I keep injuring myself during tennis. Why does this keep happening? And can a Chiropractor help with the injuries?
Serena Williams, Roger Federer or Rafael Nadal are some of the most prominent figures in the world of tennis. These highly respected athletes are favourites for many for their techniques, game play or just pure athleticism. But other than Tennis these three also have something else in common injuries.
Professional or amateur athletes will for various reasons find themselves being off-season or not able to perform at their best due to injuries sustained in the knee, back, shoulder or elbow. This article will explore how constant wear and tear, sudden acceleration and deceleration affects your joints and ultimately how it creeps into symptoms.
How Does The Body Move During a Game of Tennis?
When looking at the bio-mechanics of tennis, we first need to realise that there are a lot of movements generated. From running between strokes, to serve itself, the backhand and forehand ground strokes, to the overhead smash and more. These movements start from your foot, extending to your knees, hip, thorax going into your shoulder then the elbow down to your wrist and into the racquet. For all these movements to be performed in sequence, your reaction time (which is governed by the nervous system) needs to functioning at its optimal. This is generally referred to as the kinetic chain or the kinetic link.
Technique in tennis is governed by this kinetic chain working in synchronisation. Injuries and instabilities usually arise with bad technique as well as a “kink” or block in the your body’s kinetic chain.
Common Tennis Injuries
From Serena William’s sustaining back injuries to Roger Federer’s knee injuries, when there is a break in your kinetic chain, minor to major injuries are expected. Some of the common injuries and symptoms that come with Tennis are Lateral Epicondylitis (Tennis Elbow), Rotator Cuff Tendinitis (Shoulder), Ankle Sprains, Patellar Tendinitis (Jumper’s Knee), Back Pain (Stress Fracture)
1. Lateral Epicondylitis
When there is a stress overload on tendons or ligaments micro tears occur which lead to swelling. Lateral Epicondylitis, also known as Tennis elbow, usually presents with elbow pain and tenderness on the outside of the elbow joint. This occurs due to repetitive movements - such as gripping and swinging of the tennis racquet, which creates a tugging like effect on the tendons that connect the forearm muscles to the lateral epicondyle (Boney bump on the outside/lateral aspect of your elbow).
Lateral Epicondylitis not only occurs in the sport of Tennis but can also occur in other sports such as table tennis, badminton, squash, fencing and many more. It can also occur professions such as carpentry, painters or typing in a desk bound job.
Over time what may have presented as elbow pain, may start radiating into the upper or lower arm, as more muscles or joints start compensating for the break in the kinetic chain, leading to more damage. Daily and simple activities start being affected such as gripping objects, lifting things, tying or brushing of hair, opening doors, shaking hands etc.
2. Rotator Cuff Tendinitis
The shoulder joint is a ball and socket joint between the humerus (the long bone in your upper arm), and the scapula (shoulder blade). Holding this joint in place are your rotator cuff tendons; Compromising of the supraspinatus, infraspinatus, teres minor and subscapularis. These tendons help stabilise the joint, allowing for a wide range of motion, predominantly rotation and overhead movement. This mobility however come at the cost of joint stability.
The most common symptom presentation for rotator cuff tendinitis or tear is shoulder pain. Any overhead and repetitive movement will eventually cause fraying or tearing of tissues leading to swelling and inflammation. With age, normal wear and tear also starts to weaken the shoulder increasing the risk of injury. If not addressed and left untreated the symptoms also start affecting day to day activities, such as wearing clothes, lifting your arm sideways, pushing or pulling and even sleeping on the shoulder.
3. Ankle Sprains
This is the most common injury in the sport of tennis that can occur due to sudden stops, starts and change of direction. But one doesn’t necessarily have to play tennis to sprain their ankle. Inversion sprains are the most common, where the outside of the foot turns inward, leading to overstretched ligaments of the ankle. Landing poorly after running to catch the bus can be enough to sprain your ankle, if it lacks proper stability and neuro-muscular control
Commonly pain and swelling will be present around the joint. However depending on the severity of the sprain, tears in the ligaments do occur, which leads to more instability and a higher recurrence of the injury.
4. Patellar Tendinitis
Also known as Jumper’s knee, occurs when an athlete jumps repeatedly off a hard-court surface, leading to inflammation of a tendon which attaches to the patellar (knee cap). This tendon, known as the Patella tendon, plays a major role in the kinetic chain, from walking, running to jumping. The tendon helps to translate and transfer the force generated from your quadriceps muscles (front of the thigh) to the tibia (shinbone) allowing your leg to extend, straighten and support the body weight.
As the tendon may be strained with repetitive movement, symptoms generally present as pain or tenderness just below the knee cap. This discomfort may lead to a decrease in strength in the quadriceps muscle and mobility of the knee joint. When left untreated compensation by other surrounding joints and muscles start occurring leading to secondary injuries.
5. Back Pain
Tennis is a sport with repetitive rotations, flexions and hyper extensions of the lumbar spine during a game. These movements increase the stresses in the lumbar spine (lower back) especially at the 4th and 5th vertebrae.
If the lower back muscles aren’t able to keep up with the forces and stress exerted, the bones and joints in the lumbar spine are the next to take the hit. These stresses may impact discs, cause nerve impingement, swelling, and inflammation in the lower back reducing functionality and mobility leading to symptoms of pain. Younger athletes however are also more prone to stress fractures, also known as Spondylolisthesis. This is where the vertebrae stacked on another vertebrae starts to slip forward.
How to prevent Tennis injuries
Prevention comes in many forms, from warm ups, to strengthening weaker muscles, to better form and technique. However, unless you are fully aware of your specific bio-mechanical issues, you won’t be able to target your weak points. We often hear of patients trying out YouTube videos and performing random stretches for a muscle that didn’t even need to be stretched.
So when looking at prevention the first step is to get assessed by a trained professional. At Align Chiropractic our Doctors will help you identify key factors such as poor bio-mechanics of the spine, loss of mobility of your joints, muscles, ligaments or tendons, as well as any poor functionality of your nervous system.
But does Chiropractic really help?
Chiropractors are specialized Doctors that treat conditions of the Spine and Nervous System. The main and most effective treatment used is the Chiropractic Adjustment.
At Align Chiropractic our unique approach has given us a high success rate in prevention and performance as well as improvement of injuries related to Tennis. After a thorough evaluation and any necessary imaging, we create a specialized program involving:
Muscle Release Technique (M.R.T.)
If Tennis is a hobby, or you are a professional and are looking for a conservative, non-surgical non-medication answer, schedule an appointment with our Doctors.
For more information, or a free consult to see if your case is right for us, email us at