Tennis

01 Overview

Tennis is played around the world both recreationally and competitively. Governed locally by Tennis BC, this fast-paced Olympic racquet sport is played as singles or doubles on a court, hitting a ball across a net. Requiring quick changes in direction, sprains and strains are the most common injuries in tennis.

(see Section 04 - Prevention)
Athlete silhouette
View Common Injuries by clicking the blue dots on the silhouette

Ankle injuries, such as sprains, are one of the most common tennis injuries.

Injuries to the anterior cruciate ligament (ACL) of the knee can occur when playing tennis.

Lateral epicondylitis, or “tennis elbow,” is a common overuse injury in tennis.

Shoulder injuries are a common upper extremity injury in tennis, typically resulting from overuse.

Although less common than most other tennis injuries, stress fractures can occur in the bones of the hand.

Overuse-related wrist injuries can occur in tennis, and may be related to how the tennis player grips the racquet, or the size of the racquet grip.

02 Injury Statistics

Most tennis injuries occur in the lower extremities, followed by the upper extremities and the trunk. Injury rates for junior competitive players range from 0.6 to 1.7 for every 1,000 hours of tennis. Injury rates are slightly higher for professional adult tennis players, ranging from 2 to 6 injuries for every 1,000 hours of tennis.

Curious about the research on injuries?

It is estimated that...

View Summary of Incidence Rates

03 Risk Factors

Risk factors for sustaining a tennis injury include the court surface, equipment, length of playing time, age, sex, flexibility, and previous history of injury.

  • Court Surface

    Playing on harder surfaces has been associated with an increased risk of tennis injury. Significantly more injuries occur on hard surfaces than on clay, and few injuries occur on grass or carpeted surfaces.

  • Playing Time

    The risk of injury increases the longer you play tennis. The rate of injuries that cause a player to withdraw from the competition doubles after four matches. Total hours of tennis participation can also increase the risk of overuse injuries.

  • Sex

    Injury rates among elite junior tennis players ages 12 to 18 years are significantly higher for males than for females. This higher risk of injury among males has not been consistently demonstrated among adult professional tennis players.

  • Previous Injury

    Previous history of injury is associated with a nine times higher risk of sustaining a tennis injury.

  • Equipment

    The size of tennis racquet handle grips can result in overuse injuries for tennis players, specifically tennis elbow. How the player grips the racket may influence which parts of the wrist are injured.

  • Age

    The risk of tennis injury increases with age.

  • Flexibility

    Elite female tennis players with limited hip flexibility have a six times higher risk of sustaining abdominal strains as compared to more flexible players. Professional tennis players with limited shoulder flexibility are more likely to experience shoulder pain.

04 How can I prevent injury?

Some muscle soreness or joint pain is expected when increasing your level of physical activity. However, it is important to listen to your body for persistent or worsening pain, and to know when to rest. Learn more about how to prevent injuries in tennis.

  • Participant & Parent

    Talk to your coach or organization about the prevention strategies below and how they might be incorporated into training and policies.

    Strength Training and Neuromuscular Training Program

    The risk of all lower body injuries may be reduced by up to 50% by regular participation in a balance training exercise program with a resistance training component, such as a neuromuscular training warm-up program. Completing this warm-up program can lower the likelihood of ankle and knee injuries.

    Sport Injury Prevention Research Centre Neuromuscular Training
    The Sport Injury Prevention Research Centre has developed a neuromuscular training warm-up program that can be adapted to many sports. Incorporating a warm-up program like this one into your training program at least two times per week has been associated with a significant reduction in lower body injuries.

    Click here to view video and poster.

    Oslo Sport Trauma Research Centre Neuromuscular Training
    Adopt strength training exercises designed to prevent injuries to the shoulder and knee. The Oslo Sport Trauma Research Centre has developed exercises that specifically help keep the shoulder strong and reduce the risk of injuries. This resource includes videos and PDFs for download.

    Learn more about exercises to help prevent shoulder injuries.

    Learn more about exercises to help prevent knee injuries.

    For more exercises, visit http://fittoplay.org/.

    Get Set Neuromuscular Training
    The Get Set app contains exercises that can be done at home. Created by the Oslo Sports Trauma Center, Norwegian School of Sport Sciences, and Making Waves AS in 2014 for the International Olympic Committee, the app allows you to search by body part to view exercises that work to strengthen each area of the body, or search by sport to view a library of exercises that are specific to tennis.

    Download Get Set for Android.

    Download Get Set for iOS.

    Other Considerations (about this section)

    Equipment
    Wearing supportive insoles decreases the risk of lower limb overuse injuries in tennis. The size of the grip on the tennis racquet can increase the risk of injury to the wrist. Seek professional advice when buying tennis equipment to ensure the right size and grip.

    Sport-related Physicals
    Tennis is a physically demanding sport and some pre-existing conditions may increase the risk of injury. An annual sport-related physical evaluation ensuring fitness to play can help to reduce risk of injury. KidsHealth provides information about what sports physicals are, why they may be appropriate and where you may go to get them.

    Learn more about Kids Health Sports Physicals.

  • Coach & Teacher

    Talk to your organization or school about the prevention strategies below and how they might be incorporated into training and policies.

    Strength Training and Neuromuscular Training Program

    The risk of all lower body injuries may be reduced by up to 50% by regular participation in a balance training exercise program with a resistance training component, such as a neuromuscular training warm-up program. Completing this warm-up program can lower the likelihood of ankle and knee injuries.

    Sport Injury Prevention Research Centre Neuromuscular Training
    The Sport Injury Prevention Research Centre has developed a neuromuscular training warm-up program that can be adapted to many sports. Incorporating a warm-up program like this one into your training program at least two times per week has been associated with a significant reduction in lower body injuries.

    Click here to view video and poster.

    Oslo Sport Trauma Research Centre Neuromuscular Training
    Adopt strength training exercises designed to prevent injuries to the shoulder and knee. The Oslo Sport Trauma Research Centre has developed exercises that specifically help keep the shoulder strong and reduce the risk of injuries. This resource includes videos and PDFs for download.

    Learn more about exercises to help prevent shoulder injuries.

    Learn more about exercises to help prevent knee injuries.

    For more exercises, visit http://fittoplay.org/.

    Get Set Neuromuscular Training
    The Get Set app contains exercises that can be done at home. Created by the Oslo Sports Trauma Center, Norwegian School of Sport Sciences, and Making Waves AS in 2014 for the International Olympic Committee, the app allows you to search by body part to view exercises that work to strengthen each area of the body, or search by sport to view a library of exercises that are specific to tennis.

    Download Get Set for Android.

    Download Get Set for iOS.

    Other Considerations (about this section)

    Equipment
    Ensure players are wearing supportive insoles and that their tennis racquet and its grip are the appropriate size.

    Facilities
    The Ontario Physical Education Association (OPHEA) provides recommendations for safely implementing tennis in secondary schools.

    Learn more about implementing tennis in your school.

    Sport-related Physicals
    Tennis is a physically demanding sport and some pre-existing conditions may increase the risk of injury. An annual sport-related physical evaluation ensuring fitness to play can help to reduce risk of injury. KidsHealth provides information about what sports physicals are, why they may be appropriate and where you may go to get them.

    Learn more about Kids Health Sports Physicals.

  • Official & Administrator

    Talk to your coaches, teachers, organization, or school about the prevention strategies below and how they might be incorporated into training and policies.

    Strength Training and Neuromuscular Training Program

    The risk of all lower body injuries may be reduced by up to 50% by regular participation in a balance training exercise program with a resistance training component, such as a neuromuscular training warm-up program. Completing this warm-up program can lower the likelihood of ankle and knee injuries.

    Sport Injury Prevention Research Centre Neuromuscular Training
    The Sport Injury Prevention Research Centre has developed a neuromuscular training warm-up program that can be adapted to many sports. Incorporating a warm-up program like this one into the coach’s training program at least two times per week has been associated with a significant reduction in lower body injuries

    Click here to view video and poster.

    Oslo Sport Trauma Research Centre Neuromuscular Training
    Adopt strength training exercises designed to prevent injuries to the shoulder and knee. The Oslo Sport Trauma Research Centre has developed exercises that specifically help keep the shoulder strong and reduce the risk of injuries. This resource includes videos and PDFs for download.

    Learn more about exercises to help prevent shoulder injuries.

    Learn more about exercises to help prevent knee injuries.

    For more exercises, visit http://fittoplay.org/.

    Get Set Neuromuscular Training
    The Get Set app contains exercises that can be done at home. Created by the Oslo Sports Trauma Centre, Norwegian School of Sport Sciences, and Making Waves AS in 2014 for the International Olympic Committee, the app allows you to search by body part to view exercises that work to strengthen each area of the body, or search by sport to view a library of exercises that are specific to tennis.

    Download Get Set for Android.

    Download Get Set for iOS.

    Other Considerations (about this section)

    Equipment
    Ensure players are wearing supportive insoles and that their tennis racquet and its grip are the appropriate size.

    Facilities
    The Ontario Physical Education Association (OPHEA) provides recommendations for safely implementing tennis in secondary schools.

    Learn more about implementing tennis in your school.

    Sport-related Physicals
    Tennis is a physically demanding sport and some pre-existing conditions may increase the risk of injury. An annual sport-related physical evaluation ensuring fitness to play can help to reduce risk of injury. KidsHealth provides information about what sports physicals are, why they may be appropriate and where you may go to get them.

    Learn more about Kids Health Sports Physicals.

  • Health Professional

    The role of health professionals in preventing tennis injuries has two main components:

    1. Providing ongoing education to players, parents, and coaches on effective injury prevention programs such as balance and resistance training; and
    2. Ensuring that injured players are completely healed and fit-to-perform before returning to tennis to prevent re-injury or chronic injury.

    Strength Training and Neuromuscular Training Program

    The risk of all lower body injuries may be reduced by up to 50% by regular participation in a balance training exercise program with a resistance training component, such as a neuromuscular training warm-up program. Completing this warm-up program can lower the likelihood of ankle and knee injuries.

    Sport Injury Prevention Research Centre Neuromuscular Training
    The Sport Injury Prevention Research Centre has developed a neuromuscular training warm-up program that can be adapted to many sports. Incorporating a warm-up program like this one into the coach’s training program at least two times per week has been associated with a significant reduction in lower body injuries.

    Click here to view video and poster.

    Oslo Sport Trauma Research Centre Neuromuscular Training
    Adopt strength training exercises designed to prevent injuries to the shoulder and knee. The Oslo Sport Trauma Research Centre has developed exercises that specifically help keep the shoulder strong and reduce the risk of injuries. This resource includes videos and PDFs for download.

     

    Learn more about exercises to help prevent shoulder injuries.

    Learn more about exercises to help prevent knee injuries.

    For more exercises, visit http://fittoplay.org/.

    Get Set Neuromuscular Training
    The Get Set app contains exercises that can be done at home. Created by the Oslo Sports Trauma Centre, Norwegian School of Sport Sciences, and Making Waves AS in 2014 for the International Olympic Committee, the app allows you to search by body part to view exercises that work to strengthen each area of the body, or search by sport to view a library of exercises that are specific to tennis.

    Download Get Set for Android.

    Download Get Set for iOS.

    Other Considerations (about this section)

    Equipment
    Ensure players understand the importance of are wearing supportive insoles and that their tennis racquet and its grip are the appropriate size.

    Sport-related Physicals
    Tennis is a physically demanding sport and some pre-existing conditions may increase the risk of injury. An annual sport-related physical evaluation ensuring fitness to play can help to reduce risk of injury. The American Academy of Pediatrics provides information about preparticipation physical evaluation.

    Learn more about Preparticipation Physical Evaluation.