How to prevent tennis elbow

Palm up, fingers together. Lay a ruler along your ring finger from the tip to the lower of the long creases across your palm. That is the Nirschl method, described in a 2009 paper in Sports Health. Separately, our grip size guide has the chart. Without a ruler, hold your forehand grip and slide the index finger of your other hand into the gap between your fingertips and the heel of your hand. One finger width is the target.

A wrong handle changes how hard you squeeze: a 2014 study found an optimal size that reduced grip force during the stroke and, in their model, the load on the wrist extensor tendons behind tennis elbow. Get it right, then stop agonizing. When a 2006 study had sixteen collegiate players hit one-handed backhands with handles a quarter inch above and below their recommended size, forearm muscle activity did not change significantly.

If your handle measures small, an overgrip is the cheapest fix. Thickness is the number: our FeltTac Dry Overgrip is 0.75mm and builds a handle up; our MaxTac is 0.5mm, designed to add tack without sizing you up. One wrap of FeltTac is usually enough; our post on maintaining grip size covers heat-shrink sleeves beyond that.

Tennis elbow is a volume problem before it is an equipment problem. The AAOS lists overuse first, and the ITF injury clinic describes an injury that develops gradually through repeated micro ruptures at the muscle attachment, with backhands the stroke that usually provokes the pain. In a USTA piece on overuse injuries, sports medicine physician Dr. Morgan Busko explains that tendons lose collagen in the first 24 to 36 hours after activity and take two to four days to regain it; play again inside that window too often and they stop healing between sessions.

So add hours slowly and break up consecutive days first. A tournament weekend of four matches is the week to be careful. The ITF's prevention list is short: a gradual build-up, a warm-up, suitable equipment, and correct technique, which it defines as hitting the ball in front of the body with a straight, firm wrist. A new one-handed backhand goes to a coach first.

String tension is the setting the ITF and the AAOS agree on: lower tension keeps the ball on the strings longer, spreading the shock over more time, and looser-strung racquets often reduce stress on the forearm. If your arm is the problem, restring looser. And change overgrips before they go slick, as the USTA's Billie Jean King Cup team physician advises; a handle you cannot hold is a handle you squeeze.

A string dampener is a small piece of rubber or silicone wedged between the main strings below the sweet spot. It changes the sound of contact and the feel of the string bed. Our Multi-Feel Tennis Dampeners come three to a pack, Touch across 2 strings, Sorb 4 and Max Sorb 6, so you choose how much ping to keep.

What a dampener does not do is protect your elbow. A 2004 study in the Journal of Sports Sciences fired balls at racquets held by twenty players and measured vibration at the wrist and elbow with and without a damper: no significant difference at either joint, and a conclusion that dampers stay popular for acoustic effects and psychological support, not mechanical advantage. A 2019 paper in Sports Medicine and Health Science explains why: a damper quiets the audible string frequencies above 200 Hz, not the lower-frequency frame vibration between 80 and 200 Hz, and there is no evidence it reduces vibration at the wrist or elbow.

So buy ours for the sound and the feel, because the grooved channels lock them in, and because they carry a lifetime warranty. Do not buy them to prevent tennis elbow. Our 2020 tennis elbow post called the evidence for that mainly anecdotal and our dampener buying guide lists it under myths; that is still the honest line.

The brace that works for tennis elbow is a counterforce brace: a strap, usually with a firm pad, that goes around the forearm rather than the elbow. MedlinePlus, from the National Library of Medicine, describes it as wrapping around the upper part of your forearm and taking some of the pressure off the muscles; the 2020 review explains that pressing on the forearm extensors disperses the stress at the tendon's origin. It is not an elbow sleeve.

Placement. The AAOS says the brace is centered over the back of your forearm. Bend your hitting arm and find the bony point on the outside of the elbow. The strap does not go there. Slide down onto the upper forearm, where the muscle is thickest, and lift the back of your hand; the ridge that tightens under your fingers is the extensor group the pad belongs on. Center the pad on it, below the elbow, on the hitting arm only.

Tightness. Set the strap with your arm relaxed, then make a fist and lift the wrist. Snug enough that you feel the pad press into muscle, not so tight that your hand tingles, goes cold or changes color. If it does, loosen it.

When, and what for. We put it on before the warm-up and take it off after the session. The evidence is for symptoms: a double-blind, placebo-controlled trial cited in the 2020 review found less frequent and less severe pain for 2 to 12 weeks and better elbow function at 26 weeks than placebo, and a 2026 review in Life calls the relief immediate and short term. A brace may let you keep hitting with less pain while the tendon settles. It is not a cure: the condition is generally self-limiting, with up to 80 percent of cases recovering within a year, and the AAOS puts nonsurgical success at 80 to 95 percent.

See a doctor if the brace becomes the plan. MedlinePlus says to contact your provider if these symptoms are new to you or home treatment does not relieve them, the 2026 review notes that swelling can be visible on the outer elbow, and the AAOS asks you to tell your doctor about any past elbow injury. Pain that outlasts rest, a swollen outer elbow, or a strap you now need to open doors are doctor conversations, not fit adjustments.

Plan around the two to four days from step 2. Dr. Busko's other point is that a tendon wants to be loaded, gradually, and that strength work is a strong preventive measure: core exercises plus 20 to 30 minutes with resistance bands. Our injury prevention post has a routine. The ITF's daily stretch takes a minute: arm forward, palm down, elbow straight, fingers to the floor, then bend the wrist down with your other hand until you feel tension on the outside of the forearm. If you already have symptoms, the 2020 review reports that eccentric exercise, lowering a load slowly with the wrist, is now a first-line conservative treatment with the dose still debated, so ask a physical therapist.

Pickleball players get the same injury from the same motion. In a 2026 study of 164 pickleball injuries, six of the eight elbow cases were lateral epicondylitis, five of them on the paddle side, which the authors link to repetitive swinging. A 2025 survey of 253 recreational players found 41 percent reporting an upper-extremity injury, with higher risk for longer, more frequent and consecutive-day sessions, and acute injury 2.67 times more likely with a tight grip on baseline shots. Measure the paddle handle the same way, add a FeltTac wrap if it is small, loosen the grip, and skip the back-to-back days.