The nets are up on the tennis courts. It is now time to get out and play. On a sunny day you will find these courts busy with players enjoying the game they love.

Unlike many team sports, tennis is a game you can play for a lifetime. Plus the whole family can enjoy it together. All you need is a pair of tennis shoes, a racket, a can of balls and someone to hit with.

But remember that tennis players, like athletes of other sports, are susceptible to injuries specific to the nature of the sport. Because you hold the tennis racket in one hand for most of your shots, the elbow is vulnerable to injury.

Tennis elbow is inflammation, soreness and pain on the outside of the elbow region. There can also be a partial tear of the tendons and ligaments of the forearm. Symptoms may include a gradual increase in pain in your elbow, especially when you hit the ball. You may notice pain running down your forearm toward your wrist, or a loss of grip strength.

You might think that hitting a lot of balls would cause the injury, but Jeff Barrett, a teaching tennis pro at Foreside Fitness in Falmouth, notes this is not necessarily true. Pros hit far more balls than recreational players and rarely suffer the injury.

Barrett says the proper alignment of the racket head to the shoulder; elbow, forearm and wrist defuse the force of the impact. Professional players also play with a heavier racket to absorb the impact.

When I am presented with a tennis player with elbow pain, there are many issues that I need to evaluate. Last summer, I saw a high-level female tennis player with elbow pain.

She had the typical signs and symptoms, including pain when hitting the ball. The pain was gradually getting worse but she continued to have good grip strength. The diagnosis was classic tennis elbow. When she noticed the pain coming on, she started to wear a forearm support which offered some relief.

Our treatment plan included ice therapy, stretching, cross friction massage and ultrasound with manipulation to the elbow. She was given specific stretching exercises for her forearm and elbow to do at home. These exercises are designed to lengthen and strengthen the muscles, tendons and ligaments.

We also asked her to bring in her racket, which we found to have too big of a grip. Most professional players are now playing with a smaller grip, which allows the player to generate more spin on the ball while also reducing stress to the forearm.

This patient improved beautifully, but she was still having some issues when she played. One day, I happened to see her playing doubles. I noticed she was constantly hitting the ball late, which puts more pressure on the arm.

On her follow-up visit I told her what I thought was a flaw in her ball striking and suggested she take a lesson from the club teaching pro. She did so, and the stroke flaw was corrected. The remaining issues of her elbow were quickly resolved.

 

Dr. Robert Lynch is a former president of the Maine Chiropractic Association and head of the Lynch Chiropractic Center in South Portland. “Staying in the Game” appears every other Thursday in the Press Herald.