Tennis-Induced Wrist Pain – Every Injury Is An Opportunity To Learn And To Improve In Your Sport

The FitOldDog training wheel: don't skip a step or neglect one already encountered, as the process is additive.

To stay sports injury-free, listen to your body. Use the FitOldDog Training Wheel. Don’t skip a step or neglect one already encountered. The process is additive.

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This post is about tennis-induced wrist pain. However, the ideas expressed here extend to any sports injury. Body-awareness is the real key to staying fit and active into old age. Don’t let a chronic injury hold you back from having fun. Work out what is going on, and fix it, before it gets to be serious.

I’m still doing Ironman training as of today (February, 2016), at age 72. It’s fun! But I have to be constantly vigilant. Looking for trouble before it happens.

ADDENDUM: to see the outcome of my friend’s tennis-induced wrist pain, follow this link.

FitOldDog's logoA friend of mine. A talented tennis player. Recently consulted me, via this blog, about tennis-induced wrist pain that bothers him from time to time. The pain, which is not due to ‘tennis elbow,’ is in a specific part of his wrist. It appears to involve the region of the extensor carpi radialis tendons. Shown in the lower left region of the figure below, at the base of the thumb. To see the image more clearly click on the figure.

Human Forearm Anatomy, from Live On Earth.

My approach to such injuries is the following:

  1. Carefully define the problem: (a) where it actually is (referred or not), (b) what it is, (c) when it occurs, (d) how long it has been going on, and (e) what seems to help.
  2. Generate a differential diagnostic list for cause, such as overuse, poor mechanics, genetics (e.g. Dad had the same problem!), poor equipment, and so forth.
  3. Develop a multifaceted approach to treatment, starting by addressing symptoms to calm things down and then attack the cause, which can take minutes to years.
  4. Remind yourself that we are all different and what works for one person may not for another.
  5. Keep a record of this process, as we often forget the mistakes we make and do it again a few years later!
  6. Use it as an opportunity to learn and improve and try to take a positive attitude as this can also promote healing.
Photo of FitOldDog on the bike course at Lake Placid 2011

The author at the Lake Placid Ironman. You have to relax your hands on the bike. Avoid the death grip, or you’ll develop hand or wrist strain.

A quick search of the Internet revealed a considerable body of information on tennis-induced wrist injuries. One good example can be found at The Sports Injury Bulletin, which contains a detailed discussion of conditions concerning the region of the wrist referred to by my friend. There are many similar sites! Finding suitable discussion forums can also be very helpful. I came across such a forum at Talk Tennis, which presented an interesting range of insightful approaches that my friend might consider.

In triathlons, we can have similar wrist problems on the bike due to the development of a ‘death grip.’ The key in this case is to relax your grip. This is also an issue for rowers, as described at LiveStrong.Com. Of course, vigorous rowing is a ‘No! No!’ If you have an AAA stent graft (the origin of this blog). Don’t forget!

I think this provides my friend Byron with some food for thought!

So my advice is:

  1. Use ice (10-15 minutes ON THE CLOCK three times a day) and enough over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs), such as Advil, to reduce inflammation and significantly diminish the symptoms.  Then stop the NSAIDs after a few days as it can interfere with normal repair processes, and it may even make the tendonitis worsen. There is a lot of debate about this in the sports world, so in the end it is your call. That said, my preference is to use such drugs only when I have exhausted all other approaches.
  2. Explore relaxing the intensity of your grip on the racquet.

    FitOldDog's body movement instructors

    FitOldDog learned a lot from his famous four, from left to right, Karen, Feldenkrais, Mr. Bones, Anatomy, Rebecca, Continuum, and Tara, Gyrokinesis.

  3. Listen to your body. I’ve found my studies of body-awareness invaluable for preventing and fixing sports injuries.
  4. Consider purchasing a customized racquet if such exists – I have a custom fit bike, and what a difference that makes.
  5. Warm up thoroughly before you play including, but not limited to, your forearms as everything is linked to everything else. Don’t forget, the problem may not originate in the muscles/tendons that are strained. It could be a consequence of poor stance, tense shoulders or back, bad timing, or any number of things that we study in Feldenkrais and Continuum!
  6. Try to drive the game towards your backhand, to employ the strength of your back, and to protect your wrist. Of course, if your opponent picks up on this strategy you have a problem. Or is there a way to use both hands for some of your hard forehand drives? I’ve seen this in tennis matches and often wondered why they did it, but it seemed to work, or is this a combination forehand/backhand drive? Basically, think about how you play. For instance, I have weak adductor muscles in my legs so I try to take the load away from them by favoring other muscle groups during running and biking, when I can.
  7. Join a suitable discussion forum and ask questions of people who actually know about tennis injuries.
  8. Go back to the basics by relearning your tennis stroke. I do this with each of my sports (swim, bike and run) at least every year or so, and each time I am injured (which is less and less frequently, thank goodness!). I like to use injuries as an opportunity to eliminate old bad habits and culture new, hopefully better ones.
  9. Develop a ‘training season,’ as we do for endurance sports, to include a period of strength training during the off season. There are many strength exercises recommended for tennis players and their forearms, including those described in the linked article at LiveStrong.Com.

Each injury is a valuable lesson and a potential opportunity to improve your sport.

Hope this helps, my friend! Keep me posted on how things go, and what you learn as you go along.

-k Your Medical Mind


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Disclaimer: As a veterinarian, I do not provide medical advice for human animals. If you undertake or modify an exercise program, consult your medical advisors before doing so. Undertaking activities pursued by the author does not mean that he endorses your undertaking such activities, which is clearly your decision and responsibility. Be careful and sensible, please.