How to avoid 2 most common tennis injuries?

Tennis injuries are generally defined as either overuse or cumulative injuries and traumatic or acute injuries. Overuse injuries occur over time due to stress on the muscles, joints and soft tissues without proper time for healing. Usually they begin as a small, nagging ache, and can grow into a debilitating injury if they aren't treated early. Injuries that fall into this category for example include injuries like tennis elbow, frozen shoulder, etc. Traumatic injuries can be quite dramatic and occur due to a sudden force. As in some other sports, the most common traumatic injuries in tennis include muscle sprains and strains, ankle and wrist sprains, shoulder separation, hamstrings pull or tears, achilles tendon rupture...   


The most common injuries associated with tennis are following:

• rotator cuff tendinitis,
• tennis elbow,
• wrist strains,
• back pain,
• knee pain
• calf and Achilles tendon injuries,
• ankle sprains,
• tennis toe...

In this article we will discus treatment, but most of all prevention of the two most common overuse injuries – tennis shoulder and tennis elbow. 


Tennis shoulder

Rotator cuff tendinitis injury occurs in sports requiring the arm to be moved over the head repeatedly: inflammation of the tendons are common among tennis players, but also weight lifters, swimmers and pitchers. Therefore the alternative names such as swimmer's shoulder, pitcher's shoulder and tennis shoulder.

Treatment and prevention

Best treatment for tennis shoulder is rest, ice packs applied to the shoulder and nonsteroidal anti-inflammatory drugs (NSAIDs). In cases when the symptoms persist despite conservative therapy or rotator cuff has sustained a complete tear, surgery may be necessary.

If symptoms resolve only to recur when you return to play, you must learn to modify your tennis technique to increase the angle between your arm and side to more than 90° - ideally 135°. This position will lessen the chance of injury.

In addition to treatment, physical therapy to strengthen shoulder muscles should be started, which is one of the most recommended activities to avoid this injury in the first place.


Tennis elbow

If you play tennis, squash or racketball, chances are good that you will develop a problem called ‘tennis elbow’, since this condition affects up to 45% of regular racket sport participants.

Most experts believe that this condition is caused by overloading of the forearm muscles due to faulty backhand technique: improper body positioning with the elbow leading the racket, combined with late strokes and "wristy" impacts. For this reason it is believed that modifying your tennis technique or the two-handed backhand relieves stress.

Treatment and prevention

Proper racket selection and grip size play a significant role. Smaller heads and excessive string tightness require the forearm muscles to exert more force which can lead to tennis elbow. Choose less-stiff graphite-type rackets with large heads that expand the impact area - the stiffer the racket, the larger the force transmitted to the arm. Also, string your racket less tightly - the tighter the strings, the higher the force and more chance to increase tennis elbow injury.

The grip should be comfortable and not too small. The best way to choose grip size is to measure the distance from the crease of your palm to the tip of the ring finger. Grip that is too large or too small increases wrist-muscle fatigue, making the wrist unstable and leads to too large forces at the elbow.



Since the cement and other hard courts raise ball velocity, producing greater impacts and higher elbow forces, it is recommendable to play on clay or grass courts.

If, despite these preventive steps, tennis elbow serves up a painful challenge to your game, the following measures should help you. You may use oral anti-inflammatory medications as directed by your doctor or/and apply anti-inflammatory creams to the elbow joint. According to scientific studies Transcutaneous Electrical Nerve Stimulation treatments have been shown to reduce pain and inflammation. Another very effective method is applying ice on sore elbow, keeping the ice on for 10- to 12-minute intervals, with 20-minute rests between applications. Once the pain subsides, it is recommendable to use tennis elbow supports when you play. And at the end, if all types of treatment fail, surgery may be considered.  


Shoulder and elbow injuries occur frequently in tennis players of all ages. According to Jim Zachazewski, Clinical Director, MGH Sports Medicine these are the causes:

• Using a racket that has the wrong grip size, is too light or heavy or is strung with too much or too little tension
• Poor stroke mechanics and technique
• Not having sufficient strength and endurance of the muscles that surround and support the shoulder and elbow
• Having good cardiovascular endurance to allow you to get into position to hit the ball appropriately using your body and appropriate technique and not just reaching with the racket.
  

Many sports injuries result from lack of proper rest, lack of warm ups or poor conditioning, but also from overuse. In order to prevent them, apply these tips:

• Warm up thoroughly prior to play.
• Wear the right tennis shoes with skid-resistant soles.
• Use approprieate tennis equipment
• Use good technique.
• Clean tennis court before play - check for slippery spots.
• Get adequate recovery if injured.
• Stay hydrated.