The elbow and tennis, Part 1: An analysis of players with and without pain

Elbow injuries were studied epidemiologically among 2,633 participants in a tennis school. Thirty-one percent had experienced elbow pain at some time in their playing history. In this portion of the study, multiple factors were analyzed to identify differences between players with and without elbow pain. Variables that were not associated with tennis elbow were height, hand dominance, and two-handed strokes. Factors significantly related to elbow pain were age, weight, level of ability, years of play, frequency of play, and other tennis injuries, which were all greater in players who had elbow pain. Overall, the variables with the most significant average differences between groups with and without pain were age and frequency of play (p<.005). The study showed that women had more wrist and forearm injuries, and men had more shoulder and knee injuries. Higher wrist and forearm injury rates among women might be related to the fact that women generally have less upper extremity strength than men. A more vigorous service motion and generally more aggressive play might be associated with the higher rate of shoulder and knee injuries in men. The elbow is the primary area of injury in tennis players. The injury rate in the elbow (31 injuries per 100 players), which is almost four times as great as the next most injured region (ankle, 8%), clearly establishes this.