Overuse injuries in tennis

There are multiple causes of overuse injuries in tennis, the three primary reasons being inadequate rest and recovery, incorrect and inadequate tennis-specific conditioning, and incorrect grips and strokes.

A new study in the American Journal of Sports Medicine found an association between injuries to the palm or ulnar side of a player’s wrist and the Western or semi-Western grips used to hit the hard, top-spin forehand used by most players.

The most common tennis overuse injury is tennis elbow (tendinitis in the elbow), which almost always caused by an improper grip, repeated failure to make contact with the ball in front of the player’s body, or improper stroke technique.

A tennis ball striking a racket transfers shock or jar to the hand, wrist and arm, with the muscles in the wrist and arms acting as shock absorbers. The shock is minimized when player hits ball closer to middle of strings. Frequent mis-hits can contribute to hand, elbow and shoulder injuries. A ball hit off-center causes the racket to twist (impulsive torque). To control the increased torque, muscles, tendons and ligaments have to work harder, which can lead to overuse injuries.

Reducing overuse injuries

Here are some ways to reduce these types of overuse injuries:

  • Heavier racket with bigger head. A player may like the feel of lighter racquet holding it in pro shop, but the lighter racquet can lead to injury by increasing the amount of torque on top spin ground strokes, which today’s new, lighter rackets encourage.

  • Reduced string tension which will decrease the force and shock by increasing the amount of time the ball stays on the string (e.g. “dwell time”)

  • Stiffer racket. The stiffness of the racket frame may alter the amount of shock; a stiffer racket, while providing more power, also transfers more shock to the arm.


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