Did you know that weak leg and core muscles can contribute to tennis elbow? Think of a backhand stroke during tennis; if you’re unable to generate the force to hit the ball as hard as you’d like to from your legs and core, you’ll be likely to overuse your wrist extensors to make up for the deficits.
The same principle can apply to weak muscles in your shoulder. If the scapular and shoulder muscles aren’t strong enough to transfer the kinetic forces it needs to complete your swing, overuse of the wrist extensors can occur.
Repetitive overuse of the wrist extensors often leads to a situation in which the breakdown exceeds the muscles capacity for repair, resulting in small tears to your extensor carpi radialis brevis, one of the primary muscles involved in tennis elbow. Granulation tissue and free nerve endings that form during the healing process with tennis elbow can result in pain.
It’s very important for tennis players to work on the large muscles of the legs such as the glut muscles, quadriceps, and hip rotators, as well as the obliques. Here are a few examples:
Wall Squat
Stand with your back against the wall. Your feet should be far enough away from the wall that when you bend the knees and sit into a squat position, your knees do not come past your toes:
Knees should not bend beyond a right angle during the exercise. Hold the stretch for 3-5 seconds, and perform 10 repetitions.
Lunge
Step forward into a lunge with your stride large enough so that your knee does not come past your toe as you complete the movement:
Hold the stretch for 3-5 seconds, and perform 10 repetitions.
Wrist Extensor Stretch
Tight, shortened wrist extensor muscles put more strain on the joint, causing pain and pathology. One way to prevent this is by performing a gentle stretch. Making a closed fist and keeping your elbow straight, gently bend the wrist down, assisting lightly with the other hand:
Hold the stretch for 20-30 seconds, and perform 3-5 repetitions. You should feel a stretch but no pain during the movement.
Tennis players should also work on strength and endurance of their shoulder muscles, specifically the capular stabilizers and rotator cuffs. You can find more information about shoulder exercises in one of my previous blog posts, An Owner’s Guide to a Healthy Shoulder.
Lee Rosenzweig is a doctor of physical therapy and certified hand therapist at the Joint Mobility Center at Hospital for Special Surgery.
