10s are naturally more sensitive to adjustment, there's less slack space to work with. That said, they should work great when well adjusted (can you imagine riding the Tour with this sort of slippery shifting?).
My experience has been that alignment is the problem when when 10s shifting can't be adjusted. There are three places to look at: 1) Bent cage on the derailer. 2) Bent or mis-aligned derailer tab. 3) Twisted bottom bracket (not common).
Generally you can see if a cage is bent - it helps to look at it from behind (on the bike) and turn it on its pivot to see the plane it describes. If its bent, you can usally "adjust" it without tools.
A derailer tab can be easily tested by most bike shops. Park, Campy, Var and others make a tool specifically to test this. On steel dropout, the tool can also be used to adjust the dropout. Aluminum or carbon frames/dropouts should be returned to the manufacturer for repairs. The exception to this is a damaged replaceable derailer tab. This should be replaced even if the derailer action is fine - it's a likely point for eventual failure.
A twisted bottom bracket is rare, but changes the fundamental chainline adjustment pointing it either to the right or left of straight back. The direction opposite from where the chainline points will have problems making smooth consistent single cog shifts.
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