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Tennis Injuries – What do you need to know

Tennis is one of the most popular sport around the world and in India, played by over 75 millions of people. It is played by people of all ages and both genders.

What are the challenges involved with tennis sport?

Tennis is played at both recreational and professional level. However, there are many challenges to the game. A tennis match, unlike other sports, is not clock-bound game, it can last several hours. It is a yearlong sport. There are different environment conditions of different tournaments that a player needs to adapt in short period of time. It is played at different kind of surfaces such as clay, grass, acrylic or synthetic courts. The game involves explosive strokes and serves in addition to repetitive stresses. These all make a player prone to different set of injuries.

How to look after your health when you are preparing for the matches or during tournament?

The player should follow the principle of periodization and scheduling with variable amount of training over a period of time with given time for recovery in order to maximize the performance at the time of tournament. The training needs to focus on all the group of muscle involved in kinetic chain, including hips and core. The player needs to look after his or her nutritional needs with correct amount of macro and micronutrient and ergogenic aids. One should take good care of hydration during the tournaments to avoid heat stress.

How common are these injuries?

The injuries in tennis are less common than other contact sports, however, players tend to have almost one injury every 20 matches.

What are the common injuries would later to tennis?

The players are prone to develop acute injuries in the lower limb followed by upper limb or trunk. Acute injuries tend to happen mostly in the ankle followed by wrist, knee, foot and shoulder. In contrast, the chronic overuse injuries mostly tend to involve upper extremity than lower extremity or trunk. In upper extremity, ulnar sided wrist pain due to ECU tendinopathy, medial or lateral epicondylitis in the elbow, internal impingement in the shoulder joint, SLAP tear or partial rotator cuff tear are common. In lower extremity, ankle sprain involving lateral ligament complex followed by thigh strain are common. In trunk, abdominal muscle strain involving rectus, lumbar disc herniation are common trunk injuries.

How can you prevent those injuries?

Training, adequate technique, and proper equipment are paramount for preventing chronic overuse injuries. Many chronic injuries are result of poor techniques. For instance, ulnar sided wrist pain is result of poor hand grip pattern or low forehand. In order to hit a good stroke, linked muscle groups must perform coordinated movements resulting in greater force at stroke. This concept is referred to as the kinetic chain where the force passes from the feet, knees then core then to the upper limb. Any break in the kinetic chain put another structure at overload and subsequent injury. For instance, poor foot position or less knee flexion requires heavy load from the shoulder to generate enough force for an effective serve. It is important to develop a proper technique required for various shots as serve, ground strokes, and volleys. It is also important to maintain a healthy diet. It is important to consult a sports nutritionist for normal dietary advice or after an injury. One should also look after the hydration to avoid heat strokes during long matches in summer.

What should you do if you have those injuries?

It is important to slow down if there is suspicion of an injury. The players usually get primary evaluation by a sports physiotherapist who then refers the player to sports medicine expert or an orthopaedic surgeon for further evaluation. The evaluation includes clinical examination and few scans if needed. In less severe condition, conservative approach is followed which involves set of exercises focusing on the involved structures in addition to working on the whole kinetic chain. In serious injuries or resistant cases, a surgical approach is undertaken where most of the surgery is performed using minimally invasive arthroscopic approach. The post-operative physiotherapy holds great importance in a player’s ability to return to sports at pre-injury level. The sports psychologist plays a big role in keeping the player motivated during his return.

Dr. Priyadarshi Amit

Senior consultant Shoulder & Elbow Specialist