For a tennis player with lateral epicondylitis, what is the BEST management recommendation?

For a tennis player with lateral epicondylitis, what is the BEST management recommendation?

• A. Hold racquet less tightly and limit the number of backhand strokes
• B. Decrease racquet grip size and hold the racquet tighter
• C. Increase racquet grip size and limit the number of forehand strokes
• D. Stretch the wrist flexors & strengthen the forearm pronators

Answer: (A)

Lateral epicondylitis results from overuse and overload of the wrist extensor tendons at their elbow attachment. The main goal in management is to reduce the tendon load and modify activities that provoke pain, allowing healing to occur. Holding the racket with a lighter grip decreases the force the forearm muscles must generate to grip, which lowers the tensile stress on the common extensor tendon. Limiting backhand strokes further reduces repetitive loading on those extensor structures during a stroke that commonly aggravates symptoms in tennis players. Together, these adjustments directly address the mechanism driving pain and help the tendon recover. Stretching the wrist flexors and strengthening forearm pronators, while sometimes used in rehab, does not target the primary problem of extensor tendon overload and may not provide the same protective effect as reducing grip force and backhand repetition.

Lateral epicondylitis results from overuse and overload of the wrist extensor tendons at their elbow attachment. The main goal in management is to reduce the tendon load and modify activities that provoke pain, allowing healing to occur. Holding the racket with a lighter grip decreases the force the forearm muscles must generate to grip, which lowers the tensile stress on the common extensor tendon. Limiting backhand strokes further reduces repetitive loading on those extensor structures during a stroke that commonly aggravates symptoms in tennis players. Together, these adjustments directly address the mechanism driving pain and help the tendon recover.

Stretching the wrist flexors and strengthening forearm pronators, while sometimes used in rehab, does not target the primary problem of extensor tendon overload and may not provide the same protective effect as reducing grip force and backhand repetition.