Preventing, Identifying, and Rehabilitating Tennis Injuries

By: Dr. Brian Dombal, PT, DPT

Tennis season is in full swing. As with any sport, tennis players at all levels can experience aches, pains, and injuries when playing tennis. Two-thirds of tennis injuries are a result of overuse and the other one-third is due to a traumatic injury or acute event. Overuse injuries most often affect the shoulders, wrists, and elbows.  Understanding the most common tennis injuries, learning stretches and tips to help prevent injuries, and knowing when to see a doctor are immensely important in keeping tennis players on the court this season.

Elbow pain is one of the most common ailment that tennis players experience. Lateral epicondylitis, more commonly known as Tennis Elbow, is tendonitis caused by inflammation of the tendons on the outer bony prominence of the elbow. Tendonitis in the inside of your elbow is called Golfer’s Elbow. Both injuries are usually caused by the repeated strain and overuse of the forearm muscles through repetitive flexing, rotating, gripping, and swinging. To avoid elbow pain and injury, it is important to stretch and strengthen your forearms and wrists. Stretch your forearm by pulling your hand back and then pushing it forward slowly several times. Another good stretch is rotating your wrist in circular motions several times in both directions. Light weight training can also help strengthen your forearm muscles. Additionally, it is always a good idea to get properly sized for a tennis racket and possibly work with a tennis pro to ensure proper technique.

Shoulder pain is another common complaint of players as a result of playing a lot of tennis. The shoulder is the most flexible joint in the body, and has the potential for hundreds of different positions.  The rotator cuff helps position and stabilize the shoulder properly in the shoulder socket, and when it is weak or tired, there in an increased risk of irritation and inflammation which will result in pain with overhead motions like serving. Stretching and strengthening are very important in preventing shoulder pain.  Great shoulder stretches include shoulder rolls, neck rolls, cross-body arm stretches, cow-face poses, and standing wall stretches. Ways to strengthen your rotator cuff include shoulder raises to the side, shoulder circles, internal/external rotation with resistance, and crosses with light weights. Massage and trigger point release also helps break up any tightness in the shoulder.

Stress fractures are commonly the result of increasing training too quickly. When your muscles tire, more stress is placed on the bone. When this happens, the breaking down of the bone overtakes the rebuilding, leading to weakness in an area of the bone that is under high stress. Stress fractures are preventable with proper strength and endurance training prior to playing a lot of tennis. Standing flat footed on an incline is a great stretch for shins and calf muscles. Appropriate footwear is also very important to preventing stress fractures.

Muscle strains happen most frequently as a result of quick, sudden moves. To lessen the risk of muscle strains, you should do a good warm-up followed by proper stretching. The warm-up could include a slow jog, elliptical, or riding a bike at low intensity. Proper stretching should be slow and deliberate, and should cover all of the major muscle groups that you will be using while playing.

Playing tennis at any level can injure muscles, bones, tendons, ligaments and nerves. It is important for tennis players to be informed and educated on how best to identify, prevent and rehabilitate any pains or injuries. Changing a few habits (stretching before playing tennis); adding a few strengthen activities (simple daily exercises and light weight lifting); making slight adjustments to your swing and serve (to improve biomechanics and technique); and seeking treatment as issues arise (massage, physical therapy, and trigger point release therapy) will all make a difference in preventing injuries and keeping tennis players on the courts playing.


Dr. Brian Dombal, PT, DPT is a physical therapist at ProClinix Sports Physical Therapy & Chiropractic in Armonk. He can be reached at 914-202-0700.

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