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The Myth of Proper Form It is often claimed that if a tennis player develops tennis elbow, then their form must be poor. This is simply not true. Proper tennis form minimizes the risk of the player developing golfer's or tennis elbow but does not completely negate the risk. When executing a backhand, the hand is gripping the handle of the racket, which can contribute to the development of either golfer's or tennis elbow. This is because of the isometric contraction of the finger flexor muscles (flexor digitorum superficialis of the golfer's elbow group), as well as isometric contraction of the wrist extensor musculature to stabilize the wrist (primarily extensor carpi radialis brevis of the tennis elbow group). During the backhand stroke, the hand should remain stable and not move into extension as the stroke is performed. Certainly, if the player does have poor form and breaks the wrist into extension, then they are placing an additional stress force into the wrist extensor musculature of the tennis elbow group. But, even if the wrist joint is held perfectly stable—as it is generally recommended to be—the force of the ball hitting the face of the racket would cause the wrist joint to collapse into flexion if it were not for the isometric stabilization of the wrist extensor musculature of the tennis elbow group. When we look at the distance from the ball striking the racket strings to where the hand grips the handle, we see that there is a tremendous leverage force that multiplies many times over the contraction force that is required of this musculature. If the speed of the ball is great, the force increases even more. What often causes a tennis player to develop tennis elbow is a sudden increase in play (such as seasonal changes in activity) or playing an opponent who hits the ball harder than they are accustomed to. Similarly, these concepts apply to the development of golfer's elbow when playing tennis, although this usually involves the forehand stroke and/or serve. 62 m a s s a g e & b o d y w o r k j a n u a r y / f e b r u a r y 2 0 2 0