Frame design has chased power and forgiveness for thirty years, and the load that used to go into the racket now goes into the player.
Light stiff frames made tennis easier and arms worse
Pick up a wooden racket sometime. It is heavy, small-headed and startlingly soft, and it punishes an off-centre hit so badly that you learn to find the middle within about ten balls. Then pick up a modern frame. Light, wide, stiff, and generous about where you strike the ball.
That generosity has a bill attached. A stiff frame deforms less on impact, which means more of the collision energy goes back into the ball and less is absorbed by the racket. Good for the shot. The energy that is not absorbed by the frame does not vanish, though; a share of it travels back up the handle into a wrist, a forearm and an elbow, and the harder the frame the less of that is filtered out.
The weight change makes it worse rather than better, which surprises people. A heavier racket resists the ball more on impact and shifts less on a mishit, so the twisting force at the wrist is smaller. Light frames move. Players compensate by gripping harder, and a tight grip is the fastest route to an unhappy elbow that I know of.
Then the strings changed too. Polyester lets you swing at full speed with control that a natural gut string would never have given you, which is precisely why everybody plays with it, and it is stiffer and far less forgiving through the arm. Stiff frame plus stiff string plus lighter mass plus a swing pattern designed to generate maximum head speed. Four changes, all pointing the same way.
Coaching mostly did not respond. The technical model is still built on getting racket-head speed up, because racket-head speed is what produces the modern shot, and nobody wants to be the coach whose player hits a lighter ball than the boy on the next court.
What I would like to see is aerodynamics used for the player instead of the ball. Frame shaping that cuts through the air with less resistance is genuinely useful, because it lets a player reach the same head speed with less effort. That is available now. It mostly gets marketed as extra power, which encourages the player to swing just as hard and pocket the difference as pace.
We built equipment that removed the penalty for hitting badly. We should not be surprised that so many arms now pay it instead.
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