Tennis season: How to Avoid Injuries by Tony Kochhar and Paola Bassanese

Summer in the UK officially starts with the Wimbledon tennis championships! From June many of you will be taking advantage of the fine weather to perfect your serve, so in this article we will look at ways to warm up safely in order to prevent common injuries on the tennis court

Healthcare Specialist, Tony Kochhar, Consultant Orthopaedic Surgeon explores seasonal health issues.

Tennis season - avoid injuries on the court using our Wimbledon warm-up by Tony Kochhar and Paola Bassanese

Summer in the UK officially starts with the Wimbledon tennis championships! From June many of you will be taking advantage of the fine weather to perfect your serve, so in this article we will look at ways to warm up safely in order to prevent common injuries on the tennis court.

Tennis is a great sport to watch and play. It involves a lot of rapidly changing movements placing complex demands on the upper and lower body requiring good flexibility, strength, agility and co-ordination.

Injuries are common at all levels of the game. At best they can ruin your enjoyment of the game and at worst stop you from playing altogether. If you do suffer an injury it is best to seek medical assessment and advice straight away, but it is worth bearing in mind the old adage that prevention is better than cure.

Massage and stretching play just as an important role as training to perform well on the tennis court.

Common tennis injuries

Several of the commonly-encountered injuries in tennis are chronic or overuse conditions, the two most common being tennis elbow and rotator cuff tendonitis syndrome.

Tennis Elbow

Tennis elbow is often associated with poor technique. Not getting the body behind the ball and overexertion of the forearm muscles rather than using the power from the whole arm and trunk are the most common technical problems. The grip and the racket are also important. Over- or under-grip will also place greater strain on the forearm as will a heavy or tightly strung racket.

What does tennis elbow feel like?

The main symptom of tennis elbow is tenderness and pain that starts at the bump on the outer aspect (lateral epicondyle) of the elbow. The pain may spread down the forearm. It may go as far as the back of the middle and ring fingers. The forearm muscles may also feel tight and sore.

The pain usually gets worse when you bend your wrist backward, turn your palm upward, or hold something with a stiff wrist or straightened elbow. Grasping items also makes the pain worse. Just reaching into the refrigerator to get a carton of milk can cause pain. Sometimes the elbow feels stiff and will not straighten out completely.

Rotator cuff tendonitis

The other common, over-use condition occurs at the shoulder. Injury to the large tendon in the shoulder (the rotator cuff) affects the normal working of the muscles that move and stabilise the shoulder joint. This often goes hand-in-hand with rotator cuff tendonitis, which due to irritation and wear-and tear of the rotator cuff.

In order to perform a power serve or smash, we have to reach backwards more than our shoulders are designed to allow. That forceful manoeuvre in such an abnormal position pulls on the rotator cuff and biceps tendon, irritating it. If this on tines the tendons can tear, requiring surgery.

What does Rotator cuff tendonitis feel like?

Rotator cuff tendonitis causes generalised shoulder aches in the early stages of the condition. It also causes pain when raising the arm out to the side or in front of the body.

Most patients complain that the pain makes it difficult for them to sleep, especially when they roll onto the affected shoulder.

A reliable sign of rotator cuff tendonitis is a sharp pain when you try to reach into your back pocket. As the condition worsens, the discomfort increases. The joint may become more stiff. Sometimes a catching sensation is felt when you lower your arm. Weakness and inability to raise the arm may indicate that the rotator cuff tendon is actually torn.

A good warm-up and cool-down

A warm-up, as the name suggests, is designed to gradually raise the temperature of your muscles and get them prepared for exercise. Not only will a good warm-up help prevent injury but it can also improve your performance.

There are no hard and fast rules on warm-up strategies but it should include some gentle jogging, active and/or dynamic stretches and some tennis specific drills. Try jogging around the courts for a few minutes before stretching your leg, and arm muscles. Finish off with some light intensity tennis shots and serves.

Dynamic stretches involve sport specific movements that take the muscles through a full range of movement and include drills like lunges, high knees jogging, heel-to-bum jogging, arm circles, torso twists and gentle racket swings.

A cool-down should not be overlooked as it can help reduce muscle stiffness and soreness. The aim is to gradually lower body temperature and to continue to circulate oxygen and blood to the muscles. When you finish a game or training, have a gentle jog and finish off with static stretching for all the major muscle groups. This involves taking the muscle to the point of gentle stretch and holding if for 30 seconds, reducing the tension in the muscle.

Key points to remember to avoid injury

  • Good physical conditioning - this includes flexibility, strength, and co-ordination of the upper and lower limbs and of the core
  • Technique - poor technique will lead to injury quickly. Get some lessons with a coach - not only will you feel better but you will play better too.
  • Recovery - many tennis injuries are over-use conditions so make sure you have adequate rest between games and try not to play too many days per week (recreationally 2-3 days per week is fine)
  • Warm up properly. Stretch everything from your neck, shoulder, elbow, wrist and all the way down to your calves and achilles tendons.
  • Before you play, wrap a hot towel over your shoulder and around your elbow. It sounds silly but you can do this with a small hand towel at the gym. This encourages blood flow in the area, loosens the muscles and also makes the joint lubricating fluid much more effective
  • Make sure you cool down properly. This should take as long as your warm up. Take the time to gradually unwind and prevent those aches and pains the next day.
  • If you do get an ache, don't let it become a chronic problem. The sooner you get it checked out the sooner you will be on your way to recovery.
  • Have regular massages before and after a game. Massage will help increase blood flow to the muscles and in case of injuries it speeds up recovery.

If you feel you might have an injury

  • Do not aggravate the injury - pain is the body's way of telling you something is wrong.
  • Seek professional medical advice - do not take your injury lightly - a sports injury specialist will be able to accurately diagnose your injury.
  • Have a remedial massage to help manage the pain and improve the functionality of the affected area.
  • Early, accurate diagnosis and immediate treatment is the key to a rapid recovery and getting you back on the courts!