Tennis Injuries

Tennis, being a completely non-contact sport, has a lower incidence of injury, or at least acute, traumatic injury, that sports such as football. The majority of tennis injuries are more chronic overuse injuries such as tendonitis.

Preventing tennis injuries

A large number of injuries, in all sports, especially at the lower levels, could be avoided. The following should not be neglected:


The warm-up is one of the most important factors in all sports, in order to stay injury-free. Tennis is a whole-body sport and for that reason, the whole body should be warm-up and stretched, prior to hitting that first ball! Cardiovascular exercise should be the first component of a warm-up routine, in order to increase the circulation and warm the muscles. This should be followed by active stretches such as dynamic lunges and shoulder and wrist circles. Static stretches can also be performed.


The racket is the most obvious piece of equipment that a tennis player must ensure is right for them, to help avoid injuries. The most important factor is grip size. A grip size that is too small often places additional strain on the wrist, whereas a grip which is too large requires extra contraction of the forearm muscles and can contribute towards developing tennis elbow. A light racket and looser strings are less likely to cause injury.

The availability and range of specific tennis footwear has improved in recent years. Shoes now have thicker rubber soles, reinforced mid-foot support, and a wider toe area, all features designed to enable optimum performance and limit injury.


In order to avoid injury, the correct technique should be taught from the start. Learning the right techniques will help to reduce overuse injuries, such as tennis elbow, which is sometimes caused by a poor backhand stroke


Strength is important with any sport but must be specific to the sport in question. Tennis is a fast-paced sport requiring changes of direction and sudden bursts of speed. This requires a strong core to maintain the bodies centre of balance – important in avoiding injuries. Strength of the shoulder girdle, including the rotator cuff muscles, is also important in injury prevention.


Injuries of the shoulder, elbow, and wrist are amongst the most common injuries seen in tennis players. However, due to the bursts of speed and change of direction nature of the game, ankle and knee injuries are also common

Tennis elbow

This is the injury that everybody associates with tennis. However, it is more commonly seen in people who have never played tennis, than those that do regularly. It is an overuse injury of the wrist extensor muscles, where they attach to the lateral epicondyle (bony part on the outside of the elbow). Symptoms include pain on wrist extension (bending the wrist back) and gripping the racket. Causes include poor technique and wrong grip size. Learn more about tennis elbow.

Carpal tunnel syndrome 

Carpal tunnel syndrome is where the median nerve is compressed within the wrist. In tennis, if there is no previous injury to the wrist, the cause is likely overuse and inflammatory causing swelling within the wrist and narrowing the carpal tunnel. Sometimes the cause can be structural due to a naturally smaller carpal tunnel. Carpal tunnel causes pain in the wrist and handed, often accompanied by tingling in the fingers. Find out more about carpal tunnel syndrome.

Shoulder impingement

This refers to trapping and pinching of one or more of the rotator cuff tendons. This occurs due to the narrowing of the space through which these tendons pass. The most common cause of this reduced space is a biomechanical abnormality, usually associated with poor posture. Symptoms in shoulder impingement include pain with overhead movements – especially serving. Treatment usually consists of rest and ice, followed by a rehabilitation program. Find out more about shoulder impingement syndrome.

Back injuries 

Back injuries are reported to make up to 16% of all tennis injuries. The most stress is placed on the spine during the serve, in both the extension phase when tossing the ball and in the action of the serve itself. Both movements involve a rotation force in conjunction with the main motion of flexion or extension. Facet joint injuries are one of the more common back injuries seen in tennis. Learn more about facet joint injuries.

Ankle sprains

Lateral ankle sprains are the most common ankle injury both in and out of sport and tennis is no exception. The fast-paced changes of direction can lead to the ankle rolling over and damaging one or more of the lateral ligaments. This type of injury can be prevented by strengthening the calf, shin and peroneal muscles, ensuring good flexibility and performing proprioception exercises (using wobble boards etc). Learn more about ankle sprains.

Patella Tendinopathy

Also known as jumpers knee, patella tendinopathy is caused by repetitive strain on the tendon which connects the knee cap and quadriceps to the shin bone. Repetitive strain causes degenerative changes to the tendon, resulting in pain on jumping and running activities. Treatment should involve looking at the biomechanics of the player and correcting any problems such as a weakness in the VMO muscle or tightness in the quadriceps, as well as strengthening the quads eccentrically (with gravity so the muscle lengthens under tension). Find out more about patella tendinopathy.