Wrist kinematics differ in expert and novice tennis players performing the backhand stroke: implications for tennis elbow.

Investigators have suggested that the greater prevalence of lateral humeral epicondylitis (tennis elbow, TE) in novice tennis players compared to expert players may reflect the novice players' use of faulty mechanics for the backhand stroke. We investigated the wrist kinematics (flexion/extension), grip pressures, and wrist muscle electromyographic activity in novice (N = 8) and expert (N = 8) tennis players performing the backhand stroke. Experts performed the backhand stroke with the wrist extended (re: neutral alignment of the forearm and hand dorsum). Collision of the ball and racket occurred with the wrist extended on average of 0.41 rad (about 23 degrees from neutral alignment) in the expert players; moreover, their wrists were moving further into extension at impact. In contrast, novice subjects struck the ball with the wrist flexed 0.22 rad (about 13 degrees) while moving their wrists further into flexion. Wrist extensor EMGs showed similar levels of activity during the 500 ms interval before ball-racket impact, whereas expert subjects displayed greater EMG levels after contact, consistent with the accompanying wrist extension. The wrist kinematic and EMG data together show that the novice subjects eccentrically contracted their wrist extensor muscles throughout the stroke. We argue that conditions exist for novice subjects that assist stretch of wrist extensor muscles upon collision of the ball and racket. The resulting eccentric contraction of wrist extensor muscles may contribute to lateral TE in novice players, given previous research indicating that eccentric muscle contraction facilitates muscle fiber injury.