Tennis may not seem like one of the more dangerous sports, but there are many associated types of injuries which can affect a player’s career.
Claire Forrester, a Cape Town-based physiotherapist, says that generally in tennis players, professional or amateur, the most common injuries are upper limb injuries.
Common upper limb injuries
Regardless of the injury, Forrester says that all tendinopathies (tendon diseases) need to be treated as soon as possible:
“Basically in the beginning phase, it's what we call a reactive tendon which is an inflamed, painful tendon, which will still settle 100% with rest – but if you don't rest, this extra blood flow into the tendon actually starts to permanently damage the tendon and over time can lead to degeneration and chronicity. Physiotherapy can definitely help in early stages but often the patient needs to be referred to a specialist.”
The most common upper limb injuries include:
- Tennis elbow: A result of constant strain on the elbow joint and overuse of the tendons and muscles surrounding the joint leading to tendon inflammation in the elbow. Treatment includes rest, ice, compression, and elevation (RICE), anti-inflammatories and in some cases an elbow support. Claire advises that if you have tennis elbow you need to address it immediately to avoid it becoming chronic.
- Rotator cuff tendonitis: Injury to the rotator cuff (the sheath of tendons and ligaments that supports the arm at the shoulder joint) can be extremely painful. It often affects recreational players with improper serving form. Treatment is RICE, and anti-inflammatory drugs.
- Impingement syndrome: This condition is linked to rotator cuff tendonitis and is where the rotator cuff tendons become trapped. It is indicated by pain when trying to raise the arms above the head. Rest and anti-inflammatories will ease discomfort and a physiotherapist can help provide stretches and strengthening exercises.
- Carpal tunnel syndrome: The wrists come under a lot of strain in a sport such as tennis because of repetitive motion, and this can lead to inflammation and damage to the small nerves and tendons in the wrist. Carpal tunnel syndrome is the most common wrist injury which occurs when the medial nerve in the carpal tunnel is compressed, leading to a tingly or numb feeling in the fingers. This can affect grip and movement in tennis. Treatment includes rest and in severe cases surgery.
Common lower limb injuries include:
- Sprained ankle: The fast-paced nature of tennis involves a lot of rapid direction change, which can put a lot of strain on the ankles and often leads to falling, often with awkward landings which result in sprains. A sprain can be mild, serious or severe depending on the degree of damage to the ligaments.
- Stress fractures: The high demand placed on the feet in tennis can lead to stress fractures of the metatarsal bones of the foot or lumbar vertebrae in the back
- Stress fractures in the foot: A crack in the foot indicated by pain, swelling and tenderness.
- Back stress fractures: Repetitive pressure on the lumbar region of the spine eventually causes the bone to crack.
- Knee injuries: As with the ankles, the rapid direction-change and pace of tennis can put strain on the knees. This can lead to injuries to the tendons and cartilage such as patella tendonitis and meniscus cartilage tear.
- Hamstring and calf strain: The most common injuries to the hamstring and calf muscles include strains and tears. Treatment depends on the severity – ranging from a strain to a complete tear of the muscle.
- Achilles tendon injuries: The Achilles tendon is generally a result of a tight calf muscle and injury can result in tendinitis or rupture, which generally requires surgery to repair.
Prevention better than cure
Forrester says that tennis is a unilateral sport, which means cross training is “absolutely essential to avoid muscle imbalance, which is what leads to injury. Swimming, cycling and strength-training will all strengthen the muscles and tendons.”
Hiring a professional tennis coach to help correct technique and wearing ankle, knee, wrist or elbow supports and supportive footwear can reduce the odds of injury.
Making sure that you take time to effectively warm up before playing will also prepare the muscles for the exercise and reduce the risk of injury.
Claire Forrester, Physiotherapist; 0824532672; http://www.forresterphysio.co.za
Wimbledon 2016: Rafael Nadal will miss the championships with a wrist injury; 9 June 2016; BBC; http://www.bbc.com/sport/tennis/36493725
Tennis Injuries - Are you an ace on the court?; Nicholas E. Mihelic, M.D. Hiltong Head, South Carolina; Hughston Clinic; http://www.hughston.com/hha/a.tennisinjuries.htm
Tennis injuries: Sports Medicine Information; http://www.nsmi.org.uk/articles/tennis-injuries.html