ERICA MICHELLE FERNANDES
Friday, 26 March 2010
INTRODUCTION:
Incidence:
 Constitutes a sizeable percentage of elbow
injuries
 Elbow problems occur atleast once in 40% to
50% of tennis players (George, et al.,2006)
INTRODUCTION TO THE ELBOW
JOINT
 BASIC ANATOMY
COMMON AREAS OF
INFLAMMATION
•SUPRACONDYLAR
RIDGE & EPICONDYL
FACETS
•TENDON BODY
•MUSCULOTENDINOUS
JUNCTION
•MUSCLE BELLY
Concept of sweet spot:
FORCES ACTING on the hand:
Forces:
EQUATIONS OF MOTION IN TENNIS
1. F+Fr=MdV/dt
2. Fb-Frh= Icmdw/dt
3. FrLf= Ifdwf/dt
4. Vp= Lfwf=hw-V
Contd….
Factors responsible for tennis
elbow: Poor technique
 Forced eccentric muscle contraction
 Elbow Crunch
 Wrist Crunch
 Impulse reaction
 Shock
 Tip speed
Elbow crunch
Before impact,
Centripetal force = centrifugal force
After impact,
Centripetal force > centrifugal force
Measured in Newton:
Formula:
1N=0.225 lbs.
Shock*2/R’.
Wrist crunch:
 Measured from centre of mass to the wrist.
Formula:
Shock*2/R”
(R” = distance from wrist to axis of rotation+ distance
from axis to balance point.
Shock:
 Shock= difference between initial and final kinetic
energies
 Measured in joules
 High shock is bad because it means high elbow and
wrist crunch.
Tip speed:
 Low tip speed is better than a high tip speed.


better racquet control
more accurate
Impulse reaction:
 Positive impulse is better since it leads to less impact
force at the elbow joint.
Factors to be considered to treat
Tennis elbow
Early phase of rehabilitation
 R.I.C.E
PHASE 1
 Goals: decrease inflammation and pain,
promote tissue healing, and retard muscle
atrophy. During the acute stage of your injury,
whether the medial or lateral elbow is affected,
follow the RICE principle:

Stretching:
Strengthening exercises:
Phase 2:
Grip strengthening,Pronation
supination:
Phase 3:
 PHASE 3
 Goals: Improve muscular strength and endurance, maintain and
improve flexibility, and gradually return to prior level of sport or
high level activity.
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15 minutes forehand only
30 minutes forehand only
30 minutes forehand and two handed backhand
45 minutes forehand and backhand
45 minutes all strokes
Serve
Full play
Competitive play
Measures to avoid Tennis elbow:
ERGONOMICS
 Equipment modification
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Head size
Weight of the racquet
Frame Stiffness
String tension
Racquet material
Grip size
Moveable mass racquet
 Correct playing strategies
Grip size:
A grip too large or too small lessens control and
promotes excessive wrist movement. To
measure an appropriate grip size for your hand
see image below
MOVEABLE MASS RACQUET:
THANK YOU