Tennis Injuries

Tennis has become one the major sports and is played around the world by millions of athletes on the Olympic, professional, collegian, and junior level and those that play purely for exercise or recreation. The British Journal of Sports Medicine estimated that there were over 75 million worldwide tennis participants in 2007. A study commissioned by the United States Tennis Association (USTA) found that there were 30.1 million people playing some level of tennis in 2009 in America alone.

While tennis clearly doesn’t pose the same risk of injury as high-contact sports like football or hockey, it isn’t a game played without risk of injury. The U.S. Consumer Product Safety Commission’s National Electronic Injury Surveillance System reported there were 22,294 treated tennis-related injuries in 2007 in the U.S.

How Do Tennis Injuries Occur?

Tennis is a sport that requires a great deal of hand-eye coordination and muscle conditioning, physical agility, and endurance to sprint and position the body for a swing and hit. Players are repetitively suddenly stopping, accelerating, turning, pivoting, and lunging with their legs in an asymmetrical nature to hit the ball. The fingers, wrist, hands, arms and shoulders not only must repetitively power hitting the ball, but also be able to repetitively absorb the impact or load from a returning ball. These movements are technically challenging and place increased stress and demand on the joints, ligaments, tendons, muscles, and bones within the player’s body, especially among players at any competitive level.

According to most studies, the majority of tennis-related injuries are cumulative overuse injuries from the repetitive nature of the movements described above. However, tennis injuries can be the result of a traumatic event, such as falling on a hard court.

What Are Some Common Tennis Injuries?

Lateral Epicondylitis / Tennis Elbow

Lateral epicondylitis is commonly referred to as tennis elbow since it affects a high number of tennis players. It’s a condition characterized by inflammation, pain, and soreness on the lateral (outside) side of the upper elbow and most commonly affects the dominant arm. The pain may radiate down to the forearm and to the wrist and cause a weakened grip.

Tennis elbow is considered an overuse or repetitive stress injury to the common extensor tendon. This tendon connects the lateral epicondyle and a number of the forearm muscles. Motions such as the repetitive extension of a wrist holding a tennis racquet when it meets the resistance of a tennis ball or an improper technique during a swing like the backhand can irritate or cause microscopic tearing to the tendon, thereby causing elbow inflammation and pain.

Turf Toe

Turf toe has long been synonymous with the lack of traction provided by Astroturf. However, many tennis players are finding the same mechanism of injury is applicable when playing on a tennis court. Turf toe is actually a sprain of the big toe. It's caused when a player suddenly starts or starts and their toe hyperextends as it hit’s the end of the their shoe, the court, or any other surface that jams the toe upward. This action can damage the ligaments, joint capsule, or other soft structures associated with the first metatarsophalangeal (MTP) joint.

Like all sprains, turf toe is graded based on the degree of damage:

* Grade one - abnormal stretching or microscopic tearing of the joint capsule and ligaments, but the joint remains stable.
* Grade two - moderate tearing to the joint capsule and ligaments with some joint instability.
* Grade three - significant to complete rupture of the capsule and ligaments. This sprain may accompany a joint dislocation.

Rotator Cuff Injuries

The rotator cuff consists of four main muscles, the subscapularis, supraspinatus, infraspinatus and teres minor muscles, and their associated tendons that connect the humerus with the scapula. The rotator cuff surrounds the humerus bone and holds it in the shoulder joint.

The rotator cuff muscles and tendons may become irritated from overuse of the shoulder, especially during the repetitive overhead motions and inward rotation of the shoulder involved in tennis play. As the rotator cuff is repeatedly rubbed across the surrounding bones, the tendons can become inflamed (tendinitis). The muscles and tendons may also become abnormally stretched , fray, and tear (strain) from an acute traumatic injury to the rotator cuff or chronic degeneration from overuse. It’s also important to note that chronic rotator cuff tendinitis may lead to a rotator cuff strain and a rotator cuff strain can lead to a shoulder dislocation.

Rotator cuff strains, like all strains, are classified using a grading system for damage: 

* A grade one strain involves the stretching or microscopic fraying of an otherwise normally attached rotator cuff tendon. The shoulder joint remains stable.

* A grade two strain involves a deeper tearing with some instability of the shoulder joint.

* A grade three strain involves a full thickness tear of the rotator cuff. There is significant disruption to the shoulder joint and possible shoulder dislocation.

Of course, these are just a few of the many injuries that tennis players may encounter. Sprained ankles and wrists; de Quervain's Tenosynovitis; pulled groins; Achilles tendinitis; bursitis of the wrist and shoulders; jumper’s knee; ACL, PCL, MCL, and LCL injuries; medial gastrocnemius strain; meniscus injuries; plantar fasciitis; and lumbar strains are also concerns for tennis players.