Six ways to avoid tennis injuries like tennis elbow, jumper’s knee and wrist tendonitis

Tennis Features
Dan Evans injured

You have heard of tennis below, jumper’s knee and wrist tendonitis, but find out how you can avoid these tennis injuries while you are out and about enjoying a match this summer.

The British summertime sees tennis-fever grip the nation, with many people throwing themselves into the sport to keep active whilst enjoy the summer weather at the same time.

One of the great things about tennis is that it attracts people of all ages and levels of athletic ability,encouraging all round good health.

Tennis has several key health benefits, including improving cardiovascular fitness, balance, motor control, hand-eye coordination, bone strength and flexibility.
Serena Williams injured

However, because it isn’t a contact sport the injury risks often aren’t as widely discussed – even though, due to the fast-pace,tennis players of all abilities are susceptible to multiple types of injury.

The best way to combat tennis injury is to prevent it from happening. With this in mind, here, Mr Panos Gikas, Consultant Orthopaedic Surgeon at The Lister Hospital and the Royal National Orthopaedic Hospital, discusses six of the most common tennis injuries, and how to avoid them this summer.

Tennis elbow
Mr Panos Gikas says: “One of the most common injuries that a tennis player will experience is the aptly named ‘tennis elbow’. This is a condition characterised by pain and tenderness on the outside of the elbow and is usually the result of repetitive strain or the over-use of the wrist extensor muscles which causes micro-trauma to the tendons.

“In tennis, the wrist extensor muscles are used regularly when the ball hits the racket.The swinging movement from the elbow, twisting the forearm and gripping the handle, can also influence these muscles and lead them to become stressed during play – made even worse if a player’s technique isn’t quite right.

“In order to prevent tennis elbow, players must have a racket that is appropriate for their size and ability. Larger rackets are usually advisable for beginners because the ‘sweet spot’ on the racket (the area on the string grid which gives maximum response from the racket) is bigger. Reducing the tension on the racket strings can also help to minimise the impact on the forearm muscles.”

Jumper’s knee
Mr Panos Gikas says: “Jumper’s knee occurs as a chronic reaction to overuse or injury to the patellar tendon, which joins the bottom of the kneecap to the shin bone. Activities like tennis, which require a lot of jumping, can trigger the condition by causing microscopic tears.

“Tennis is a fantastic activity for keeping fit and active however, due to the demanding and fast-paced nature of the game it’s not always a good idea to push too hard while playing. Overexertion causes accidents and injuries, and all impact activities like tennis, netball and running effect the knees. Partaking in these activities on a regular basis may eventually wear out the cartilage in the knees, and result in a player needing either a partial or total knee replacement.

“Keeping exercise varied is usually a good way to go to avoid this type of injury. Not only will this ensure that not too muchtime is spent on high-impact activities, but it should help with strengthening the body to resist injury. Low impact activities like walking, swimming, strength training and yoga are all excellent ways to keep active that will have minimal impact on the knees.”

Rotator cuff injury
Mr Panos Gikas says: “The tendons and four muscles around the shoulder are known as the rotator cuff which helps to provide stability and enables the shoulder to rotate. Damage to the rotator cuff can happen suddenly or very gradually over time, usually by overuse. The repetitive action of swinging a tennis racket can cause a rotator cuff tear.
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“In order to prevent this injury, it’s crucial that players do stretching and strengthening exercises before they start playing, in order to strengthen and protect the muscles that make up the rotator cuff. These exercises include the parallel arm shoulder stretch, reverse shoulder stretch, and yoga poses like downward facing dog.”

Wrist tendonitis
Mr Panos Gikas says: “Sometimes tennis players can suffer from tendonitis, which is essentially inflammation of the tendons in the wrist. This can develop over time from swinging a racket a lot, especially if the player has an excessive wrist motion when they swing. With wrist tendonitis, there may be swelling around the wrist joint, warmth, and redness of the tendons and/or a grinding sensation in the wrist – with or without a ‘clicking’ sound.

“To prevent wrist tendonitis from occurring, players need to ensure their tennis technique is safe by working with a tennis instructor. It’s also important to have the right racket – based on size and ability, with the correct grip size. This is important as if a grip is too small or too big this will cause the player to squeeze the racket tighter which can lead to wrist tendonitis, among other arm injuries.”

Ankle sprains
Mr Panos Gikas says: “Sprains can occur when a ligament is stretched or torn. Most commonly an ankle sprain occurs when it is ‘twisted’ and the ankle rolls inwards, spraining the ligaments on the outside. Tennis can be a very fast-paced and ‘urgent’ game with quick direction changes and lots of jumping, which puts players at a heightened risk of spraining their ankle.

“Sprains are less likely to happen when the muscles in the ankle are strong. So, in order to avoid injury from occurring players will need to ensure the muscles in their ankles are adequately strengthened and properly warmed up before they start playing. Integrating balance, co-ordination, and proprioceptive exercises into a training regimewill help improve control. It’s also important to wear appropriate tennis shoes that offer support for the ankles, with the addition of ankle supports or even tape if there is any risk of a sprain.”

Stress fractures in the back
Mr Panos Gikas says: “Stress fractures aren’t always painful to begin with, but eventually they will result in lower back pain that gets gradually worse. Tennis can cause stress fractures through the extension of movements it requires to serve the ball – including bending and rotating during play. Unsurprisingly, excessive use of strained movement can put stress on the spine.

“It’s important to work with a tennis instructor, particularly as a beginner, as will help players to develop correct technique from the start – it’s much harder to break old habits!

“Technique is very important, but so is how and when players decide to rest. Every player should ensure they have enough rest periods between playing, to allow time for bones to recover and reduce the risk of fracture. Players should also partake in muscle strengthening exercises to ensure as much shock as possible can be absorbed by the muscles, and not the bones.”

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