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Sport-specific guide

Common Tennis injuries

Tennis is an overhead and rotational sport that challenges the shoulder, elbow, and lower extremity. The signature injury is tennis elbow (lateral epicondylitis), but shoulder and knee problems are also common, particularly in older recreational players.

Most common tennis injuries

Tennis Elbow (Lateral Epicondylitis)

Repetitive backhand strokes or gripping stress the extensor tendons at the lateral elbow. Despite the name, 95% of cases occur in non-tennis players; in tennis, poor backhand technique is a common trigger.

Medial Epicondylitis

Stress on the medial elbow from the serving motion and forehand topspin stroke.

Shoulder Impingement

The overhead serve places high rotational forces on the shoulder, particularly with poor mechanics or excessive serving volume.

Rotator Cuff Tear

Cumulative damage from high-volume serving and overhead shots, more common in older recreational players.

Ankle Sprain

Lateral ankle sprains from sudden direction changes on hard courts.

Stress Fracture

Hard court surfaces increase impact stress on the lower extremity, particularly for players who have recently increased court time.

Injury prevention tips

  • Use a racket with appropriate grip size and string tension to reduce forearm stress
  • Learn proper backhand technique - a two-handed backhand reduces lateral elbow stress significantly
  • Warm up thoroughly before serving and overhead play
  • Strengthen forearm extensors and rotator cuff during the off-season
  • Play on clay or synthetic surfaces when possible to reduce impact on joints

Return to tennis timeline

Tennis elbow treated conservatively: 6-12 weeks of modified activity and physical therapy, though full resolution can take 6-18 months. Surgery for refractory cases: 3-6 months before return. Rotator cuff surgery: 6-9 months for return to overhead play.

Common procedures for tennis injuries

Lateral Epicondyle Release

Rotator Cuff Repair

Acromioplasty

Common questions

How do you treat tennis elbow without surgery?
Conservative treatment includes relative rest from the aggravating activity, forearm stretching and eccentric strengthening, counter-force bracing, and occasional corticosteroid or PRP injection. The majority of cases resolve within 12-18 months with conservative care. Surgery is considered only after 6-12 months of failed conservative treatment.
Does grip size matter for tennis elbow?
Yes. Using a grip that is too small causes increased forearm muscle contraction to maintain control of the racket, increasing tendon stress. A racket fitted to your hand size, combined with appropriate string tension and a proper backhand technique, significantly reduces lateral elbow load.

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