If you're pushing 40 and play tennis a couple of times a week, you're an even money bet to develop tennis elbow. The older you are and more often you play, the likelier the injury.

Although not limited to tennis players, lateral epicondylitis as it is known medically comes from exerting too much force on a joint that wasn't designed to do what people do when they play tennis. For most individuals the pleasure and fun that comes from tennis as a leisure activity far out weights the risk.

There are ways to tilt the odds in your favor. First recognize that pain, often after years of play, is the obvious tip-off. Left to run its course, tennis elbow can get so hot that even the toughest of baseliners can't take the agony of gripping a racket.

No mistaking the diagnosis there. What it reflects is the weekend warrior's headstrong resistance to listening to what his body is saying. As Dirty Harry once said, "a man has got to know his limits" (and by-the-way, it is not gender specific.)

The onset of this tendonitis is often more insidious, beginning with a slight bearable ache that grows. At first it might seem inconsequential, as for example, when switching to a new racket that is either too tightly strung or so stiff that it magnifies the impact of repeated force on the elbow.

Sometimes the cause is due partly or completely to something else such as arthritis, rheumatism or gout. If no other conditions exist, lateral involvement is seven times more common than at the side nearest the body (medial) and the most likely causes are backhand hits off the rear foot and serves hit with too much wrist. However if the culprit is on the medial side it is most likely late forehand hits.

The comparatively low incidence of tennis elbow on the pro circuit (per hours played) underscores the importance of technique. Most recreational players tend not to get enough body motion into their strokes. The result is an overload on the small arm and shoulder muscles with predictable results, particularly on fast, hard-surface courts.

If you are hurting don't wait; first and foremost apply cold therapy. While the local pharmacy is full of remedies, topical analgesics and anti-inflammatories, the best treatment you can use is cold therapy and then exercise the demon.

After you have quenched some of the initial heat, start on the standard exercises-wrist curls (see list and description below)-designed to promote healing. Get your priorities straight, don't play tennis to get in shape, get in shape to play tennis.

Get together with your Club Pro and review these pointers, it can help:

• Racket size - midsize rackets offer the best combination of hitting surface and control, Racket material, graphite composites seem to do a good job to damping vibration
• Racket weight - (lighter is better) and grip size (very important)
• Racket stringing - a couple of pounds below manufacturers minimum for ailing elbows

Cold therapy should be applied as quickly as possible to treat tennis elbow. Cold therapy wraps reduce pain and inflammation and promote healing. Cold therapy is the most widely used modality for the treatment of musculoskeletal injuries and pain management; cold wraps are a great way

The I.C.E. DOWN cold therapy system is designed to deliver cold and compression in the simplest and most convenient manner possible. Because of the various sizes, the ease of application and portability of I.C.E. Down, it can be worn while exercising and immediately after a set or two on your favorite court.

Excersing the Demon

Wrist Stretching - place palms together, raise your elbows, push hands together and hold for ten seconds. Relax and repeat ten times. Place back of hands together lower elbows towards the floor, push hands together. Hold for ten seconds, relax and repeat ten times.

Forearm Stretching – sit on a stool or chair, rest your arm on a table and with the opposite hand pull your tennis hand up to a 45-degree angle. Hold for ten seconds, repeat ten times. Repeat by easing the palm of the hand back to the body.

Strengthening – starting with a light barbell (1 to 3 lbs), slowly flex your wrist up and down, palm up and palm down, hold at the top and bottom of the motion for one second.

Perform all exercises at least daily and preferably more often.

Click here to view cold therapy packs for the elbow by I.C.E DOWN.