Tennis is a pretty popular sport played all over the world. Matches can be long and there are high forces being generated over and over in the shoulder and elbow. This can result in injuries from overuse in the shoulder and elbow. There are also a lot of quick movements for stopping, starting, and changing direction and this can cause acute injuries in the lower body. This article discusses many common tennis related injuries, why the occur and some basic treatment guidelines.
Changes in equipment have improved performance allowing a faster racquet head which causes higher ball speeds and more spin, but these changes may also be causing increased injury. Increases in racquet and string stiffness will cause an increase in vibration which is transmitted to the arm, and this can create increased forces for the muscles in the arm. Different grips have also been shown to be associated with increased rate of certain injuries. For those using a western or semi-western grip it is more common to have injuries on the pinky side of the wrist and arm, where as those using the eastern grip are more likely to have injuries on the thumb side of the forearm.
Common shoulder injuries are related to the repetitive overhead movements, including the high forces during serving. These include labral injuries, impingements, and rotator cuff injuries and biceps tendonitis. Diagnosis is usually based on physical examination, but can sometimes MRI is requested. Usually treatment for these injures can be non-surgical, improving shoulder blade and muscle function. However sometimes this doesn’t work and surgery is needed to repair damaged tissues.
The most common elbow injury in recreational tennis players is lateral epicondylitis, or tennis elbow. It is more common in recreational players because they tend not to have the correct wrist angle for their back hand, compared to professionals. Most cases will respond well to rest and physical therapy including stretching and strengthening. Sometimes using a larger grip racquet or a brace can improve time to return to playing. If these treatments are not successful the next step is to try a corticosteriod injection and as a last resort surgery to remove the injured area of the tendon, can be very effective.
Injuries in the trunk include abdominal strains. These are usually related to the forces involved in serving. Treatment of abdominal strains includes rest, sometimes even from such simple activities as walking. Then gradual stretching and strengthening before beginning an aerobic conditioning program. Abdominal injuries can last up to or more than six months depending on the severity of the injury, so patience is often required to allow a slow return to play.
Low back injuries can be from a muscle strain or spasm in lumbar muscles. This usually presents with pain or stiffness just located in the back, usually from overuse. A more serious back injury can be from a disc herniation, which can include back pain, leg pain or both. Both these can be treated with rest, over the counter pain killers, and physical therapy. For herniated discs more awareness of movement in the lumbar spine for daily activities and exercises is important. Generally surgery is not needed for these injuries, but time for return to sport can vary a lot. Surgery is usually only indicated if there is frank weakness, bladder dysfunction or persistent pain that isn’t responding to conservative management.
In the lower body, hip and ankle injuries are the most common. They usually involve muscle strains in the hip or ligament sprains in the ankle. Both these types of injuries should respond to rest, ice and physical therapy to improve strength and balance. With ankle sprains, the treatment will be based on the grade of injury and may include a short period of immobilization and then the use of tape or bracing to prevent re-injury.
Fortunately there are successful treatments for most tennis injuries and it usually only means a short time away from the sport. There is also some good research being done on prevention programs to help minimize muscle imbalances and improve form to decrease these chronic injuries of tennis players.