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Common Tennis Injuries and How to Prevent Them

Private: Elizabeth G. Matzkin, MD
Contributor Elizabeth G. Matzkin, MD

With warmer weather and sunny days around the corner, many of us will be eager to get outside and hit the tennis courts this spring and summer. Often known as a “lifetime” sport, tennis is a great way for people of all ages and levels of athletic ability to stay in shape. Tennis has many proven health benefits, such as improving cardiovascular fitness, balance, motor control, hand-eye coordination, bone strength, and flexibility. However, injuries can and do occur at all skill levels, from beginners to the pros. Below, we describe some of the most common tennis injuries, as well as tips on how to avoid them.

Tennis Elbow

What is it?

Medically known as lateral epicondylitis, “tennis elbow” is caused by inflammation of the forearm muscles and tendons on the outside of the elbow. Tennis elbow is often caused by overuse – from too much repetition or improper technique. Common symptoms of tennis elbow include pain localized to the outside of the elbow and moderate to severe pain with certain movements of the wrist.

How can I avoid this?

Tennis elbow can be caused by improper backhand technique or body positioning, combined with late strokes or “wristy” impacts. Try switching to a two-handed backhand (if you currently use a one-handed technique) to relieve the stress on the muscles and tendons in the forearm and elbow. It is also important to make sure that the equipment you are using is the right size and fit. Consult with a tennis professional to ensure that your racquet is properly sized for your grip and that the string tension is appropriate for your level of play. Proper mechanics and body positioning is also important.

How is it treated?

Tennis elbow is initially treated with rest, ice, and a non-steroidal anti-inflammatory (NSAID) medication, such as ibuprofen. A wrist brace or tennis elbow counterforce brace also can be used. Special physical therapy exercises for stretching and strengthening the forearm muscles are beneficial. If symptoms persist, a steroid injection can help alleviate the inflammation. If symptoms don’t improve with non-operative measures over six to 12 months, surgical intervention can be considered.

Rotator cuff tendinitis

tennis racket hitting tennis ball
Tennis has many proven health benefits. However, injuries can and do occur at all skill levels, from beginners to the pros.

What is it?

The rotator cuff is a group of muscles and tendons that surround the shoulder joint, allowing for multi-directional motion and stability. Rotator cuff tendinitis occurs when these tendons become inflamed, resulting in pain with overhead movements and limitations in shoulder motion and function.

How can I avoid this?

Rotator cuff tendinitis is often caused by excessive overhead serving. Changing your technique to increase the angle between your arm and your side to more than 90 degrees will decrease tendon strain and minimize the chance of injuring your rotator cuff. Additionally, making contact with the ball overhead when it is slightly in front of you, as opposed to directly above or behind you, also will lessen the strain on these tendons.

How is it treated?

Similar to tennis elbow, the first line of treatment is rest, ice, and NSAIDs. Physical therapy to improve the range of motion and strength of the rotator cuff muscles is important in returning to activities. If rest and physical therapy do not relieve the shoulder pain, a steroid injection can be helpful. If nonsurgical treatment fails, then surgery may be recommended.

Ankle sprain

What is it?

An ankle sprain (also known as a “twisted” or “rolled” ankle) occurs when one or more of the ligaments attached to the ankle joint is stretched or partially torn.

How do I avoid this?

Tennis involves side-to-side movements and quick changes of direction, and spraining the outer ligaments of the ankle by rolling onto the lateral side of the foot is common. To avoid this, make sure you are wearing sneakers specifically designed for tennis, with substantial, firm support on the outer edge of the shoe. Some players will benefit from wearing stabilizing ankle braces for additional support.

How is it treated?

If you are experiencing persistent pain from a tennis injury, including but not limited to the ones described above, please consult a physician for diagnosis and treatment. Although rest, icing, and NSAID medications can relieve some of the pain from mild injuries, it’s important to seek treatment when pain lasts for several days and is not relieved by any of these measures.

As you hit the courts this year, be aware of these common injuries and be sure to stretch and warm up before you play to reduce your risk of injury. We hope you have a fun and safe tennis season – game, set, match!

Private: Elizabeth G. Matzkin, MD
Elizabeth G. Matzkin, MD

Elizabeth G. Matzkin, MD, is Surgical Director of the Women’s Sports Medicine Program at Brigham and Women’s Hospital, Team Physician for Stonehill College Athletics, and Assistant Professor of Orthopaedic Surgery at Harvard Medical School.

Before you go,

Staying active through regular exercise and playing sports offers many physical and mental health benefits. Get tips on how to optimize your workouts and keep your body safe from injury. Read more exercise and sports articles.