Tennis elbow / bicep tendon issue

Dear Jordan/Austin

Over the past two months I have gotten back into playing tennis. I am playing 2-3 times a week. Annoyingly, I have been experiencing discomfort / mild pain in my right arm – particularly when I serve.

After one or two serves, my right arm starts to get achy and tight (and a pump – especially after I finish the session). There is no bruising or redness.

This happened on Sunday. And it happened again today (Thursday). In both cases, once home, I applied ice around the bicep (near the elbow and up towards the shoulder) and elbow – 15 mins on, 5 mins off, then repeated by switching area – and it feels better now – no ache, minimal tightness. Although if I place pressure on my elbow (like lifting myself out of an office chair) I definitely notice a slight weakness in my right elbow.

So I have just read through the guide on tendinopathy. I note the use of heavy/slow or 3-0-3 tempo work - I recall doing this in the Knee Rehab template a few years ago - not fun!

FYI, I am on week 2 of the BBI, 2nd Gen, 3 day program (switched from week 5 of 4-day program last week to accommodate the tennis sessions). I was thinking to add some of the suggested exercises, using 3-0-3 tempo, at the beginning of each workout, for shoulder and elbow rehab – preacher curls / reverse curls, possibly a hand gripper. Say 3 sets for 12-15 reps?

I was curious that there were no triceps extensions in the list – an overhead triceps extension is similar to the serve – would it be useful addition?

I also noticed, on an upper body workout on Tuesday, mild discomfort doing the bench press and overhead press – it did not really infer with completing the reps, but I definitely felt the weakness / dull achiness in my right arm. So I am also wondering if I should back off the weight on these exercises. Do you agree?

I would appreciate it if you could tell me if there anything else I should add/deduct from my training?

I will play again in a couple of days. I plan to do 50% second serves and hope it doesn’t aggravate my arm.

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Hey there – sorry to hear about this. A frustrating, but common issue. I’m not sure whether you’re referring to our “general” tendinopathy guide, but we do also have a more specific piece for this type of elbow pain, here: Lateral Elbow Pain for Lifters  - Barbell Medicine

Most people with this type of issue do generally need to back off of the intensity & volume of their bench pressing, and occasionally/less often, of their overhead pressing.

Incorporating some targeted tempo work like you describe is a reasonable strategy, as long as you are following the recommendations on monitoring symptoms during and for ~24 hours after your sessions; if symptoms increase significantly during these periods, it’s typically a sign that you’re still doing “too much, too soon” for the area, compared with what it’s ready to tolerate.

Also agree with backing off the intensity of your tennis until this gets more calmed down. If you need further individualized guidance, we’d be happy to meet with you for a consultation, which can be arranged via the website.

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Thanks Austin. Yes it was the general guide. The article you have linked looks ideal - thanks.