Tennis elbow—the dreaded lateral epicondylitis that can sideline even the most dedicated players—doesn’t have to be an inevitable part of your game. At Burlingame Country Club, where our four Har-Tru courts invite year-round play in the beautiful Western North Carolina mountains, smart players know that preventing tennis elbow is far easier than treating it.
The good news: most cases of tennis elbow are preventable through proper technique, smart conditioning, and attention to recovery. Whether you’re a competitive player logging hours on the court every week or a recreational player enjoying social matches, understanding how to protect your elbow keeps you playing the game you love.
Understanding Tennis Elbow
Tennis elbow is an overuse injury affecting the tendons that connect your forearm muscles to the outside of your elbow. Despite the name, you don’t have to play tennis to get it—any repetitive gripping or wrist extension can cause the condition. But tennis players are particularly vulnerable because of the repetitive nature of groundstrokes, especially one-handed backhands.
The pain typically starts as a dull ache on the outside of your elbow and can progress to sharp pain that radiates down your forearm. Gripping a racquet, shaking hands, or even lifting a coffee cup can become painful. Left untreated, tennis elbow can persist for months or even years.
The root cause is usually a combination of factors: poor technique that stresses the elbow joint, inadequate conditioning of the forearm muscles, equipment issues, and insufficient recovery time between sessions. Address these factors proactively, and you significantly reduce your risk.
Technique: Your First Line of Defense
Most tennis elbow cases stem from improper stroke mechanics that put excessive stress on the elbow joint and forearm muscles.
The Backhand Culprit: The one-handed backhand is the primary offender, especially when players “arm” the shot rather than using proper body rotation. If your backhand relies heavily on wrist and forearm strength instead of core rotation and shoulder turn, you’re asking for trouble.
Fix it by ensuring your backhand swing starts with shoulder rotation, not arm extension. Your upper body should coil and uncoil, with your arm acting as a connection point rather than the power source. The hitting arm should stay relatively relaxed throughout the stroke.
Late Contact Points: Hitting balls behind your body—late contact—forces your arm to compensate with additional stress on the elbow. This happens when you’re rushed or positioning poorly.
Work on footwork and court positioning so you’re set up early for shots. Better positioning allows proper contact points where your body mechanics work efficiently rather than forcing your arm to save balls.
Tense Grip: Squeezing the racquet too tightly throughout points exhausts forearm muscles and increases injury risk. Many players don’t realize how tightly they’re gripping until they consciously pay attention.
Practice a relaxed grip between shots and only tightening at impact. Your grip pressure should vary—loose during setup, firm at contact, relaxed again during follow-through. This reduces cumulative stress on forearm muscles.
Equipment Choices That Protect Your Elbow
Your racquet and strings significantly affect elbow stress.
Racquet Selection: Heavier, head-light racquets generally cause less elbow stress than light, head-heavy ones. The extra mass absorbs shock better. If you’re prone to elbow issues, consider a racquet in the 11-11.5 ounce range (strung weight) with a balance point that’s 4-6 points head-light.
Modern racquets with “comfort” or “arm-friendly” designs incorporate vibration dampening technology. Brands like Wilson Pro Staff, Yonex EZONE, and Head Radical are known for comfort. Test different frames to find one that feels solid without jarring your arm on impact.
String Selection: This matters enormously. Natural gut and multifilament synthetic strings are softer and more arm-friendly than polyester strings. Polyester strings (used by pros for maximum spin) are stiff and transmit more shock to your arm. Unless you’re an advanced player who absolutely needs polyester’s control, avoid them.
Consider natural gut or premium multifilament strings like Tecnifibre NRG2 or Wilson NXT. Yes, they cost more and break faster, but protecting your elbow is worth the investment.
String Tension: Lower tension (50-55 pounds) is more comfortable than higher tension (60+ pounds). The looser strings create more of a trampoline effect, absorbing shock and reducing stress on your arm. Don’t believe the myth that you need tight strings for control—proper technique provides control, not tight strings.
Grip Size: An incorrect grip size forces you to squeeze harder to maintain control. Too small is worse than too large. Your grip should allow you to hold the racquet comfortably without excessive squeezing. A general test: when holding the racquet in your Eastern forehand grip, you should be able to fit your other hand’s index finger in the gap between your fingers and palm.
Conditioning Exercises for Elbow Health
Strong, flexible forearm muscles support your elbow joint and distribute stress more evenly.
Wrist Curls and Extensions: Use a light dumbbell (2-5 pounds). Sit with your forearm resting on your thigh, palm up, and curl the weight toward you by flexing your wrist. Do 15 reps, then flip your hand over (palm down) and extend your wrist upward for 15 reps. Do 3 sets for each position. This strengthens the muscles that support your elbow.
Reverse Wrist Curls: Hold a light dumbbell with your palm facing down, forearm supported on your thigh or table. Slowly lift the weight by extending your wrist upward, then lower with control. This targets the extensor muscles most vulnerable to tennis elbow. Start with 3 sets of 12-15 reps.
Eccentric Wrist Extensions: These are particularly effective for rehab and prevention. Hold a light weight, palm down. Use your other hand to help lift the weight (wrist extension), then slowly lower it down using only the working hand. The slow, controlled lowering (eccentric contraction) strengthens the tendon. Do 3 sets of 15 reps.
Forearm Squeezes: Use a tennis ball or therapy putty. Squeeze firmly for 5 seconds, release, and repeat 10-15 times. This builds grip strength and forearm endurance. You can do this anywhere—watching TV, sitting at your desk, or waiting for a court.
Forearm Twists: Hold a light dumbbell or hammer by the end of the handle. Slowly rotate your forearm from palm-down to palm-up position and back. This works the rotational strength crucial for tennis strokes. Do 3 sets of 12 reps.
Finger Extensions: Place a rubber band around your fingers and thumb. Spread your fingers against the resistance, then relax. This strengthens the extensor muscles often neglected in training. Do 3 sets of 15-20 reps.
Perform these exercises 3-4 times per week on non-playing days or as part of your warmup routine. Start with light weights and progress gradually. These exercises should never cause pain—if they do, reduce the weight or stop.
Stretching and Flexibility Work
Flexible forearm muscles resist injury better than tight ones.
Wrist Flexor Stretch: Extend your arm in front of you, palm up. Use your other hand to gently pull your fingers back toward your body. Hold for 30 seconds, feeling the stretch along your inner forearm. Repeat 3 times per arm.
Wrist Extensor Stretch: Extend your arm in front, palm down. Use your other hand to gently pull your fingers down toward the floor. Hold for 30 seconds, stretching the outer forearm and elbow area. Repeat 3 times per arm.
Forearm Rotation Stretch: Hold your arm out with elbow bent 90 degrees. Slowly rotate your forearm so your palm faces up, then down, feeling the stretch throughout your forearm. Do 10 slow rotations in each direction.
Prayer Stretch: Place your palms together in front of your chest, fingers pointing up. Slowly lower your hands (keeping palms together) until you feel a stretch in your wrists and forearms. Hold for 30 seconds.
Do these stretches before playing (as part of your warmup) and after playing (as part of your cooldown). Also stretch on non-playing days to maintain flexibility.
Recovery Strategies
Adequate recovery between sessions prevents overuse injuries.
Rest Days: Don’t play tennis every single day. Your tendons need recovery time to repair micro-damage from play. Schedule at least 1-2 rest days per week where you don’t play tennis or do heavy forearm work.
Ice After Play: Apply ice to your elbow for 15-20 minutes after playing, especially if you feel any discomfort. This reduces inflammation and promotes healing. Don’t apply ice directly to skin—use a towel or ice pack wrap.
Listen to Your Body: If your elbow feels sore before a session, consider skipping that day or playing very lightly. Pushing through pain leads to chronic issues that take months to resolve. One missed session beats six months of forced rest due to injury.
Gradual Volume Increases: If you’re returning from time off or increasing your playing frequency, do it gradually. Don’t jump from once-a-week casual play to daily tournament preparation. Your tendons need time to adapt to increased stress. Increase playing time by no more than 10-15% per week.
Treatment Options When Pain Starts
Catching tennis elbow early makes treatment much easier.
RICE Protocol: Rest, Ice, Compression, Elevation. At the first sign of elbow pain, take a few days off, ice regularly, use a compression sleeve if helpful, and avoid activities that aggravate the pain.
Counterforce Bracing: A tennis elbow strap or brace worn just below the elbow can help by redistributing stress away from the painful area. Many players find these helpful for both prevention and treatment. Position the brace about an inch below the point of pain.
Physical Therapy: If self-care doesn’t resolve the issue within a couple weeks, see a physical therapist who specializes in sports injuries. They can assess your specific situation, identify contributing factors, and design a personalized treatment plan.
Professional Coaching: Sometimes the root cause is technical. A session with Burlingame’s tennis professional can identify stroke flaws contributing to your elbow stress. Fixing technique is often the permanent solution.
Playing Through Mild Discomfort (Carefully)
If you must play with mild elbow discomfort, take precautions:
Warm up extra thoroughly. Spend 15-20 minutes on dynamic stretching and gentle ball-hitting before playing seriously.
Reduce your playing time. Cut your normal session length in half. It’s better to play three 45-minute sessions per week than try to power through two 2-hour sessions.
Modify your strokes temporarily. If your backhand hurts, slice more—the slice uses different muscles and often causes less pain. Use two hands on your backhand if you normally hit with one.
Avoid hitting with topspin-heavy or powerful hitters. The increased pace and spin force you to work harder, stressing your elbow more.
Ice immediately after playing, and take the next day off completely.
Long-Term Elbow Health
Prevention is a lifestyle, not a one-time fix.
Make conditioning exercises part of your regular routine. Five minutes of forearm work 3-4 times per week prevents most tennis elbow issues.
Maintain flexibility with regular stretching. This takes minimal time and offers maximum benefit.
Replace strings regularly. Dead strings transmit more shock to your arm. Restring at least every 40-50 hours of play, or more frequently if you play often.
Stay hydrated and maintain good nutrition. Healthy tendons require proper hydration and nutrients to maintain elasticity and repair micro-damage.
Cross-train with activities that don’t stress your elbow. Swimming, cycling, and walking keep you fit without repetitive arm stress.
When to See a Doctor
Most tennis elbow cases resolve with conservative treatment, but see a doctor if:
- Pain persists despite rest and self-care for more than 2-3 weeks
- Pain is severe or suddenly worsens
- You have numbness or tingling in your forearm or hand
- Your elbow is swollen, red, or warm to the touch
- You can’t fully extend your arm or grip objects
These symptoms might indicate a more serious issue requiring professional medical evaluation.
Using Proactive Prevention
Tennis elbow doesn’t have to end your playing days at Burlingame. With proper technique, smart equipment choices, dedicated conditioning, and adequate recovery, you can play tennis for years without elbow problems.
The key is proactive prevention. Don’t wait until you’re in pain to address these factors. Make elbow health part of your regular tennis routine, and you’ll spend more time enjoying Burlingame’s beautiful courts and less time sitting on the sidelines.
Your elbow is asking you to play smarter, not harder. Listen to it, take care of it, and it will serve you well for many seasons to come.
Ready to refine your technique and prevent tennis elbow on premier Har-Tru courts? Burlingame Country Club’s tennis professionals can help you develop proper mechanics and create a personalized prevention program. Call (828) 966-9200 to schedule your lesson.