Tennis Injuries

Tennis is a fast-paced sport which can take place on a number of different surfaces; this may contribute to a range of different injuries. Some of the most common tennis injuries are listed below:

Tennis elbow

What is tennis elbow?

Tennis elbow, also known as lateral epicondylitis, is a condition which commonly affects tennis players as a result of constant strain on the elbow joint and overuse of the tendons and muscles surrounding the joint. Tennis elbow is caused by inflammation of one or more of the tendons around the elbow; commonly the tendon in the extensor carpi radialis brevis muscle becomes inflamed; this tendon is located below the outer side of the elbow.

Causes of tennis elbow

Most cases of tennis elbow result from overuse and repeated bending of the wrist. In tennis, tennis elbow may also be caused by poor technique; using wet balls and racquet strings that are too tight may also trigger tennis elbow.

Symptoms of tennis elbow

Common symptoms of tennis elbow include localised pain in areas of the elbow joint (this depends on the location of the inflamed tendon) and restricted movement in the wrist. Pain often becomes heightened when the fingers are straightened or the hand is bent backwards.

Treating tennis elbow

Tennis elbow is an overuse injury, so the elbow should be rested in order to allow it time to heal. Ice may also help to ease any inflammation. In some cases, doctors may recommend wearing a support to protect the tendon during physical activity. Physiotherapy may also increase flexibility in the joint and strengthen the muscles and connective tissue surrounding the elbow. Acupuncture has also been proven to improve cases of tennis elbow.

Preventing tennis elbow

It is important to warm up and cool down thoroughly before and after physical exercise. Wearing supports and doing specific exercises may also reduce the risk of suffering from tennis elbow.

Sprained ankle

Sprains affect the tissue that surrounds a bone or joint. The ankle is the most commonly sprained joint in the body.

Types of sprain

Sprains may be mild, serious or severe; they are categorised by the extent of ligament damage. Minor sprains commonly involve the ligament being stretched beyond its limit, while more serious sprains imply a partial or complete ligament tear.

Causes of a sprained ankle

Common causes of sprained ankles include falling awkwardly, walking or running on uneven ground and quick changes of direction. In tennis, players are constantly required to change direction quickly which can often apply pressure to the ligaments surrounding the ankle and cause the player to ‘go over’ on their ankle.

Symptoms of a sprained ankle

Common symptoms include pain, swelling and restricted movement; sometimes a cracking or popping noise may be heard. In severe cases, the player may not be able to walk on the ankle. Bruising may appear after the incident; this usually takes up to 24 hours to show.

Treating a sprained ankle

Minor sprains will usually heal over time with the help of rest, strapping, ice and anti-inflammatory medication and pain relief. Gradually, the ligaments will heal and normal movement will be restored; this may take up to 6 weeks but will usually heal quicker. More serious sprains will need to be rested for a long period of time to allow the ligaments to heal fully; connective tissue heals much slower than bone so this may take several weeks. It may be necessary to support the ankle in a cast or supportive brace; a player may also need to use crutches to prevent the ankle from bearing weight. Physiotherapy will often be used to steadily increase strength in the joint and improve movement.

Preventing a sprained ankle

Wearing ankle supports and supportive footwear will often help to reduce the possibility of suffering a sprain. It is also advisable to avoid uneven surfaces. A thorough warm up and cool down will also help to prevent injury.

Stress fractures

Stress fractures are common in tennis due to the repetitive nature of the actions involved and the repeated landing of the foot on a hard surface. Common stress fractures include back and foot stress fractures.

Stress fractures in the foot

Stress fractures commonly occur in the metatarsal bones of the foot. A stress fracture is a crack in the bone; these fractures are often associated with repeated actions and overuse.

Causes of stress fractures

The most common cause is overuse; athletes who participate in sports which require a series of repetitive actions such as running, tennis and field event athletes, are prone to stress fractures. Other causes also include a sudden increase in the intensity of training and a change in the type of training.

Symptoms of stress fractures in the foot

The most common symptom is pain over the site of the fracture which may extend to other areas of the foot; there may also be swelling and tenderness around the affected bone.

Treating stress fractures

The most successful treatment for a stress fracture is rest; this allows the bone time to heal and prevents any further damage. Ice and anti-inflammatory medication will help to ease pain and swelling. Many professional sports players use crutches to allow the foot to rest completely. Over time, once the bone has started to heal, physiotherapy will help to strengthen the bone and surrounding tissue and improve the range of movement.

Back stress fractures

Stress fractures are common in the lower region of the back and usually affect the lumbar vertebrae (the bottom 5 vertebrae).

Causes of stress fractures in the back

The most common cause of a stress fracture in the back is overuse; sporting activities, such as tennis, involve actions which apply considerable pressure on the lower spine; over time, the pressure builds and the bone may crack slightly.

Symptoms of stress fractures in the back

The most common symptom is pain in the affected area, which may increase when the back bends to lean forwards or backwards. The patient may also experience a dull ache for prolonged periods of time.

Treating a stress fracture in the back

The most beneficial treatment is rest; more serious stress fractures may require the back to be immobilised, which will involve wearing a cast for a period of time. Recovery may take several weeks; ice and medication to control swelling and pain will also aid the healing process. Physiotherapy, osteopathy and chiropractic may also speed up recovery and help to prevent further injury by strengthening the affected area.

Preventing stress fractures

Stress fractures can usually be prevented by ensuring sufficient rest periods between physical activity and gradually increasing the intensity of training sessions; this will allow the body to adapt. Professional athletes who are prone to stress fractures should alternate demanding training sessions with activities which apply less stress to the bones such as swimming or light cycling; these activities will maintain cardiovascular fitness while allowing the affected bones time to rest.

Shoulder pain and injuries

The range of shots involved in tennis applies considerable pressure to the shoulder joint; this can contribute to injuries.

Rotator cuff tendonitis

The rotator cuff is made up of four muscles and allows a range of movement in the shoulder joint. The most common rotator cuff injury is rotator cuff tendonitis, which occurs when the tendons surrounding the rotator cuff become inflamed.

Causes of rotator cuff tendonitis

In tennis, the overhead ‘slam’ and serve are common causes of rotator cuff tendonitis as the tendons are put under pressure during these actions; as the activity is repeated, the tendons become inflamed.

Symptoms of rotator cuff tendonitis

Symptoms of rotator cuff injuries include localised pain, which may increase when the arms are raised above the head. The range of movement may be restricted and the area may swell and feel tender.

Treating rotator cuff tendonitis

Tendonitis usually heals over time if the affected area is sufficiently rested; this means avoiding any movements or activities which put pressure on the shoulder, such as lifting or playing sports that require repeated shoulder movement. Ice and anti-inflammatory medication will help to ease pain and reduce swelling. Physiotherapy will help to gradually build up strength and increase movement in the joint.

Impingement syndrome

What is impingement syndrome?

Impingement syndrome occurs when the tendons surrounding the rotator cuff become trapped in the subacromial space; this usually happens as a result of rotator cuff tendonitis. When the tendons become inflamed, there is less space for them to travel in the subacromial space, which often leads them to become trapped.

Symptoms of impingement syndrome

The most obvious symptom is pain, which may become heightened when the arms are raised above the head or the shoulder is extended; this occurs during activities such as reaching upwards or behind the back. Other symptoms include swelling and restricted movement.

Treating impingement syndrome

Treatment usually involves a combination of rest, anti-inflammatory medication and pain relief. Specific stretches and exercises will help to gradually improve the range of movement in the shoulder and strengthen the surrounding muscles. Physiotherapy will also help to speed up recovery and condition the shoulder to prevent further damage. Steroid injections are frequently given to professional athletes to reduce inflammation quickly.

Preventing shoulder injuries

Professional sports players, who compete in sports which involve repetitive shoulder movements, should ensure they allow sufficient rest periods between strenuous exercises; it may be beneficial to alternate specific tennis training sessions with other activities such as jogging or cycling, for example. Warming up and cooling down thoroughly will also help to reduce the risk of injury and specific stretches will help to strengthen the area and increase flexibility around the joint, to prevent injury in the future.

Wrist injuries

Tennis involves constant use of the wrist and a variety of actions which change the position of the wrist; for example, putting spin on a shot requires flicking the wrist. The most common wrist injury is carpal tunnel syndrome.

Carpal tunnel syndrome

What is carpal tunnel syndrome?

The carpal tunnel runs from the bottom of the wrist to the lower region of the palm of the hand; nerves and tendons run through this tunnel in order to bring about movement of the fingers and sensations in the hand. The medial nerve, which controls sensation in the hand and delivers messages from the brain to the hand, is located in the carpal tunnel. When carpal tunnel syndrome occurs, the nerve comes under pressure as the space inside the tunnel is restricted.

Symptoms of carpal tunnel syndrome

Symptoms of carpal tunnel syndrome occur due to the compression of the medial nerve; this usually beings about tingling or numbness in the index and middle fingers and the thumb. This condition may also restrict movement in the fingers, which can make certain activities difficult.

Treating carpal tunnel syndrome

Most cases heal over time without the help of any treatment; however, more severe cases may require surgical treatment and anti-inflammatory medication.

Knee injuries

Knee injuries can be common in tennis due to the quick changes of direction and the pressure caused by playing on a hard surface. The most common injuries are tendonitis and damage to the ligaments and cartilage.

Patella tendonitis

Patella tendonitis (also known as jumper’s knee) occurs when the cartilage surrounding the kneecap becomes inflamed; this is usually due to overuse and is particularly common in sports which involve continuous jumping or landing, such as tennis and triple or long jump.

Symptoms of patella tendonitis

Symptoms commonly include pain and swelling in and around the kneecap; pain is often heightened when pressure is applied to the kneecap and when the leg is bent at the knee.

Treating patella tendonitis

The most common treatments for patella tendonitis include rest, ice and medication to control inflammation and pain. Physiotherapy will also help to condition the knee and strengthen the tissue surrounding the joint.

Meniscus cartilage tear

The knee is supported by the lateral and medial menisci, which protect the knee and absorb pressure during physical activity. Some actions can cause the menisci to be stretched beyond their limits, which may contribute to sprains or tears.

Causes of cartilage tears

Common causes of cartilage tears include quick changes of direction and action which involve the body reaching or twisting; often tears are caused when the body moves but the feet stay planted on the ground; this is common in tennis when a player twists to reach a shot and their feet stay in the same position.

Symptoms of cartilage tears

Symptoms usually include severe localised pain, swelling and restricted movement; usually a tear will prohibit movement and a player will usually spend a long period of time on crutches. Pain will be heightened if the knee is moved.

Treating cartilage tears

Cartilage tears take a long time to heal; during this time the knee should be rested, this usually implies the patient using crutches to prevent the knee from bearing weight. Anti-inflammatory medication and pain relief will help to ease symptoms. Larger tears may require surgery, although only certain injuries may be treated surgically. Surgery is usually carried out by means of an arthroscopy (keyhole surgery). The knee should be rested for a long period of time following a cartilage tear. Physiotherapy will help to build strength around the affected knee and help to prevent injury in the future.

Preventing knee injuries

Thorough warm ups and cool downs will help to prevent all forms of injury. Wearing knee supports and doing specific stretches to improve flexibility in the knee joint will also help to reduce the possibility of an injury.

Leg injuries

Leg injuries are common in tennis due to the constant movement and change in direction. The most common leg injuries in tennis are calf and hamstring strains.

Hamstring strain

A hamstring strain is also known as a pulled or torn hamstring and is common in many sports. Hamstring strains are categorised into 3 grades which are determined by the severity of the injury; grade 1 strains involve minor damage to the muscle, grade 2 strains involve a partial tear of the muscle and grade 3 implies a complete tear of the muscle.

Causes of a hamstring strain

Often a hamstring strain results from a sudden change in direction or a sudden movement; hamstring strains are common in sports where the need to sprint suddenly may arise at any time, such as tennis and football. Usually, hamstring tears are sudden, which causes the individual to ‘pull up’.

Symptoms of hamstring strains

Symptoms include severe pain, especially when the leg is straightened, swelling and subsequent bruising (this may take up to 24 hours to appear). Movement will be restricted, particularly if the strain is severe.

Treating hamstring strains

Treatment will usually involve a long period of rest, in addition to anti-inflammatory medication and pain relief. The leg will need to be rested for several weeks; using crutches may be advisable to prevent the leg from bearing weight. Once the leg has started to heal, physiotherapy will help to strengthen the affected leg and increase movement.

Calf strain

Calf strains occur when the muscles is stretched beyond its limits; this is common in sports.

Symptoms of calf strain

Common symptoms include a sudden on-set of pain in the calf, which increases when the leg is straightened or the muscle is stretched. Serious strains may cause bruising and a restricted range of movement.

Treating a calf strain

Initial treatment will usually involve applying ice to the area, elevating the leg and resting the affected muscle. Anti-inflammatory medication and pain relief will also help to ease swelling and reduce pain. The leg should generally be rested for several weeks; severe strains may require months to heal. Exercise should be built up very gradually; physiotherapy will help to steadily build up strength and prepare the body for physical activity.

Preventing leg injuries

Carrying out a thorough warm up and cool down will help to reduce the possibility of injury. It may also be advisable to do specific stretches and exercises to strengthen the leg muscles and improve flexibility. Wearing supportive footwear will decrease the chance of falling which will subsequently reduce the risk of leg, foot and ankle injuries.

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