Tennis specific arm injuries
11 October 2018
Who’s getting excited for the start of penance again? It seems like summer is finally arriving and with it, Tennis is returning to Australia. I was fortunate to look after a couple of Pro women’s tennis tournaments in Perth last summer and learnt a lot along the way about common tennis injuries. I’ll briefly outline a few common wrist, elbow and shoulder injuries we tend to see and their management strategies.
Most of the wrist pain I saw in tennis was what we call TFCC (Triangular Fibro-Cartilagenous Complex). On the outside of the wrist there is a small triangular piece of cartilage which can be injured by repeat loading into rotation and side flexing of the wrist. If you can pick this up soon enough it can often be managed with strapping to help offload, massage, strengthening and technique changes. If not picked up early enough, it can result in weeks spent in a splint and not training or in the worst cases surgery. Other slightly less common injuries are tendon overload and ligament instability.
You can probably guess one of the main causes of elbow pain in tennis players is tennis elbow (though we also see it in a lot of non- tennis players). Also known as Lateral Epicondylalgia, it presents as pain on the outside of the elbow due to irritation or tearing of the tendon that attaches there. The wrist extensor muscles (which help to pull the hand back and stabilise the wrist) can be overloaded either with repeat lower level loads (eg. Serving a tennis ball 100 times) or one maximal load. Management of tennis elbow relies on a good strengthening program combined with addressing technique and other contributing factors (grip size), soft tissue massage, taping or bracing and modified training loads to allow for adaptation to occur.
One of the other common elbow injuries happens on the inside of the elbow where the ligaments can be stressed by repeat over stretching. This can be partly due to strength but also largely due to technique and control. Management is similar to above with taping for support, strengthening and technique correction.
Structurally there are many muscles/tendons and ligaments that can be injured in the shoulder. Rather than outlining each of these structures what I would say is that regardless of what is sore, we try to work out why it is sore? Is it because the shoulder is hypermobile and the excess movement means structures are getting pinched and stretched. Is it because muscles are weak and being overloaded? Is there technique issues which are overloading structures? Usually sorting out shoulder pain is a combination of correcting technique, strengthening the shoulder muscles as well as muscles throughout the rest of the chain which if they are weak might lead to excess loading at the shoulder, taping, massage and stretches.
As you can see most of these injuries are managed in a similar matter. We make sure your technique is optimal (In saying we it is a matter of liaising with your coach who is the technique expert), we adjust training loads to allow the pain to settle to a manageable level, we strength not only the affected area but other areas of weakness and we provide massage and taping or bracing to offload the area. As mentioned these are just a few of the injuries we treat in tennis players and we’re always happy to discuss any injuries or give second opinions if you’re not improving to get you back out on the court.