Tennis is one of our favourite summer sports and it’s not hard to see why. The fast-paced, exciting game, played on grass, clay or other hard courts, requires physical fitness and great hand-eye co-ordination. Players need to be fast and have good technique and physical endurance to run, position, swing and hit the ball throughout the match.
Nearly a third of injuries are upper limb
However, with the exhilaration and adrenaline comes a high risk of injury. A report in the British Journal of Sports Medicine looked at tennis injury data from Wimbledon between 2003 and 2012. The overall injury rate for all players was 20.7 per 1000 sets played. Injury rates were higher for female players (23.4 injuries per 1000 sets played) than for male players (17.7 injuries per 1000 sets played). Upper limb injuries account for 28% of all injuries in both men and women. The report called for more studies to analyse variations in injuries between the sexes and between different playing surfaces.
Two thirds from repetitive use
Strains placed on the upper limbs by tennis strokes, and in particular the serve, can cause repetitive use injuries of the shoulder, elbow and wrists. According to the American Orthopaedic Society for Sports Medicine, around two-thirds of tennis injuries are due to overuse. A third are caused by trauma, such as fractures, strains, and tears.
Tips for preventing common injuries
Although some tennis injuries are unavoidable, others can be prevented through a combination of proper conditioning, good technique, using the right equipment and seeking medical attention promptly if you suffer an injury.
Here are some of the most common tennis injuries and our tips for preventing them:
Rotator cuff injuries
The rotator cuff is a group of muscles and tendons that surround the top, rear and front of the shoulder, keeping the ball of the humerus bone centred inside the socket and stabilising the shoulder joint. You use the rotator cuff for lifting and rotating your arm.
If you play tennis regularly, microtears or partial tears may develop in the rotator cuff as a result of repetitive use or jarring from hitting the ball. These are referred to as tendinopathy (formerly tendinitis or impingement syndrome) and they cause pain throughout the upper arm, which is worse at night or when you move your arm away from your body. Sometimes the rotator cuff may become completely torn.
To prevent this type of injury it is important to do a proper warm up before starting any type of vigorous exercise. Training with a professional tennis coach will not only help you to develop the correct technique but will show you exercises to stretch your shoulders and arms before a tennis match.
You can strengthen your rotator cuff using low resistance exercises, making small, controlled movements. If you start to develop any kind of pain in your upper arm or shoulder you should reduce the amount you are playing and seek the attention of a healthcare professional, who will usually recommend physiotherapy in the first instance, to help rebalance your shoulder.
Tennis and golfer’s elbow
Tennis elbow, also called lateral epicondylitis, is a painful condition caused by overuse of the tendons and muscles surrounding the elbow joint. This leads to small tears of one or more of the tendons, and symptoms include pain around the outer (lateral) part of the elbow and forearm and with movement in the wrist. The pain may worsen if you try to straighten your fingers or bend your hand backwards. It tends to cause most pain during the backhand stroke, especially if you play it as one-handed stroke. The condition is not restricted to tennis players but can occur in anyone who makes repetitive movements of the elbow and wrist.
Golfer’s elbow is very similar in nature to tennis elbow, but affects the tendons on the inner (medial part) of the elbow. It is actually more common in tennis players than golfers and is most associated with pain during the forehand and service strokes.
It is not always possible to prevent tennis elbow but avoiding putting too much strain on the tendons of the elbow will help. Again, having proper coaching is essential to improve your technique. Often the ball is being struck on the backhand side with the elbow locked out too straight and without enough rotation of the torso and shoulder. Using a lighter weight racket and enlarging your grip size will help to avoid overstraining your tendons.
You may want to wear a tennis elbow splint when you are using your arm and doing exercises to strengthen the muscles in your forearm can also help. Because the problem is due to a small tear in the tendon, it is important that you take a small break from tennis, or at least from playing the painful strokes, until things have had a chance to heal. A healthcare professional can help guide you.