Common Injuries in Tennis

Any sport we participate in will always carry a higher risk of injury than would usually be encountered in routine everyday life. That said, each sport possesses a varying degree of risk to the player in terms of injury. Tennis is a sport which features highly when it comes to the likelihood of injury. This may seem quite surprising to a layperson that a non-contact sport such as tennis can result in an extremely high number of injuries, particularly to the lower and upper extremities.

We will examine some of the reasons why tennis results in a high number of physical injuries, as well as investigating their causes and how they can be best taken care of in terms of both healing and prevention of further injury in the future.

Why is Tennis High Risk?

When considering injury risk, we may presume sports such as American Football, Basketball or even soccer to fall into the high-risk bracket due to their nature of repeated contact and the high number of opponents present at any one time. In fact, tennis presents with an average injury rate of 5 per 1,000 hours played. According to recently published research, soccer shows a varying injury rate with a baseline of around 2.38/1,000 hours played, categorizing tennis as having a greater injury risk for players.

Taking a more in depth look at why these numbers are being produced, we have to consider the risk factors when playing tennis. These factors contribute greatly to the increased injuries rates among tennis players, both recreational and professional.

Court Surface

Statistics show that both clay and hard court surfaces carry a significantly higher risk of injury than their grass counterparts. This can be attributed to several factors. The most obvious of these is the firmness of the court. Hard courts produce a stronger impact on the lower limbs when moving around the court and landing firmly.

Inappropriate Footwear

The importance of the correct footwear in tennis is vital to avoiding unnecessary injury. Tennis is a sport where sudden, sharp changes of direction are commonplace. Largely related to that is the high percentage of ankle injuries. Canadian Milos Raonic is a player often hampered by such trouble. 

Lack of Physical Preparation

Highly prevalent among recreational players is a rather cavalier attitude toward playing tennis. A great percentage fail to recognize the level of strain the sport places on the body, seeing it merely as hitting a ball over a net with no physical contact. Due to this, many fail to engage in warm-up stretching. This is a recipe for disaster in any sport.

What are the Most Common Injuries?

Sprained Ankle

Studies have shown that a sprained ankle is one of the most common foot injuries in recreational sport. Tennis is no exception when it comes to this statistic. The occurrence of sprained ankles is likely increased by the fast paced nature of tennis. Regular changes of pace, and sudden directional shifts on the court leave players very vulnerable to ankle ligament damage.

Even the best professional players in the modern game are no stranger to a sprained ankle. Just recently, Andy Murray has returned from an ankle injury, while in the women’s side, Simona Halep has also had a rollercoaster year with ankle troubles. This type of injury can usually be expected to sideline a player for around six weeks.

Knee Tendonitis

Tendonitis of the patellar tendon is a very common injury among tennis players, so much so that it has earned the name, Jumpers Knee. The patellar tendon connects the kneecap to the shinbone. Repetitive jumping action, as is common is tennis especially during the serve and landing on a firm surface causes injury over a sustained period of time.

This repetitive action causes excessive strain to the tendon, leading to tears and damage to the area. Mobility can be greatly impaired when suffering from tendonitis and it can become chronic if not dealt with correctly. Depending on severity, it is likely to cause an absence of at least six months before full recovery can be expected. Rafael Nadal is the latest to be struck down with knee troubles, expecting to keep him out for some time.

Tennis Elbow

One of the most instantly recognizable injuries by name, tennis elbow is indeed highly prevalent. Recent research indicates that there are over 1 million cases of tennis elbow each year in the United States alone.

The injury itself is caused by the inflammation of tendons on the outside of the elbow joint and is otherwise known as Lateral Epicondylitis. The forearm muscles and tendons become damaged over time due to repetitive actions and overuse. This leads to tennis elbow which may present symptoms such as pain or burning sensation on the outer elbow or a weakened grip strength.

While Tennis players are particularly at risk of developing this injury, anybody who performs repetitive tasks encompassing the forearm and elbow joint can be considered vulnerable. Servers at restaurants or bars who are constantly carrying heavy trays full of items are a prime example of a high risk group. Players of other racket sports such as badminton or squash should also be aware of the risk.

Depending on severity and method of treatment, tennis elbow can take between six and twelve months to fully recover, representing a serious chunk of time to any career for a professional player.

Available Treatment Options

A plethora of treatment options are available. These depend greatly on both the type and severity of injury. Treatment can range from basic stretching to a variety of surgical procedures. Focusing on the most commonly diagnosed injuries as discussed above, these are the most likely and effective treatments available to remedy such injuries.

A sprained ankle is most commonly treated by observing the R.I.C.E. guidelines.

Rest by avoiding to place any weight on your injured ankle. The best way to achieve this is by not walking at all on the ankle. Use crutches if necessary. An ankle brace to help protect the injured area and limit motion may also be beneficial if you must move around.

Icing can assist with reducing swelling, be cautious, applying the ice only for limited durations and never directly on to the skin without the use of a cloth. Compression will also help with the reduction of swelling while elevating above the waist or heart will reduce blood flow to the area and further promote recovery and reduced swelling.

In the case of knee tendonitis, there are again multiple levels of treatment depending on the severity of the injury. These range from simply over the counter medication to reduce inflammation to arthroscopic surgery in extreme cases. The vast majority of patellar tendonitis injuries however, can be resolved with a thorough course of physical therapy.

A physical therapy program will focus on the goals of reducing pain in the knee and assisting the correct healing process to then strengthening the affected knee, reducing the chances of recurrence.

Alternative treatments such as hyperthermia thermotherapy which works by combining deep tissue heating with a cooling device on the surface of the skin to reduce pain, and ultrasound dry needling which actually makes tiny holes in the tendon, relieving pain are viable options gaining traction within the medical community.

Tennis elbow can in fact heal independently within the right resting environment. The likelihood however is that sufficient rest is difficult to achieve, especially in tennis. An elbow brace can be worn to help limit movement and promote healing. Further to that, anti-inflammatory medication and injections can help to relieve pain and swelling from the area.

If your symptoms are unresponsive to non-surgical options for 6-12 months, surgery may be presented as an option. This can take the form of either open elbow surgery or arthroscopic surgery. This would involve the removal of damaged tendon and the repair of the remaining tendon. Success rates are extremely high for tennis elbow surgery although the rehabilitation period as with any surgery can be lengthy.

Preventing Future Injuries

It goes without saying that prevention is better than cure. From the standpoint of a professional player, it is key to be on the court as much as possible to earn a living and achieve performance goals. On a recreational level, undue medical expense along with the pain and stress caused by injury is something which can have a huge impact on daily life. For these reasons, we seek to do everything in our power to avoid injury and recurrence of old injuries. The best way to do this is by taking a proactive strategy to injury prevention.

Stretching

Warm-up and rehabilitation stretching is key when playing tennis or recovering from injury. Studies show that stretching can greatly reduce muscle pain and tension, allowing for improved on-court performance. There are a number of stretches you can perform to help loosen the muscles and also protect against damage. These include the wrist flexor stretch performed with your arm outstretched in front, push your downward facing palm back toward your body until you feel a stretch in the forearm. This particular stretch is helpful in preventing tennis elbow.

Stretching your quads is very beneficial in the prevention of jumper’s knee. The most common stretch for this purpose is the hold one leg behind your back close to the buttocks area from a standing position for 30 seconds before repeating on the opposite side.

Most commonly used in the rehabilitation of sprained ankles inversion and eversion stretches. By effectively moving the ankle in a circular motion you help to release tension and reduce stress on the ligaments, a very import warm up and recovery exercise.  

Rehabilitation

Key to injury prevention is a thorough rehabilitation program. This not only helps to overcome injury in a more effective manner, but also to strengthen the injured area, helping to reduce the likelihood of recurrence. Rushed or incomplete rehabilitation accounts for a large amount of repeat injuries.

Ample rest as well as many of the strengthening exercises mentioned above will form a key component of any rehab program, allowing athletes and recreational players alike to stay injury free for longer periods.

There are many types of supporting brace on the market which can assist speedy recovery from all types of injury. From the specific injuries we have covered, you could consider the DonJoy Trizone ankle brace, any good tennis elbow strap, or any of these patellar tendon straps to help boost your recovery and provide added protection.

Equipment

Having the incorrect or unsuitable equipment is one of the leading causes of injury in tennis, be it a poor quality racket which can increase the likelihood of wrist, shoulder and elbow injuries or incorrect footwear which put the wearer at great risk of ankle injury, having the correctly sized and quality equipment is essential.

For footwear especially, you should ensure that you are wearing shoes designed specifically for tennis and the particular surface. These can help provide the best ankle protection as well as cushioning to reduce incidences of jumpers knee and other issues.

Conclusion

It is clearly demonstrated that tennis is a sport which rivals and exceeds many others in terms of injuries and risk level. Despite being a non-contact, individual sport, we should employ the same caution and thoroughness to our preparations as with any other sporting activity.

Highlighting some of the more common injuries, has allowed us to see that although there is a high injury risk present, the existing paths to recovery and preventative measures are both very accessible and effective. With the correct preparations in place, a long career as a professional or recreational player can be enjoyed, allowing you to serve up pain free aces for many years.

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