Tennis Injuries

Tennis might be a mental game, but it also challenges you physically in many different ways. From repeated serving to explosive sprints in all directions, the sport asks a lot of your body.

“You can really injure anything playing tennis,” says Haylee E. Borgstrom, MD, a Mass General Brigham sports medicine specialist.

But don’t let that discourage you from playing the game. Gain the advantage on the court by learning about possible tennis injuries and tips to prevent them.

Common tennis injuries

Many tennis injuries happen from overuse, which causes tissues in your joints to slowly break down. “You can overuse something because you’re doing too much of the activity, or you can overuse something because you’re using it in the wrong way,” says Dr. Borgstrom. A lot of tennis overuse injuries affect your upper body, namely your shoulder, elbow, wrist, or hand.

You could also get an acute (sudden) injury. This type happens from a single traumatic event and causes almost immediate swelling and bruising. Acute injuries tend to affect your lower body in explosive sports like tennis.

Rotator cuff tendinopathy and shoulder tears

Shoulder flexibility helps you hit everything from forehands to overheads. But that flexibility also makes shoulder joints less stable and more prone to injury. In addition, many people use their shoulders to make up for weakness in the torso (your chest, core, and back) without realizing it.

Common shoulder injuries from tennis include:

• Labral tear: Tearing of the cartilage tissue that helps keep your joint in place
• Rotator cuff tendinopathy: Wearing down of shoulder tendons from overuse (more common as you age)
• Rotator cuff tendonitis (shoulder impingement): Rubbing or pinching of shoulder tendons on shoulder bones

Tennis elbow

You’ve probably heard of tennis elbow (pain on the outer part of the elbow), but tennis players can also get golfer’s elbow (pain in the inner elbow). Both are names for overuse or chronic inflammation of the tendons that start in your elbow. These tendons run down your forearm and let you move your hand and wrist.

Wrist injuries

You can also hurt your wrist playing tennis, which may look like:

• Carpal tunnel syndrome: A nerve in your wrist that gets pinched or squeezed, which causes numbness and tingling
• Tendon injuries: Inflammation (tendonitis) or overuse (tendinopathy) of the inner or outer tendons in your wrist
• Wrist sprain: Stretching or tearing of a ligament in your wrist

Knee injuries, tennis leg, and ankle sprain

Fast sprints and sudden pivots on the court can lead to injuries in your lower body. Dr. Borgstrom commonly sees knee injuries, including:

• Ligament injuries: Spraining or tearing a ligament in your knee, such as the anterior cruciate ligament (ACL)
• Meniscus injuries: Wearing down or tearing of the cartilage (meniscus) in your knee
• Patellar tendonitis (jumper’s knee): Inflammation of the patellar tendon, which connects your kneecap to your shin bone

Playing tennis may also lead to strained muscles in your calf (tennis leg) and a sprained ankle. “Because you’re cutting a lot in tennis, you can tear the ligaments on the outside (or, less commonly, the inside) of the ankle,” she says.

Preventing tennis injuries

“In many cases, injury prevention comes back to form and biomechanics, or how everything is working together,” highlights Dr. Borgstrom. “Paying attention to the entire chain of joints and muscles in a movement is absolutely key.”

She stresses the importance of strengthening and stretching your body. On both your dominant and nondominant side, concentrate on your:

• Torso: Your trunk is essential in every movement, both for generating power in your swing and for explosive movements. Make sure your core and hip abductor muscles are strong to prevent lower body injuries. Check out exercises for the hip.
• Chest, shoulders, and upper back: Proper alignment, strength and range of motion in these areas, as well as your upper and middle spine, can prevent elbow and wrist injuries. In particular, Dr. Borgstrom recommends a shoulder strengthening program.
• Elbow and wrist: Try doing wrist and elbow strengthening and stretching exercises. By targeting the muscles in your wrist, you actually strengthen your elbow because the tendons don’t have to absorb so much force. “The stronger the muscles, the better the biomechanics in the region, and the fewer overuse injuries you will typically have,” says Dr. Borgstrom.
• Ankle: If you’ve had an ankle injury, you’re at risk for another one. “Using tape or a lace-up brace can be helpful in preventing ankle sprains,” suggests Dr. Borgstrom.

Warm up and cool down

“An adequate warm up and cool down session is important, especially in sports that involve sudden movements,” says Dr. Borgstrom. Actively warming up gives your body a chance to increase blood flow to your muscles, which helps prevent acute injuries.

Check your equipment

Make sure you have the right racket for you, from grip size to string tension. “A lot of the muscles and tendons you use in tennis are responsible for gripping,” says Dr. Borgstrom. “If your racket handle is too small, then you have to grip the handle tighter, which causes inflammation.”

Switch it up

Dr. Borgstrom encourages everyone to stay active in more than one way. “Even if tennis is your primary sport, taking up another activity that you enjoy can be very useful for recovery, cardio, and strength,” she says. “It’s also important for young people to not specialize in a sport too early. Doing so exposes athletes to overuse injuries, overtraining syndrome, and burnout.”

As for tennis, “start low and go slow,” she advises. “Listen to your body, and give yourself adequate rest and time to recover.”