Summer means tennis is Australia, and as the Australian Open heated up Melbourne, so too does participation - and injuries - in tennis.
In the latest AusPlay report, tennis was named Australia’s seventh most participated sport/physical activity in the country, behind walking/running, swimming, cycling and golf to name a few.
With a spike in general tennis participation, this often comes with a spike in common tennis injuries. Since COVID largely closed recreational courts and shut players out of practice for most of 2020, you might be feeling the demands of the sport more than ever. Tennis Physiotherapy can help you unlock your sudden, recurring or ongoing injuries to get back into the match.
No matter what level you play at, tennis injuries most often occur from completing repetitive loads in positions that require high levels of power production, stability and strength. Some tennis injuries may occur in a sudden moment like a rolled ankle or muscle tear, but many present as overuse injuries from gripping, repeating poor body positions, sudden starts and stops and over exertion. Tennis elbow, rotator cuffs and ankle sprains are common injuries we see with tennis players.
How can minimise your risk of injury?
Like any sport, the risk of receiving tennis injuries can be minimised with a consistent strength and conditioning program, employing correct swing and grip technique, and ensuring you gradually increase the intensity and load of your playing. Melbourne CBD Physiotherapy and Sports Medicine consults many patients with these issues.
Most Common Injuries associated with Tennis (and how they get treated)
Lateral elbow tendinopathy (Tennis Elbow)
Widely known as tennis elbow, lateral epicondylitis is the most common overuse syndrome in the elbow.
Tennis elbow a painful tendon condition that can radiate pain up and along the upper arm and down on the outside of the forearm. In rare cases, pain can even radiate to the third and fourth fingers. Patients often report to us that their grip strength is weak or they have difficulty carrying objects in their hand, especially when the elbow is extended.
On average, symptoms last from 2 weeks to 2 years, which makes it incredibly important to seek experienced tennis physiotherapy advice to resolve pain and dysfunction as soon as you can. Twenty percent of cases persist for more than a year. Melbourne CBD Physiotherapy and Sports Medicine will approach tennis elbow with a number of therapies, but they will all have the same goal of reducing pain and installing function back to the elbow, grip strength and lifting.
Some common considerations our clinicians make are:
- Has there been a training error whereby the tendon capacity has been exceeded?
- How long have you had the symptoms?
- Has there been a change in equipment use?
- Does the capacity of the extensors need to be addressed?
- Is another joint contributing to the pain e.g. shoulder?
Tennis shoulder injuries
The serve is the most demanding and injury prone stroke in tennis, with repeated stress and high forces exerted through the shoulder joint. With the shoulder complex being one of the most sophisticated joints in the body, there are a number of common shoulder injuries that present with tennis players, sometimes in a combination of:
Rotator cuff tendinopathy
Characterised by pain and weakness commonly experienced with external rotation and elevation of the shoulder, usually as a consequence of excessive overhead serving.
A bursa is characterised as a fluid–filled sac that acts as a cushion, to help the muscles, ligaments, and tendons, glide easily within the shoulder joint. This can be a common radiological finding, and not always a "problem" so to speak. The bursa can be impacted due to poor scapular control or posturing, so it is really important to establish whether a change in posture, movement mechanics or muscle recruitment patterns can alleviate symptoms. If so, addressing the bursa is not usually the primary concern and is known to settle as other concerns are addressed.
How do you treat tennis shoulder injuries?
During your initial consultation, your physiotherapist will assess your problem, watching you move and understand your history and goals moving forward. Your particular strategy may include hands-on treatment and specific exercise interventions to complete at home.
We will provide a clear diagnosis with a treatment and management strategy that includes clear timeframes and expectations. Our team is confident on deciding whether you can be managed conservatively under physiotherapy guidance reconditioning program, whether you require imaging such as MRI and/or a very specific opinion from one of our extended team members or specialists.
Sprains or a ‘rolled ankle’ is an injury to the ligaments in the ankle. They're very common in tennis with the sharp stops, lunges and change in direction required for tennis. Ankle sprains can be really nasty and they will need specific intervention to deliver a full and safe return to tennis.
How can I prevent ankle injuries?
It’s not possible to entirely prevent injuries, but there are loads of things you can do to minimise the risk of getting an ankle sprain.
- Incorporate ankle and foot stability exercises and drills into your strength and conditioning program and your warm up. These will build the strength of the entire area and offer substantial coordination and balance through the ankle complex.
- A Melbourne CBD Physiotherapy and Sports Medicine can give specific exercises and advise as to what might be lacking in your calf and ankle complex. Exercises to address proprioception, strength, power and agility need to be definitely considered, and progressed accordingly depending on your ankle injury history and the level of capacity at the time.
If you are returning from an ankle injury, most athletes like to return with some form of ankle stabilisation in place. If you are competent at taping your ankle, this is one way to assist you and your ankle awareness. Another way we can do this is by fitting a brace. No, it won’t make your ankle joint weak! What it will do is provide you with the same stability and feedback as the tape and for a longer period of time.
Ankle Injury Tips
1. If wearing braces and supportive devices, this does not mean your ankle exercises should conclude.
2. Use the brace in training before going to compete or play a game
3. Tape or brace both ankles! Did you know that if you have rolled one, you’re more likely to injure the other.
What do I do if I have sprained my ankle?
Starting with standard first aid treatment is always advised: Rest, Ice, Compression, Elevation (RICE).
The second thing to do is not pass the ankle injury off as “just a rolled ankle” and get it checked. You need an accurate diagnosis! This can allow you to know what management strategies need to be put in place to allow it to recover, what could possibly speed up recovery, when it is advised to load the joint, and what steps can be put in place to prevent re-injury.
Not all ankle injuries are the same. Sometimes further investigation in the form of an X-Ray or MRI might be required for more serious cases. Depending on what is suspected clinically; tape, brace, boots and crutches can be utilised in the interim to help stabilise your injury. However, once confirmed and physiotherapy is indicated as the best treatment path, the focus is on building back the ankle capacity through specific exercises and treatment, relative to your goals and performance desire.
Written by Nick Cross (B.Ex.Sci,M.Ap.Sci(Ex.Rehab), DPT(Melb), GradCert.SportsPhysio)