A tennis player’s wrist joint must be able to withstand large forces acting on it as the muscles and tendons surrounding the joint fight to control the racket head on ball impact. Due to the repetitive nature of the sport the wrist absorbs large forces over and over again during a tennis match. One commonly injured tendon in tennis players is the Extensor Carpi Ulnaris (ECU) tendon which attaches into the wrist joint on the same side as your 5th digit or small finger. Although ECU tendinopathy’s are predominantly caused by the repeated bending and extending of the wrist joint during play, it can also result from an acute overload of the wrist joint. For example ECU tendinopathy may result acutely due to an off centre impact between the ball and racket head as these forms of impacts have been shown to create up to seven times greater torque forces on the wrist joint compared to centred impacts.
Tennis players suffering with ECU tendinopathy commonly complain of pain in the wrist joint on impacting the ball, in more severe cases just bending or extending the wrist joint whilst gripping the racket can be painful. The tendon is often tender to press down on and in acute presentations where the tendon has been strained there may be the presence of swelling.
Treatment of ECU tendinopathy usually involves a period of rest or modified play whilst addressing any factors that may have caused or predisposed the player to developing the condition. Hands on manual therapy to address any muscle tightness or joint stiffness may be used in combination with other treatment modalities (dry needling, Laser, heat therapy) to help reduce pain and aid healing. The cornerstone of any wrist pain program will involve a progressive strengthening program to address any weakness in the muscles and tendons around the wrist helping to prevent future reoccurrence.