Tennis elbow is the bane of many players’ existence. A chronic injury to the tissues of the forearm, it is very difficult to treat. Cortisone shots may mask the pain, but don’t contribute to the healing process. And exercise, while beneficial, is often too painful for many sufferers to perform on a regular basis. Most players contract tennis elbow due to problems with technique. However, there are several equipment-related issues that can jar your joint. Let's look at them, and how you can solve them, now.

Stringing Problems and Solutions

Just because your strings aren’t broken doesn’t mean they’re still good. Most tennis players, particularly women, do not restring their racquets often enough. Strings are constantly stretched under tension, even if you're not using them. This stress makes them lose resilience, their ability to return to their original shape quickly after impact. This is where string power comes from.

The United States Racquet Stringers Association (USRSA) recommends restringing your racquet as many times per year, as you play per week. As we previously discussed in our blog, this is probably not sufficient, especially if your elbow is hurting. Lack of string performance makes the body work harder to produce power, and is a main cause of arm and shoulder injury. Tennis elbow sufferers should restring as often as they can afford, and at a minimum, every 60-90 days until the problem subsides (every month is preferable). Keeping your strings at peak performance levels will save stress on your arm.

If your body hurts while playing tennis, choose softer-playing strings. Many manufacturers produce more flexible multifilament strings, which will absorb impact shock better. At Tennis Express, we offer a vast selection of arm-friendly strings, such as Babolat Xcel, Dunlop Silk, Gamma TNT2 Rx, Prince Premier LT, Tecnifibre TGV and Wilson NXT. Select your next set of strings from these offerings (playing with the most flexible string that feels comfortable to you), and stay with them until you're pain-free.

Use the thinnest gauge string you can. There will be more space between thinner strings, making for a softer string bed than a thicker string of the same type. By contacting a more open string bed, the impact of the ball will be dissipated more readily. If your elbow hurts, use at least one gauge thinner string than normal, and preferably, the thinnest gauge you can afford to replace. All of the strings listed above are available in 17 gauge, and many come in an ultra-thin 18 gauge for the most comfort available.

Natural gut offers the best shock absorption of any string. Gut’s natural properties allow it to flex more with ball impact, allowing shock to dissipate. While gut is clearly the most expensive string choice you can make, its added power and shock absorption make it the best. At Tennis Express, we offer a broad variety of natural gut strings, featuring Babolat VS Team, Wilson Natural Gut, and Pacific Prime Gut.

Strings installed too tightly will not flex enough to absorb impact shock and propel the ball as efficiently as a lower-tension string job will. String at the bottom of, or below, the manufacturer's recommended tension range, to lessen the amount of work your body must do, and the amount of shock it must endure. Looser strings will give more on impact, "pocketing" the ball and absorbing shock and vibration more than higher-tension string jobs will. Use the lowest tension you can, while still making your normal swing.

Racquet Problems and Solutions

The modern trend to more powerful racquets has left many players using too stiff of a stick. More power generally means less flex in the frame, and the shock from impact has to go somewhere: your arm is the closest place. Check below for the most arm-friendly frames from numerous manufacturers, and switch if you don't already have one. Use the most forgiving frame you feel comfortable with now, and consider staying with it after symptoms disappear.

There are frames designed with specific traits that will be easier on the arm. Pro-Kennex, for example, developed their innovative Kinetic Moveable mass system to transfer weight where it’s needed to absorb shock. Check out the Kinetic “Q” series frames for the latest in arm-friendly Kennex racquets. Wilson and Pacific have added basalt (volcanic rock) to their graphite racquets to reduce unwanted shock and vibration. Volkl has added cellulose to their Organix line of frames to act as a “buffer” against unwanted vibrations, while Dunlop has added Biofibre, or plant stem fibers, in the throat and shaft areas of their new Biomimetic frames to reduce shock. Check out our demo program and see how these racquets help your arm.

While you would think a sore arm would feel better with a lighter racquet, the opposite is true: a heavier racquet (more mass) absorbs shock and resists twisting (torque) better than the same racquet with less weight. There are, however, limits to this corollary. A 70-year-old, 100-pound woman cannot swing as heavy a frame as a 30-year-old, 200-pound man. Swing the heaviest stick you can use, while still making your normal swing. Ask our Tennis Express racquet specialists for help in this, and all, matters.

Use a racquet that is light in the head. If the majority of the weight of a racquet is close to your hand, it will be easier to maneuver. Even a light, head-heavy frame will be harder to move, especially at net, and having the balance point farther from your hand will force you to work harder to pull it around.

Larger-headed racquets offer a bigger sweet spot, but your aching arm will like the lowered torque better. Larger racquet heads will torque (twist) less from off-center hits than their midsize counterparts. Try to use the largest head size racquet you feel confident swinging. An open string pattern will provide a more cushioned feel. A dense string pattern (18 mains x 20 crosses) will have a tighter “grid” and will flex less on impact than a more open pattern (16x18, 16x19, or 16x20). Opening up the string bed will allow the strings to “give” more on impact and better dissipate shock especially on mishits.

Grip Problems and Solutions

Many tennis players use grips that are too small. Smaller handle sizes make it harder, not easier, to grip the racquet. Squeezing too tightly on the grip tenses the forearm muscles, straining them to the point of injury. Have your pro or racquet specialist check your grip size. Many manufacturers supply charts to verify the proper fit (look here for two more ways to determine your proper grip size). If yours is too small, have it built up, or replace the racquet with one of the proper handle size. If your hand measures between grip sizes, select the larger one.

Even if your grip is the proper size, it is of little use if you don't keep it in good working order. Today's replacement grips, while offering more traction and comfort than their leather predecessors, will compress after months of use, and could make the handle one or more sizes smaller. The resulting smaller handle size will force you to stress your tender arm by gripping too tightly. Placing an overgrip on it does nothing to stop this process. Many manufacturers offer softer, shock-absorbing grips. Change yours if it feels too firm. Replace your grip every time you restring, even if you use an overgrip, and your handle size will not hurt your arm. See more on choosing the right grip size here.

At Tennis Express, we offer several soft, cushioned replacement grips known for their comfort, such as the Babolat Air Sphere, Dunlop Gelzorb, Gamma Pro Rx, Prince ResiSoft and Wilson Comfort Hybrid. Making this change alone could relieve many arm issues.

So if your arm hurts due to improper technique, see your pro and work it out. However, if you think your racquet is to blame, follow the steps mentioned above:

1. Restring your racquet as often as you can, preferably every 30 days.
2. Use a softer-feeling string in a thinner gauge. For the most shock absorption, use natural gut strings.
3. String your racquet as loosely as you can, while maintaining normal shot production.
4. Take advantage of technology and select an arm-friendly racquet.
5. Use a more flexible racquet, with the largest head size that feels comfortable.
6. Use the heaviest racquet you can comfortably swing.
7. Use a racquet with a head-light balance.
8. Select a racquet with an open string pattern.
9. Use the largest grip size you can comfortably hold. If in doubt between two sizes, select the larger one.
10. Replace your grip every time you restring, even if you use an overgrip.

While you may consider these extreme measures, tennis elbow is an extreme situation. Injury to the elbow joint not only interferes with enjoyment of tennis, it lessens overall enjoyment of life. Follow these instructions, and your limbs should heal, along with your game.