Tennis Injuries: How to Prevent and Treat Them

If you are an avid tennis player, all gearing up to become one, then it’s very unlikely that you ever had or will ever have any injury as tennis is one of the most injury-prone sports. When you play tennis, you coordinate between your eyes and hands and swing your body from side to front. You need complete body participation while you play this sport, resulting in severe injuries in different parts.

However, every problem has its solution, including injuries related to tennis.

In this blog we will discuss the common types of tennis injuries, the reasons for the injuries, how the playing techniques are responsible for the injuries, and lastly, the treatments that can relieve you.

The Vicious Cycle of Adaptation and Injury

Before you know more about tennis injury prevention, let’s discuss how adaptation is related to injury.

Long-term tennis players often get flexibility adaptation, and balance in strength. This results in inflexibility to move the hips, shoulder, and elbow, touch the toes, and feel tightness in extending the forearm. These specific weaknesses can create overall weakness in the entire body.

As a result, though the body doesn’t get injuries frequently, the optimal capability of withstanding the injuries is reduced. This creates an overload process in the body’s further adaptability and makes the body more susceptible to further injuries. This specific way of getting injured over time is also known as the “Negative feedback vicious cycle,” described by the diagram below.

Types of Injuries

There are mainly 2 groups of factors that affect a player’s performance by creating tennis injuries. They are:

• Specific injuries while playing
• Individual factors

However, to be precise, there are 2 broad types of tennis injuries. They are:

Traumatic injuries

Types:

These types of injuries include sprains, fractures, and pulls in the muscles.

Causes:

1/3rd of the injuries that occur while playing tennis are traumatic injuries, though the severity depends on the age and the player’s activity levels. Normally, the lower extremities of the body are more vulnerable to traumatic injuries. These injuries take time to heal and have nothing to do with the playing techniques.

Overuse injuries

Types:

These types of injuries include tendonitis, strain, tendinosis low back pain, etc.

Causes:

2/3rd injuries that occur while playing tennis are overuse injuries. The players’ techniques or musculoskeletal system changes can create this type of injury. Repetitive forceful motions, less recovery time, lack of rest, inflexibility with time, or strength imbalance, etc. can create such injuries.

The Effect of Racquets and Surfaces

Tennis injuries are mostly caused by the types and use of Racquets and the surface type. However, it’s difficult to determine which factor is solely responsible for which injury, and hence tennis injury prevention also changes depending on the reasons.

But normally, racquet-related injuries are not too serious a determinant of injuries.

Racquets

It’s important to mention that the tennis bat creates a load on the arms, shoulders, and hands of the player. The loads come from the movement of the arms, the speed of the ball, and impacts on the racquet.

The racquet has three types of impacts on the types of body injuries. They are:

Vibration

The string vibration while hitting the ball coming from the opponent and the oscillation vibration are the two types of vibration that can create tennis injuries. String vibration can be mitigated using elastic damper devices on the strong bed. However, oscillation vibration can’t be controlled by damper devices.

Ways to mitigate: Significant muscle activation is needed to reduce the activation energy of the tennis ball.

Shock and jar

When the tennis ball hits the racquet, a notable shock or jar is felt in the hand. Though this shock lasts a very short time, the impact is prominent.

Ways to mitigate: A shock absorber in the wrist and forearm helps lessen the shock-related injury. But it’s difficult for the player to understand the vibration relation or the shock and jar-related injury.

Shoe surface interaction

Friction- This is the horizontal movement of the body depending on the grip of the shoes.

Compliance- This depends on the softness and the vertical load-bearing capacity between the shoe and the surface.

The Relation of Technique to Injury

If we consider the biomechanical or medical point of view, there is no perfect technique or posture to give a shot. Normally, when the hands are given a shot, there can be several combinations of handwork, footsteps, legwork, joint movement, racquet movement, and muscle activation. None of these combinations are wrong.

The injuries are normally determined by this coordination and can be described by the kinetic chain below.

The kinetic chain

As you give a shot to the tennis ball, the shock or energy is transferred throughout the body, creating a cascade of impact from the hand to the toes. This principle of energy transfer is known as the Kinetic chain.

Image A above shows that the kinetic chain starts from the ground to the legs, hips, trunk, back, shoulder, elbow, and wrist.

However, if the chain is broken somewhere, for example, in image B, then the energy cascade will not be able to transfer properly and will result in injuries. This chain break may affect different parts of the body and these specific spots’ tennis injury prevention and care methods will be different.

Some relevant statistics

To understand more about the patterns of injuries, let’s get into some interesting statistics.

Injury localization

It is found that 10 out of 13 people get injuries in their lower body extremities.

Injury type

4 out of 6 studies show that more acute injuries are common rather chronic injuries. Acute injuries occur mostly in the lower extremities, and chronic injuries occur in the upper extremities. Body injuries comprise 5-25% injuries out of the overall injuries.

Injury severity

When the injury severity is measured depending on the rate of admission to the hospital, time loss, medical treatment, etc., it is found that 3.3% are normally acute and 2.2% of chronic injuries need surgeries.

Sex

In a particular study, it has been found that male players suffer from 1.6 injuries per 1000 hours, whereas female players get 1.0 injuries per 1000 hours.

Age

It is found as per The Letsel Informatie Systeem, 6-10 age group players get 0.01 injuries/player/year. The number is increased to 0.5 injuries/player/year.

The volume of play

Increased playing hours create more injuries like tennis elbow. However, playing for 4-6 hours for regular and recreational players is almost the same.

Level of play

Performance success is highly related to the extent of injuries.

Some Common Tennis Injuries and Prevention

Shoulder Injuries

When glenohumeral external rotation increases, rotator cuff tears. The rotator cuff is the combination of tendons and muscles that is responsible for the shoulder’s mobility and stability. In simpler language, overuse causes this injury, leading to symptoms of tenderness, pain, and crackling noise. You will also face difficulty in lifting your arm because of a weak shoulder.

How is it diagnosed:

X-rays and MRIs are normally followed to diagnose shoulder injuries.

Treatment:

Some common treatments include:

• Physical therapy for mild tear
• Cortisone injections on doctor’s advice
• Surgery is an extreme situation

Elbow Injuries

Flexor Pronator Tendinitis and Lateral Epicondylitis are two common elbow injuries in novice tennis players. Such condition are lateral elbow tendinopathy, most commonly known as tennis elbow which happens because of flex positions. On the contrary, expert players are more prone to medial elbow tendinopathy, which is mostly caused due to wrist snaps. Pain, burning sensation, and weak grip are some of the common symptoms of elbow injuries.

How is it diagnosed:

Physical diagnosis and MRI are some common ways to diagnose the condition.

Treatment:

Some common treatments include:

• Use of anti-inflammatory and anti-steroid drugs
• Elbow elastic support
• Practicing with correct grip and position
• Choosing the correct racquet with the appropriate weight and size

Lower Back Injuries

Injury in the lumbosacral spine is common because of excessive axial rotation. Also, at times trunk’s rotation and bending together can cause lower vertebra fractures or cause the vertebrae to shift forward leading to the condition of spondylolisthesis. Such lower back injuries are also known as stress fractures and are extremely painful. A hard tennis court is one of the most common reasons for such injuries.

How is it diagnosed:

CT scan, MRI, and X-ray can diagnose this injury.

Treatment:

Stretching before playing can help reduce stiffness.

Include a combination of lower and upper body flexibility training program.

Experiment with other activities like swimming or motorcycling where the focus is on the back.

Ankle Sprains

Ankle sprains are the most common sports injuries that players experience. Among various ankle sprain injuries, an inversion ankle sprain is the most common one among tennis players. Tennis players have to constantly move, jump, and run because of which they land on their ankles in a wrong posture, causing a sprain. Swelling, bruising, stiffness, and pain are common symptoms of ankle sprains.

How is it diagnosed:

Ankle sprains are diagnosed mainly with clinical observation when the player has a swollen outer part of the ankle along with pain and discoloration.

Treatment:

These options can help in relaxing:

• Use of supportive footwear
• Not playing on uneven surfaces
• Offer rest, ice pack, compression, and elevation for about 48 hours
• Correct your balance through hips, ankles, and knees to reduce pressure on the ankle

Knee Injuries

Knee injury is another common injury that most tennis players suffer from. The kneecap manages your leg’s movement and balances you when you jump and land on the ground. So, when you jump and do not land appropriately, it impacts the knee cap, causing injury. Knee injuries are painful, and you feel a little swelling with warmth.

How is it diagnosed:

X-ray, MRI, and CT scans are some of the ways that help in diagnosing knee injuries in a tennis player.

Treatment:

While rest is the only way to relax knee injuries, you can try these options too:

• Practice the method of rest, ice pack, compression, and elevation for at least 24 hours
• Practicing a few stretching exercises can also help in reducing the discomfort.

Wrist Injuries

Players often exert extra pressure on the wrists in a two-handed backhand or forearm position. When you use the wrists in ulnar deviation during such strokes, your wrists get prone to a major injury called extensor carpi ulnaris tendinitis. This injury is not caused due to overuse like other injuries. Sudden deviation is the main cause of wrist injuries.

How is it diagnosed:

MRI is the best way to diagnose wrist injuries.

Treatment:

Wrist injuries can be extremely painful, and these treatments can help:

• Rest and splinting
• Non-steroidal anti-inflammatory drugs
• Corticosteroid injections directly into the sheath

Abdominal Injuries

The abdominal muscle plays a major role during service through trunk rotation movement. Asynchrony during the trunk movement can cause abdominal muscle injuries that can get extremely uncomfortable over a long period. If you get abdominal or groin injuries, the pain and discomfort can last for a long and aggravate even when you are walking.

How is it diagnosed:

Clinical observation is common for diagnosing abdominal injuries. However, MRI and diagnostic ultrasonography are used these days to better understand the injury.

Treatment:

Patients with abdominal injuries can get relief in these ways:

• A minimum rest of 1 to 2 weeks
• Ice packs and compression
• Use of non-steroidal anti-inflammatory drugs
• Starting slow stretching after the resting phase of 2 weeks

It’s very crucial to follow the doctors’ advice as different injuries may show different symptoms for different players. Here we discussed some common ways to diagnose and treat them. However, visit and follow your doctor as soon as possible. You should start playing only after completely recovering from abdominal muscle injuries and pain and when approved as fit by your doctor.

Movement cascade that creates pain

Conclusion

Injuries are the part-and-parcels of a tennis player, no matter how experienced or aged he is. Again, it is very difficult to predict which posture or shot will give the body a negative effect by disrupting the kinetic chain. So, it’s of utmost importance to consult trainers and use proper tennis equipment and accessories when you decide to play this high-intensity sport. We have discussed several aspects of the injuries and the treatments along with different other scientific know-how.

Hope you liked reading this blog and you can share your thoughts in the comment section.