Tennis elbow is only a general term for pain in the elbow for a variety of reasons. The most common case of elbow pain is due to an overuse or overload condition on the tendons and muscles about the elbow, leading to inflammation of the involved area. In many cases, the tendons about the elbow are damaged or partially torn, which leads to continued pain whenever the activity is performed. In tennis, tremendous forces and torques are generated in the forearm, arm and shoulder. Improper technique can magnify these forces injuring tendon and joint structures.
Specific problems can arise in performing forehand, backhand and services.
The swing involves total arm involvement, and the shock of the hit should be absorbed by the entire extremity. Late ball contact means the arm is past the optimum position to strike the ball and therefore an adjustment to late contact can concentrate undue forces on the arm. In striking and swinging motions, if excessive wrist roll or twisting occurs, this can lead to stretching and pulling of proximal forearm muscles. Having the elbow bent past 45 may lead to an elbow swing rather than a swinging of the entire arm. In this position, the motion and impact is imparted on the elbow joint, which can be injurious.