Tennis injuries can be avoided with proper training

Tennis is regarded as a year-round sport for those fortunate enough to live in a region with a moderate climate or to have access to an indoor facility.

Another group of tennis players has a short season extending from Wimbledon to the U.S. Open. Interestingly, both groups are susceptible to different types of afflictions.

Injuries associated with tennis are divided into chronic and acute types. Chronic injuries are those resulting from longstanding overuse while acute injuries are sudden and short-lived. Many of these injuries can be avoided with proper training, stretching, and technique.

Cardiovascular fitness is essential before participating in any vigorous activity. Warm-up exercises and starting off with a slow, deliberate stroke will increase circulation to muscles.

A classification of common medical problems associated with tennis would include:

• Upper extremities: The shoulder, elbow, and wrist are most susceptible to chronic overuse given the nature of the sport. Since the rotator cuff is responsible for stabilizing the shoulder, a tennis serve can lead to a tear or impingement when executed poorly. Shoulder problems typically develop when the shoulder is lifted to a 90-degree angle. Increasing the angle between the shoulder and torso will minimize the chance of injury.

Tennis elbow, acute inflammation of the outer surface of the elbow, is caused by strain during the backhand stroke. A two-handed backhand stroke is helpful.

Wrist injuries occur when a player snaps the wrist to put spin on the ball.

• Lower extremities: Tennis involves a lot of stop-and-go activity that can stress the ligaments that hold the knee in place. This varies with the playing surface. Reports show fewer knee injuries when playing on clay as opposed to a hard surface. Ankle sprains are a common acute injury due to sudden changes in direction.

• Lower back: Constant bending and twisting is part of the sport of tennis. This activity leads to severe strain of muscles and ligaments which support the lower spine. Repeated injury can lead to tiny stress fractures of the vertebrae.

Tennis is a superb sport requiring much skill, strategy, and fitness. As time goes by, many players often transition from competitive singles to social doubles.

Sometimes the next step is golf.

Anthony G. Alessi, MD, is Chief of Neurology at The William W. Backus Hospital and in private practice at NeuroDiagnostics, LLC, in Norwich. E-mail him at If you wish to learn more about sports health topics, listen to the podcast or go to the Healthy Sports blog at

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