate cushioning

Technique Factors

Equipment is only part of the equation. How you swing affects arm stress as much as what you swing with.

Backhand Technique

The one-handed backhand is most commonly associated with tennis elbow when performed incorrectly:

• Lead with your shoulder: Use body rotation, not arm force
• Avoid wristy contact: Firm wrist at contact, loose afterwards
• Proper preparation: Take the racket back early to avoid rushed, arm-heavy swings
• Consider two-handed: Two-handed backhands distribute force across both arms

Serving Technique

• Use your legs and core, not just your arm
• Develop a proper trophy position for efficient power generation
• Don't serve through pain—reduce power or take a break
• Warm up thoroughly before serving hard

General Playing Adjustments

• Warm up properly before playing—never start cold
• Focus on hitting the sweet spot—mishits cause more arm stress
• Use your legs and body rotation rather than arming the ball
• Consider shortening sessions when arms feel fatigued
• Avoid playing with wet, heavy balls that increase shock

Prevention Strategies

Strengthening Exercises

Building forearm strength and flexibility reduces injury risk:

• Wrist curls: With light dumbbells, both palm up and palm down
• Reverse wrist curls: Targets the extensor muscles affected by tennis elbow
• Forearm twists: Rotation exercises with a hammer or weighted bar
• Finger extensions: Using rubber bands around fingers
• Eccentric exercises: Slowly lowering weight, particularly effective for tendon health

Stretching Routine

Perform these stretches before and after playing:

• Wrist flexor stretch: Extend arm, bend wrist back with other hand
• Wrist extensor stretch: Extend arm, bend wrist forward with other hand
• Forearm rotation stretches
• Hold each stretch for 30 seconds, repeat 3 times

Recovery Practices

• Ice your elbow after play if experiencing any discomfort
• Allow adequate rest between sessions
• Consider using an elbow counterforce strap during play
• Massage forearm muscles to release tension
• Stay hydrated—dehydration affects muscle function

Managing Existing Tennis Elbow

If you're already experiencing tennis elbow, consider these steps in addition to medical advice:

Short-term Management

• Rest from tennis—continuing to play usually worsens the condition
• Apply ice for 15-20 minutes several times daily
• Use over-the-counter anti-inflammatory medication as directed
• Wear a counterforce brace during daily activities

Returning to Play

• Return gradually—start with light hitting before match play
• Consider lessons to improve technique and reduce strain
• Implement all equipment changes before returning
• Stop immediately if pain returns
• Be patient—rushing return often causes relapse

Tennis elbow is frustrating, but it's largely preventable and manageable with the right approach. By choosing arm-friendly equipment, developing sound technique, and maintaining strength and flexibility, you can protect yourself from this common injury and enjoy tennis for years to come.