St Albans Osteopathy Blog


Tennis players are subject to a range of injuries, falling into the broad categories of acute and overuse. Due to the considerable requirements of the sport in terms of hand-eye coordination, cardiovascular endurance and complex musculoskeletal participation and flexibility, a range of conditioning exercises is recommended.

Common Injuries

  • Rotator cuff tendonitis: This overuse injury affects the muscles and tendons originating from the shoulder blade or scapula, attaching to the upper arm bone or humerus. A wide range of movement in the shoulder is provided by these muscles and tendons, which are prone to becoming inflamed from overuse. In recreational tennis players, rotator cuff tendonitis commonly results from excessive overhead serving.
  • Tennis elbow, or lateral humeral epicondylitis: This painful injury is due to inflammation or small tears of the forearm muscles and tendons on the lateral side of the elbow.  
  • Overloading of the forearm muscles, often due to faulty backhand technique, especially overemphasizing the wrist, can cause the affliction.
  • Back pain: This condition often results from improper technique, particularly an exaggeratedly arched, or swaybacked posture during execution of the serve. Such exaggerated postures cause stress to the small joints and soft tissues of the spine, a situation more critical in older players, who may develop progressive stiffness and arthritis.
  • Knee pain: Pain to the anterior portion or front of the knee is the most common. This is either caused by chondromalacia (a softening of the cartilage) of the knee cap or patella or tendonitis, usually at the patellar tendon. The injury is more common in professional players or elite recreational players as it tends to result from springing up from the knee during the serve.
  • Calf and Achilles tendon injuries: Tendons and muscles of the calf or Achilles can result from an overload from pushing off with the foot while the leg is fully extended. Overuse of the tendon can produce Achilles tendonitis, involving painful inflammation. In severe cases, the Achilles tendon can rupture, producing a sudden snap. The injury requires casting and sometimes surgery. Tearing of calf muscles is also common.
  • Ankle sprains: Most commonly, the outer ligaments of the ankle become sprained.
  • Tennis toe: This injury results from the toes being too tightly jammed against the toebox of the shoe, especially during abrupt starts and stops. The condition is actually a haemorrhage under the toenail, often causing considerable pain.

Injury Prevention Strategies

  • Training in agility can help prevent loss of balance and sudden, traumatic stress to muscles, joints and tendons
  • A two-handed backhand reduces stress on the muscles attaching to the lateral epicondyle of the humerus, helping to prevent tennis elbow
  • Proper racquet selection and grip size are critical in preventing tennis elbow and other injuries related to improper technique. Smaller racquet heads or excessive string tightness place more stress on forearm muscles, which can lead to tennis elbow.
  • Stiffer graphite-type racquets with larger heads offer an enhanced “sweet spot,” causing less muscle stress
  • Flexibility and strength training should be undertaken to avoid both overuse and traumatic injuries, especially among those who play the game more than twice a week

3 Tennis Stretches

  1. Rotating Wrist Stretch: Place one arm straight out in front and parallel to the ground. Rotate your wrist down and outwards and then use your other hand to further rotate your hand upwards.
  2. Assisted Reverse Chest Stretch: Stand upright with your back towards a table or bench and place your hands on the edge. Bend your arms and slowly lower your entire body.
  3. Kneeling Heel-down Achilles Stretch: Kneel on one foot and place your body weight over your knee. Keep your heel on the ground and lean forward.
April 26th 2019

Philip Bayliss, St Albans Osteopathy, 43 Thames Street, Christchurch 8013 ☎️ 03 356 1353