Wrist injury from tennis?

Question

My wrist has been hurting and I think it might be from playing tennis.

I use a continental grip and sometimes shift to a semi-western. My wrist only really others me on forehands (regardless of how hard it is hit). Sometimes it gets pretty bad and i won't even be able to feed it over the net. It hurts along the outside of my arm between my wrist and elbow and also around the wristbone.

After playing, my whole right arm feels sore and the wristbone(?) appears a little more pronounced than usual (don't want to say swollen, it's just a little more noticeable). I also noticed that my wrist hurts a lot when i do push ups.

Few things I think that might be a problem:

lose strings- making me put more effort into each swing

unbalanced racket- mine's head heavy

What do you think?

Answer 1

It's your technique that's causing your wrist problem.  Can't blame anything else.

Racquet weight doesn't make much of a difference.

String tension makes no difference.

Grip size can make a slight difference.  

A heavy racquet actually absorbs shock and should help you prevent injuries

Loose strings allow you to hit a hard ball with less exertion.

I also string loose, around 50 pounds, but I have no wrist problem.  I used to string around 65 and had a wrist problem, but that was because I was using bad technique for a few weeks... I fixed my techique, and I no longer have wrist problems.

I also tried adding weight lead weight to differnt parts of the my racquet... the head, or the handle.  That made no difference in wrist pain.  In the end, it was all technique.

After using proper technque, changing strings, tension, lead-weight, and even using other people's racquets didn't cause any wrist problems or pain whatoever.

THE CURE:

Don't use your wrist to create power.  Your wrist should be loose and relaxed, but it shouldn't be flopping all over the place.  It should not be moving much through the stroke or contact -- or at least you should even feel that it is.

PROPER MAIN POWER SOURCES:

Legs -- weight shifting forward

Hip and shoulder rotation

Everything else follows from that.... the Arms... the racquet (notice, I left out the wrist)

The muscles controlling your wrists are reall small and weak compared to the other muscles your could be using the create racquet head speed.

The wrist is only used to control racquet face angle.

TIMING

People feel they should do a wrist "snap" right at contact -- THIS IS BAD.  Doing this implies that you're trying to use your muscle to drive the ball, and you'll always be late.  You should be building full racquet-head speed around a foot before you make contact -- a loose wrist will allow you to maintain the racquet-head speed up until contact.  A tight wrist will actually slow-down the racquet head once you built up full speed.

CORRECT:

1 -- Legs drive hips and shoulder

2 -- Hips and shoulders drive arm

3 -- Arm throws racquet-head

4 -- Racquet-head collides with the Ball

INCORRECT:

1 -- Wrist drives Racquet Head

2 -- Racquet head drives ball.

FEEL:

It should feel like you're swinging a ball at the end of a chain -- you wouldn't use your wrist to do that, right?

Through the contact zopne, it should feel like the racquet will fly directly out of your hand over the net.  Picute yourself throwing a stick over the net... that's exactly how it shold feel -- except you're throwing the racquet head at the ball.

Answer 2

The repetitive demands placed upon the wrist of elite players frequently lead to injury.  Loads placed upon the wrist can result in the development of tendonitis in the muscle tendon units that cross the joint and provide both stability and movement of the forearm wrist and hand.  Additionally, stress fractures, ligament sprains, and tears in the cartilage at the end of the forearm bone (ulna) can also occur and limit performance.  





Proper technique can cut down on wrist injuries.

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Several important factors can be applied to prevent wrist injuries.  The first and most important is the use of proper technique. Players using extreme grips place their wrist and forearm in positions that place additional stress on the muscles, tendons, and ligaments and can predispose them to injury.  

Additionally, the use of the wrist and hand as primary force generators also can lead to injury.  The wrist and hand must be viewed as links in the kinetic chain whereby large forces generated from the ground, lower extremity and trunk are transferred.  The reasonably delicate tendons crossing the wrist cannot be asked to generate the forces required for powerful strokes in tennis without injury occurring.  

Other factors in preventing wrist injury are to increase strength and range of motion using specific exercises which will form the basis for discussion in this article.

The muscles that control forearm, wrist and hand movement actually originate near the elbow joint.  Hence, strengthening the wrist involves the use of exercises typically thought to increase elbow strength and prevent tennis elbow.  These exercises include wrist radial deviation (figs. 1a-1b) and ulnar deviation (figs. 2a-2b) and wrist flexion and extension (figs. 3-4).  

Use of these four exercises will stimulate muscle development of virtually all the muscles that support the wrist joint.  Note that the forearm is stabilized during the performance of the wrist flexion and extension exercises, and that the radial and ulnar deviation exercises are done in standing using one end of the weight to produce a bit of a counter-balance.

Start by using three sets of 15 repetitions of each exercise.  Typically a 3-5 pound weight will produce fatigue of these muscles initially, or light to medium resistance elastic tubing which is easier for players to travel with.  Avoid doing these exercises immediately before playing tennis as pre-fatiguing the muscles prior to play is not recommended.  

An additional exercise that can also improve the strength and endurance of the wrist and forearm muscles is the ball dribble (fig. 5).  Dribbling a basketball or exercise ball first against the floor and then against a wall at approximately eye level rapidly for 30 seconds or more creates significant fatigue of these muscles.  Performing these exercises should be a regular part of a tennis players program.  

In addition to the strengthening exercises, stretches to ensure optimal range of wrist motion are important.  Research has shown that tennis players often lose elbow and wrist motion on their dominant side from long-term play.  Stretches to improve the flexion and extension of the wrist can be done with the elbow in an extended (straight) position in front of the player.  

Bending the wrist downward (with the palm down) and rotating the fingers outward using the other hand stretches the muscles on the top side of the wrist and forearm, while repeating a stretch with the elbow straight and hand in the palm up position bending it downward and rotating the forearm inward will stretch the muscles on the underside of the forearm.  

  



Figure 1a: Radial Deviation Starting Position

  

  



  



Fig. 1b - Radial Deviation Finishing Position

  

  



  



Fig 2a - Ulnar Deviation Starting Position

  

  



  



Fig 2b - Ulnar Deviation Finishing Position

  

  







  



Fig. 3 - Wrist Flexion

  

  







Fig. 4 - Wrist Extension

  





















  



Fig. 5 - Ball Dribble

  

  



Holding each stretch for 15-30 seconds will help to maintain and even improve wrist range of motion. Remember, it is very important to stretch after you play when the muscles are very warm and optimal gains in flexibility can occur.

Following the simple use of exercises to increase wrist and forearm strength and endurance as well as flexibility exercises to prevent range of motion restrictions in the wrist can help to minimize the risk of an injury from the demands of repetitive tennis play.  Coupled with proper stroke mechanics, these exercises can help to enhance performance.  

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Tennis is a complex physical sport requiring hand-eye coordination and full body participation to run, position, swing, and hit. Because of these demands, endurance, flexibility, and muscle-conditioning exercises are important to prevent injuries. Some tennis injuries may be random occurrences (such as those that are the result of a fall). However, most can be minimized or prevented entirely by proper conditioning, proper technique, appropriate equipment, and seeking medical attention for persistent, painful conditions in a timely fashion.

Types of injuries

The most common injuries associated with tennis are rotator cuff tendinitis, tennis elbow, wrist strains, back pain, anterior (front) knee pain involving the knee cap, calf and Achilles tendon injuries, ankle sprains, and tennis toe.

Rotator cuff tendinitis

The rotator cuff consists of muscles and tendons that originate from the scapula (shoulder blade) and attach to the humerus (upper arm bone). These muscles and tendons allow the shoulder to move in many directions. As a result of overuse, you can develop tendinitis, or inflammation of the tendons. Rotator cuff tendinitis in recreational tennis players usually results from excessive overhead serving. This is more likely to occur if you hold your arm at a 90-degree angle from your side while you are serving (Fig. 1). Changing your technique to increase the angle between your arm and side to more than 90° (ideally 135°) will lessen the chance of injury to your rotator cuff.

Treatment for this condition is rest, ice, and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. If symptoms persist after 7 to 10 days of this treatment, see your physician. If symptoms resolve only to recur when you return to play, lessons from a tennis professional to modify your technique may help to prevent recurrence.

Tennis elbow

Tennis elbow, or lateral humeral epicondylitis, is a painful condition caused by inflammation or small tears of the forearm muscles and tendons on the lateral side (outside) of the elbow. Most experts believe that tennis elbow is caused by overloading of the forearm muscles due to faulty backhand technique. Improper body positioning with the elbow leading the racquet, combined with late strokes and "wristy" impacts seem to cause this overloading. The two-handed backhand relieves stress on the muscles that attach to the lateral epicondyle of the humerus at the elbow (Click to enlarge Fig. 2).

Proper racquet selection and grip size play a significant role in preventing tennis elbow. Smaller heads and excessive string tightness require the forearm muscles to exert more force, which can lead to tennis elbow. Stiffer graphite-type racquets with large heads that expand the impact area, or "sweet spot," are preferred. String tension should be at the manufacturer's lowest recommendation. The grip should be comfortable and not too small. The best way to choose grip size is to measure the distance from the crease of your palm to the tip of the ring finger.

The treatment of tennis elbow involves rest, ice, compression, and elevation (RICE) and perhaps NSAIDs. Often, the condition becomes chronic (long lasting) and is difficult to resolve. Other available treatments include decreasing playing time, counterforce braces (tennis elbow supports), and rehabilitation programs. If all types of treatment fail, surgery may be considered.

Wrist strain

Wrist strains seem to be related to the "laid-back" grip position: rotating the palm upward and quickly turning your wrist over as you hit the ball in order to achieve topspin. The best grip position for preventing wrist and elbow injuries is the "hand-shake" grip, with the racquet making an "L" position with the forearm (Fig. 3).

Back pain

Back pain seems to be related to an exaggerated arched, or swaybacked, posture used for power production during service strokes (Fig. 4). This exaggerated position stresses the small joints and soft tissues of the spine. Older tennis players seem to have the most back pain due to progressive stiffness and degenerative disease, such as arthritis. A conditioning program designed to strengthen abdominal and back muscles and to increase flexibility can minimize back pain associated with tennis.

Knee pain

The most common knee problem in tennis players is anterior (front) knee pain. This is due to either chondromalacia (softening of the cartilage) of the patella (knee cap) or tendinitis, especially at the patellar tendon. Elite and highly ranked recreational tennis players seem to encounter these injuries more frequently than others. This is thought to be related to the "spring-up" action of the knees on the serve (Fig. 5). Treatment of acute anterior knee pain involves the usual RICE, but frequently needs to be complemented with NSAIDs and a short-arc knee strengthening program to build up the innermost quadriceps muscle in the thigh.

Calf and Achilles tendon injuries

The common underlying cause in both calf muscle and Achilles tendon injuries is a tight calf

Answer 3

I think that u probably twisted ur wrist in like a funny way. For the wrist bone, u might want to ask ur doctor about that and have him/her take a look at it. I kind of had a little bit of the same problem.

One day when my friend was over; we were playing around and what happened was that my back went on top of my wrist and then my wrist started hurting. It was hurting for a couple days and then it got better.

Try putting ice on ur wrist. If the ice won't work; then ask ur mom to write a note for P.E. saying that u can't do push-ups. Also, It's not good putting pressure on a wrist that migth be sprained.

Answer 4

1st. get checkout by your doctor make sure nothing is broken or torn.

If nothing is broken, then use semi-western grip only, tape your wrist while playing, don't use excessive power, don't play for too much.  Time will heal so let your wrist rest for a while.

If it's still not getting better, you might book a session with local teaching pro to help on your stroke.  Also you might want to get a lighter racket.

Answer 5

Sounds like you play with your wrist and with your forearm too much. My coach used to tell me: if you play right, your legs and your buttocks should hurt, not your wrists and arms. Because that's where your stroke should come from. Hands are just for fine tuning, giving some additional spin. All the force comes from legs. Try to watch your stroke technique and see if you over-use your hands\wrists\arms and under-use your legs\body.

Also grip size may be wrong for you. It is a big deal, check it.

Answer 6

hm, sounds like you're a beastly tennis player.

might wanna get that checked out though? =\

feel better!! =]

Answer 7

I had a wrist injury last year and in came on just after I bought a new racket so your head heavy racket could definately be the reason behind it. Also I talked to a doctor about mine and the said the best things to do are A) Rest it for 2 weeks with no tennis and B) Buy a proper wrist support from a tennis source. These two things can help a lot. Also if you haven't already buy a string dampener and next time you string the racket ask to have it strung at a lower tension. Also the final thing that I find helps is to wear a rubber wrist band, like those charity support ones people wear because that absorbs some shock from going up the arm. Hope it helped!