Racquet string tension directly affects force experienced at the elbow: implications for the development of lateral epicondylitis in tennis players

Badri R. Mohandhas, Navnit Makaram, Tim S. Drew, Weijie Wang, Graham P. Arnold, Rami J. Abboud (Lead / Corresponding author)

Research output: Contribution to journalArticle

1 Citation (Scopus)


BACKGROUND: Lateral epicondylitis (LE) occurs in almost half of all tennis players. Racket-string tension is considered to be an important factor influencing the development of LE. No literature yet exists that substantiates how string-tension affects force transmission to the elbow, as implicated in LE development. We establish a quantitative relationship between string-tension and elbow loading, analyzing tennis strokes using rackets with varying string-tensions.

METHODS: Twenty recreational tennis players simulated backhand tennis strokes using three rackets strung at tensions of 200 N, 222 N and 245 N. Accelerometers recorded accelerations at the elbow, wrist and racket handle. Average peak acceleration was determined to correlate string-tension with elbow loading.

RESULTS: Statistically significant differences (p < 0.05) were observed when average peak acceleration at the elbow at 200 N string-tension (acceleration of 5.58 m/s(2)) was compared with that at 222 N tension (acceleration of 6.83 m/s(2)) and 245 N tension (acceleration of 7.45 m/s(2)). The 200 N racket induced the least acceleration at the elbow.

CONCLUSIONS: Although parameters determining force transmission to the elbow during a tennis stroke are complex, the present study was able to control these parameters, isolating the effect of string-tension. Lower string-tensions transmit less force to the elbow in backhand strokes. Reducing string-tension should be considered favourably with respect to reducing the risk of developing LE.

Original languageEnglish
Pages (from-to)184-191
Number of pages8
JournalShoulder and Elbow
Issue number3
Early online date6 Apr 2016
Publication statusPublished - Jul 2016



  • Journal article
  • Biomechanics
  • Elbo
  • Lateral epicondylitis
  • String-tension
  • Tennis

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