With the Wimbledon tournament upon us and the longer evenings outside, many seasonal tennis players are digging out their racquets or putting more hours in on the tennis court. Tennis is a sport which challenges the whole body (and mind!) and therefore injuries can be very varied. The most common causes of injury I see in tennis, both in professionals and amateurs relate to the complex relationship between training patterns, equipment and playing surfaces.
For the professionals, the change from hard or clay courts to grass often means an increase in patella tendonopathy (previously called tendinitis), knee pain in general and sometimes back pain. This comes from the fact that the ball bounces lower on grass and the player therefore has to drop lower to take a shot. A higher bounce can also cause problems with back pain and shoulder pain as the player tries to rise higher to take the shot at its ideal point. If you are going to change from one playing surface to another with the change to the summer season, it is worth being aware that the change may trigger a few niggles, even though the time you spend on your tennis has not changed. It is worth spending a little less time on a new surface until you are used to it, building up gradually and using the extra time to do some stretches – many people stretch their lower limbs, but it’s also important to do some upper limb stretches too.
Any change in equipment can also cause problems. It is important to have the right grip size to your racquet – too big or too small can cause shoulder problems , wrist problems or ‘tennis elbow’. If you have bought a new racquet for the summer, ease your way in; even a different tension on the strings can affect how much your arm is loaded over a 1-2 hour session with a knock on effect of overuse injury. In addition, if you have been playing squash or badminton over the winter, remember that the use of the wrist you have used in these sports during your shot cannot be continued into a tennis swing. If you overuse the wrist in your tennis strokes (particularly the backhand), this can cause wrist and elbow problems.
If you do notice a low grade pain with or after tennis, it is worth narrowing down which part of this complex game is the source of your problems. For instance, sometimes shoulder pain with tennis is triggered by serve practise, which repeatedly takes the serving arm into an extreme position, back and above the head. Dropping this out of your sessions and perhaps serving underarm in training may help settle things to a manageable level again – the number of times you serve in a match is much less. Back pain can be enormously aggravated by bending to pick up balls! Whilst this isn’t a problem for professionals during a match, with an army of ball boys and ball girls on hand, all professional coaches would have a hopper or other device to pick up balls without bending during training.
Injury problems which do not come under control with simple measures may need to be seen by a professional, either a sports physiotherapist or sports physician. Understanding the mechanics of tennis, and the way that ground reaction forces can manifest anywhere in the body (the principle of the ‘kinetic chain’) is key to getting to the bottom of tennis related problems. As Rafa Nadal has shown – there’s nearly always a way back….!