Dr. Mark E. Pruzansky
Dr. Jason S. Pruzansky
975 Park Avenue New York, NY 10028

Tennis Injuries

What are Tennis Injuries?

Tennis is a popular racket sport for individuals of all ages. Long practice times and frequent matches for casual players, and a high number of tournaments for professional tennis players, may lead to overuse injuries, such as tennis elbow and various types of wrist injuries. For deconditioned tennis players, inadequate physical and technical training may lead to the development of overuse injuries.

Characteristics and Clinical Presentation of Tennis Injuries

Tennis injuries can be divided as a chronic injury and acute or traumatic injury.

67% of tennis injuries are secondary to overuse injuries. Instead, only the remaining 33% of reported injuries are due to a traumatic injury or a sudden unexpected event. In most cases, overuse injuries in tennis players usually affect the wrists and elbows.

The presentation and clinical manifestations of the tennis injuries will vary according to the severity of the injury, the part of the body affected, and the type of injury sustained.

Tennis Elbow

Tennis elbow is considered an overuse injury of the tendons responsible for the extension of the wrist or bending backward. The most common symptom of tennis elbow is a recurrent pain on the outside of the elbow and upper forearm, radiated down the arm, towards the wrist. Pain can also be felt while performing basic activities, such as writing or when gripping small objects, as well as rotating the forearm and wrist.

Stress Fractures

Stress fractures are the result of progressing training too fast, too much playing, deficient technique, and fatigue. When the muscles are tired, more stress is focused on the bones.

If a player does not take the time to recover and train properly to build strength safely, the bone is not able to repair and strengthen rapidly enough to accommodate the added stress, and as a result, it can fracture.

Causes of Tennis Injuries

In most cases, tennis players are affected by chronic injuries to their upper extremities.

Serving is the movement most demanding in tennis. Forearm and wrist injuries may occur with spin and kick serve motions. Hand grip positions seem to be related to the damage or injury of the overall biomechanical loads transmitted to the upper extremity as well as stroke biomechanics. The eastern grip predisposes to thumb side wrist tendonitis. The western variations predispose to pinky side wrist tendonitis and ligament tears. Forceful wrist rotation in topspin and drop shots may damage the extensor carpi ulnaris and/or its subsheath.

Common elbow injuries in tennis players include lateral epicondylitis and flexor-pronator tendonitis—medial epicondylitis. Lateral elbow tendinopathy affects recreational players because they tend to hit their backhand strokes with their wrists in a more flexed position, whereas high-level players have an increase in wrist extension just before ball contact. In contradistinction to lateral elbow tendinopathy, medial elbow tendinopathy more commonly occurs in harder hitting players.

Treatment Options

The treatment of tennis injuries includes conservative and less common options. The approach of every injury needs to be individualized depending on the severity, type of injury, cause, and level of play.

Tennis players are very sensitive to overuse injuries to the wrist. Extensor carpi ulnaris tendinitis and subsheath tears are common injuries to the forearm and wrist with spin shots and the two-handed backhand. The treatment for these injuries may include temporary immobilization with a splint or soft support,  rest, and anti-inflammatory medication as well as a corticosteroid injection into the affected sheath if appropriate. Platelet-rich plasma and counterforce bracing are useful in tennis elbow.

Rehabilitation and understanding the causes in the kinetic chain from the feet to the hand are considered important elements in recovering from overuse injuries.

If You Believe You Have a Tennis Injury, Contact HandSport Surgery Institute

Please contact us as soon as possible to schedule an appointment with our talented team. People who have been hurt while playing tennis should be evaluated to try and prevent further injury and mobility issues.

If you have been injured, it’s important to be evaluated by a highly skilled upper extremity sports professional. Call Drs. Mark and Jason Pruzansky at 212-249-8700 to schedule an appointment and obtain an accurate diagnosis.