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Tennis Elbow is Not Caused Due to Improperly Sized Tennis Racket Grip

thors at Kerlan-Jobe Orthopaedic Clinic studied 16 NCAA Division I and II tennis players (10 men, 6 women) with no prior history of elbow problems. Twelve players were right-handed; four left-handed. All players were proficient at using a one-handed backhand. Players' "recommended" grip size was determined using an industry standard: measuring the distance from the bottom lengthwise crease in the palm to the tip of the ring finger with a ruler.

The researchers inserted electrodes into five different muscles in each player's dominant arm to measure the firing pattern of their muscles (electromyogram, EMG). After a warm-up period, players then performed three single-handed backhand strokes using identical model rackets with three different grip sizes: the "recommended" grip size, a "small" grip size (1/4 inch smaller than recommended), and a "large" grip size (1/4 inch larger than recommended). One-quarter inch size variations were chosen because most commercially available adult-sized rackets have grip sizes ranging from 4 inches to 4 5/8 inches. A ball machine set at a constant speed and angle provided consistent ball delivery. Each player's strokes were captured on high speed video which was then synchronized with the corresponding EMG.

Of the five forearm muscles studied, none showed significant variations in firing patterns during three phases of the backhand stroke: accelerated forward motion of the racket, ball impact, and early follow-through. Close attention was paid to two specific muscles, the extensor carpi radialis brevis (ECRB) and the extensor digitorium communis (EDC), which are located beside each other in the forearm and originate from the bony prominence on the outside of the elbow. Overuse, microtrauma, and failed healing in both of these muscles can result in tendonitis. Yet larger and smaller grip sizes did not affect the activity of these two muscles, the authors found.

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