Tennis, one of the most popular sports, carries a risk of orthopedic injuries. Experts note that many injuries can occur—including shoulder injuries, tennis elbow, and wrist sprains—and emphasize the importance of stretching exercises in tennis. According to experts, hard tennis courts also increase the risk of injury.
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Assoc. Prof. Dr. Mehmet Kerem Canbora, an Orthopedics and Traumatology Specialist at Üsküdar University NPİSTANBUL Hospital, provided important information about tennis injuries.
Tennis Injuries Lead to Lost Work Time
Pointing out that many tennis-specific injuries can result in lost work time and disability, Assoc. Prof. Dr. Mehmet Kerem Canbora stated that tennis-related injuries can be prevented by identifying risk factors.
Elbow and shoulder injuries are the most common
“In approximately two-thirds of tennis injuries, the cause is overuse injuries. One-third of injuries, however, are traumatic and occur suddenly. Regionally, elbow problems (tennis elbow), shoulder injuries, stress fractures (small fractures that form in specific areas due to repetitive, strenuous, cumulative movements), ankle sprains and ligament injuries, and muscle strains and injuries are the most common,” he said.
Hard Court Warning!
Noting that hard tennis courts contribute to injuries, Assoc. Prof. Dr. Mehmet Kerem Canbora warned, “Hard tennis courts—whether made of asphalt or waxed concrete—place greater stress on the body. Every landing on a hard court carries a risk of stress fractures.”
Stretching is important
Assoc. Prof. Dr. Mehmet Kerem Canbora explained, “Clay or grass courts, on the other hand, create less stress on the bones because they are softer. However, the increased risk of slipping on soft courts can lead to injuries—particularly sprains—in the ligaments of the knees and ankles.” A study found that the incidence of injuries among elite tennis players undergoing treatment was approximately 2.5 to 3 times higher on hard or clay courts compared to grass courts. Flexibility exercises incorporated into training programs could be effective in preventing this type of strain,” he said.
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Assoc. Prof. Dr. Mehmet Kerem Canbora provided the following information regarding injuries that occur in tennis:
“Stress fractures: When we talk about stress fractures, we are referring to small cracks in the bone. Pain and swelling eventually give way to chronic pain. A hard court surface, such as asphalt, places excessive strain on the lower limb bones, particularly the feet. Stress fractures are less common on clay or grass courts. The most important way to prevent stress fractures is to follow a proper strength and endurance training program, combined with thorough warm-ups and stretching before intense play. In addition, taking short rest breaks during intense training sessions can be preventive.
Ankle Sprains and Ligament Injuries: Ankle sprains can occur on any surface. This is because tennis is a sport that requires multi-directional movements. Sudden sprints and jumps often lead to improper landing and ankle sprains. It should be kept in mind that clay courts pose a higher risk for ankle sprains. Most sprains heal with rest, immobilization, ice, and, in some cases, pain relievers. Wearing shoes that support the ankle, avoiding questionable surfaces, and performing warm-up and cool-down exercises before and after activity are helpful preventive measures.
Tennis elbow: In tennis and other sports, the way an athlete holds the racket and the grip of the hand are the most important movements that initiate the stroke mechanics. During sports, the elbow joint is exposed to cumulative, repetitive microtraumas. It can be described as localized inflammation at the attachment site of the muscle tissue that lifts the wrist to the bony prominence on the outside of the elbow joint. Studies have shown that tennis elbow develops more frequently in recreational athletes. Although the level of evidence is not high, there are studies indicating that in players who use both hands for the backhand, the non-dominant hand helps absorb the stress by taking some of the force, thereby reducing the risk of developing tennis elbow.
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Shoulder injuries: As in all sports where the ball is hit overhead, tennis players place excessive strain on the shoulder joint and surrounding tissues. The shoulder and elbow joints are subjected to excessive stress during every overhead movement, particularly when serving. Athletes must be familiar with techniques for effectively utilizing the kinetic chain, particularly during serves, overhead smashes, and long shots. Treatment should prioritize strengthening the internal rotation movement, the posterior rotator muscles, and the scapular muscles.
Hip and Knee Injuries: Injuries around the hip are reported in up to approximately 25% of elite athletes. Hip injuries lead to compression and groin pain due to asymmetrical growth of the groin muscles.
Tennis leg: This
is a phenomenon similar to tennis elbow. It refers to chronic strain on the inner side of the gastrocnemius muscle, commonly known as the calf muscle. It occurs in 1 in 6 athletes engaged in tennis-related activities.
Back and lower back issues: Chronic back pain is observed in more than one-third of tennis players. Long and powerful serves can lead to back pain. Spondylolisthesis may also occur in athletes.”
Pay attention to these warnings before playing!
Assoc. Prof. Dr. Mehmet Kerem Canbora, who emphasizes the importance of warming up and stretching before playing, stated, “Resting during breaks will prevent overexertion during training. Another way to prevent stress fractures is to switch to alternative low-impact activities such as swimming or cycling,” he suggested.
Assoc. Prof. Dr. Mehmet Kerem Canbora also listed his other recommendations as follows: “In conclusion, tennis—a popular sport—is prone to injuries in both the upper and lower extremities. While upper-body injuries tend to be chronic, acute injuries are more common in the lower body. The characteristics of the court surface, the vibration caused by the racket, the grip position, the habit of warming up and cooling down before and after training, and—especially during the initial period—proper execution of the overhand serve are effective measures for preventing injuries.”
