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Share the load! Why tennis elbow may originate from your hips.

Updated: Mar 1, 2020

There is one principle that has helped me to demystify pain and dysfunction in the body more than any other: “sharing the load”.

Each movement that we make places a demand on our body. As with any well-engineered structure, the demands placed upon it should be shared appropriately between the various parts of the machine.

Some parts may be bigger and stronger than others and, therefore, be designed to cope with more demand. If one part of the body begins to take on too much demand, or more demand than it is designed to cope with, the body may begin to fail in that area. We refer to this as an 'overload'.

Usually, this is not the fault of the failing muscle, tendon or ligament that is doing its best to handle the excess demand; but the fault of the area that is not doing it's job properly. This may be some distance from the symptom!

This logic is surprisingly misunderstood when dealing with the human body. We tend to blame and treat the symptom with little or no understanding of the cause.

If a hip, foot or back is not moving well, then it may create an overload elsewhere during movement. When you reach down to the dishwasher your hips and glutes may not be providing quite as much support as they should be. The demand of the movement is, therefore, placed somewhere else – usually the lower back. For a while your lower back will work harder and put up with this excess demand, but an increased load or unfamiliar movement may cause pain and dysfunction to occur in an overloaded spine. Blaming the lower back in this situation does not address the underlying cause.

Let’s notch this up a level and move on from our dishwasher to everyone’s favourite tennis player – Roger Federer.

When you watch Federer play a forehand, you can see how he sinks into his hips and then accelerates into the shot through his whole body. It is almost like the hips and upper body play the forehand before his arm whips through the shot. The powerful bits (pelvis and trunk) have rotated already creating an acceleration and whip like movement in the arm. The arm is going along for a free ride, as all the power has been generated elsewhere. It makes sense, we don’t want our poor little forearms to do all the work – we want our big bottoms and hips to do it for us. Roger won’t be getting tennis elbow if he plays like this, because the stress of the shot has been taken away from the arm.

If, however, you are a mere mortal on the tennis court, you may overuse your arm and shoulder without generating sufficient power in the bigger parts of the body. Tennis elbow and shoulder issues may then become a factor, as you are asking the smaller bits of you to take up all the demand, while underusing the big bits!

You could make a case for tennis elbow being renamed tennis pelvis! Ok, it sounds like an entirely different (and more unfortunate) type of injury, but it helps us to understand where the problem may originate from. It also might encourage us to think differently about how to tackle it.

This principle applies to all of us and you don’t have to be a superstar athlete to move well and avoid these problems. You just have to move regularly in the right ways in order to remind your body which parts should be strong and functioning well. Training in an integrated way, using whole body movements can promote a well functioning muscular system. If our movements and exercises reflect the tasks and hobbies that we perform, then this can make us even more robust and resilient when performing these tasks.

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