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Neil is a GoSC registered osteopath, sports massage therapist and fellow of Applied Functional Science, with extensive clinical experience. Neil has also trained with the British Medical Acupuncture Society and often uses western medical acupuncture during treatment. Neil has studied with the world leading Gray Institute in the USA, attaining a GIFT fellowship in Applied Functional Science, and is passionate about the power of functional movement to alleviate pain and enhance performance. Neil has been working in Balham for 4 years. Neil has recently moved to Surrey and commutes to Balham once a week to see patients.

Sharing the load: Why Roger Federer doesn’t get tennis elbow.

June 28, 2017

When you first start to learn about the body, the information can be overwhelming. What’s where, how it works, why it goes wrong…? You find yourself looking for principles to thread together the pieces of the puzzle. Often, however, you struggle to find clarity amongst all the detail. There is one principle, however, 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. Whether it is reaching down to the dishwasher or swinging a tennis racket. Our bodies are designed to cope efficiently with these demands and, when done successfully, our bodies will enjoy and condition themselves to the demands we place upon them.

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 machine begins to take on too much demand, or more demand than it is designed to cope with, the machine may begin to fail in that area. This, however, is often not the fault of the failed component that bravely did its best to handle the excess demand; it is, more likely, the fault of the component elsewhere that stopped sharing its part of the load appropriately.

Recently, I took my car into the garage and was told that the front two tyres were wearing out too quickly. Was this the fault of the tyres? Had I been sold soft tyres that weren’t able to cope with the demands of the road? No, it was due to a problem with the suspension and a resulting misalignment of the wheels causing excess wear. So, should the mechanic a) replace the wheels and hope for the best or b) fix the suspension to stop the wearing. The answer is obvious.

This logic is surprisingly misunderstood when dealing with the human body. The biggest bit of your body is your glutes (bum). The size of the glutes suggests that they are rather important and powerful, and should, therefore, take their fair share of the load. Sadly, with our sedentary lifestyles, the glutes have often lost some of their fine tuning and don’t quite pull their weight.

So, when you reach down to the dishwasher it is very possible that your glutes aren’t helping you quite as much as they should be. The demand of the movement is, therefore, placed somewhere else – usually your lower back. For a while your lower back will work harder and put up with this excess demand, but eventually (just like our well-engineered machine) you may reach a tipping point and pain and dysfunction may occur. Blaming the lower back in this situation doesn’t seem logical. Our mechanic would argue that we need to look harder for, and fix, the cause.
Let’s notch this up a level and move on from our dishwasher analogy to everyone’s favourite tennis player – Roger Federer. Look at the image below of Roger at the end of his forehand:

Roger Federer

Do you notice how open his body is at the point of ball contact? It is almost like his hips and upper body have played the forehand already and his arm is the last thing to whip through. That is exactly what is happening. The powerful bits (this hips and the torso) have rotated through already and have created a 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 bits should be doing what.