The 3 Most Common Tennis Injuries: Expert Physiotherapy Tips

Tennis is a sport which requires high levels of agility, explosive power and stamina – the longest match ever recorded spanned over three days! As it is a non-contact sport you are more likely to sustain ‘niggles’ than acute injuries – here's how to identify and prevent the niggles from getting worse, and keep you firmly on court.  

Tennis elbow

It wouldn’t be a tennis article without mentioning this injury – the clue is in the name. Tennis elbow (or lateral epicondylalgia) occurs when the structures on the outside of the elbow become irritated. It can feel like a dull ache but sometimes also brings on shooting pains or tingling down the outside of the forearm. Golfer’s elbow is when the same issue occurs at the inside of the elbow and is also common in tennis players.

What causes Tennis Elbow?

In a nutshell, overuse. Exaggerated topspin grips and flicking the wrist to achieve topspin can also put you more at risk of developing tennis elbow, as it encourages more torque through the elbow. However, it’s not just tennis that causes this problem – desk workers, mechanics, and others doing repetitive wrist and elbow movements can also find themselves at risk of tennis elbow.  

How to fix Tennis Elbow?

Ice and over the counter pain relievers, plus a tennis elbow compression strap if you feel you need it while playing. Using a racket dampener can help reduce the vibration through the elbow, and ensuring you play with the correct grip size can also help reduce the effects. For desk workers suffering with elbow pain, we recommend breaks from typing and frequent stretches of the affected joint. An ergonomic desk set-up can also be of use to help offload the tendons in the elbow. Changes as simple as altering the height of your office chair can sometimes be enough to help the elbow settle.  

When should I visit a physiotherapist for Tennis Elbow?

If the symptoms are not going away with ice, ibuprofen and rest, it might be a good idea to visit a physiotherapist. Here they will typically ask questions about your lifestyle and any aggravating and easing factors. They will then assess functional actions like your movement and strength, and depending on your symptoms they may also perform tests to check the integrity of the nerves in your arm. After this your physiotherapist will work with you to create a plan to reach your goals – for tennis elbow, this usually consists of gradually loaded exercises with advice on how to fit this into your lifestyle.  

What is the prognosis of Tennis Elbow?

Tennis elbow normally gets better within 8-12 weeks, but more severe cases can last up to a year. If you are worried about your prognosis, your physiotherapist will be more than happy to advise if you might benefit from further intervention. Some people with longer lasting tennis elbow find benefit from injections from their GP, and others require a surgical referral, although this is very rare.  

Jumper’s Knee

Otherwise known as patella tendinitis, jumper’s knee is another injury caused by overuse. It occurs when the tendon on the front of the knee (just below the kneecap) becomes irritated and sore. It can sometimes also cause inflammation of a shock-absorbing structure within the knee called a bursa, so you may have heard of this condition also referred to as ‘bursitis’. 

What causes Jumper's Knee?

Repeated explosive movements through the knee can cause this overtime, especially if done on a hard surface (like indoor tennis courts). Runners can also be prone to this, especially if they run for long distances on hard ground. Another group of people who can develop this is those returning to sport after a long time off, such as those recovering from another injury, as the bodily structures become deconditioned during a long period of rest.  

How to fix Jumper’s Knee?

For this condition, prevention is better than cure. Keeping the leg muscles as strong as possible can help prevent jumper’s knee, and strengthening exercises are a key component in rehabilitation of the patella tendon. Your physiotherapist will lead you through these followed by graded exposure to more explosive movements to safely facilitate your return to sport.  

Similarly to tennis elbow, some athletes like to strap their knee during matches to provide some pain relief and support to the tendon when they need it to perform. A good dynamic warm-up is also beneficial in preventing tendon damage before sport.

When should I visit a physiotherapist for Jumper’s Knee?

The knee is a load-bearing structure that we all use frequently – so if the symptoms are starting to interfere with your day to day life, or are negatively affecting your sporting performance, it is a good idea to seek physiotherapists' advice.  

Symptoms to look out for are swelling at the front of the knee, a grinding sensation coming from the knee, instability, or an inability to bend or extend the leg fully. If any of these things occur, it is a good idea to gain assistance from a healthcare professional. However, a modest amount of ‘clicking’ at the knee can usually be ignored as long as it is pain-free.  

Thrower’s Shoulder

This is not an accurate diagnosis but rather a cluster of issues related to the rotator cuff – the four muscles that guide the shoulder. Tennis players’ shoulders go through a lot of stress especially during the serve, which can lead to discomfort and instability at the joint. Most commonly, this is caused by overuse of the tendons, which you might have explained to you as rotator cuff syndrome.  

What causes Thrower’s Shoulder?

High velocity movements through the shoulder. The shoulder is a complex joint which can perform many movements, and to be used effectively in sport it needs to be very flexible yet incredibly strong. During a tennis match where a lot of serves are hit in quick succession, the shoulder joint is put under incredible force. As tennis is a non-contact sport, it is unlikely to elicit full tears of the rotator cuff, but other issues like tendonitis, bursitis or joint instability are very common.  

How to fix Thrower’s Shoulder?

Again, prevention is better than cure – make sure you are warming up your dominant arm adequately – using a combination of mobility and strength based exercises. Ensuring your shoulder is as strong as possible should help prevent rotator cuff problems. If you are having prolonged discomfort that affects your range of movement or strength at the shoulder, it is recommended to see a physiotherapist who can address this swiftly and reduce injury time and severity. 

When should I see a physiotherapist about Thrower’s Shoulder?

Injuries of the shoulder often bring on a loss of ‘range of movement’, which can present as an inability to reach behind your back, or reach your arm fully up in the air. They can also cause a reduction of strength through the shoulder or a loss of grip strength, which may have you struggling to do day to day tasks like picking up a kettle to make a cup of tea. Finally, shoulder injuries are also common culprits for creating sensations like tingling down the arm or into the hand, which are indicative of nerve irritation.

If your shoulder discomfort brings on any of the above, it is recommended to see a physiotherapist. Shoulders can be complex to diagnose and treat on your own, but a physiotherapist can help guide you back to fitness, and should also be able to advise if you need any further intervention.  

What is the prognosis for Thrower’s Shoulder?

This depends on the severity of the injury, as thrower’s shoulder encompasses a range of injuries. Most shoulder injuries are caused by simple tendon inflammation which can often feel much better in 6-8 weeks, however longer term issues or injuries causing significant strength loss can take a while longer to heal. Most people recover well with conservative management, however there is also the option for injections and eventually surgery, although very few people require this. Your physiotherapist will be able to advise if and when this is needed for you, and can help you prepare for any further intervention that may be needed.