Common tennis injuries

The usual suspects

1) Tennis elbow (lateral epicondylitis)

Typical signs: Outer-elbow pain with gripping, backhand, or lifting kettles/garden tools.
Why it happens: Load exceeds tendon capacity in wrist/forearm extensors.

Rehab options (evidence-based):

• Relative load management (reduce painful gripping/backhands temporarily; consider a softer string setup).

• Progressive loading of wrist/forearm (isometrics → slow, heavy eccentrics/concentrics), 3–4×/week for 6–12+ weeks.

• Time course: Many improve over months; ~80% settle within a year.

When to escalate: Night pain, marked weakness, or failure to improve after a sustained, well-progressed program—see a physio/GP.

2) Ankle sprain

• Typical signs: Lateral ankle pain/swelling after a mis-step or cut.
  How common: In sprain/strain data sets, ankle ≈30% of tennis sprains. Lower limb is the leading injury region.

  Rehab options:

  • PEACE & LOVE in the first days (Protection, Elevation, Avoid anti-inflammatories early, Compression, Education → Load, Optimism, Vascularisation, Exercise). Then early and progressive loading. Icing can be necessary along with anti-inflammatories is swelling is very marked or continues past 3 days.

  • Range, strength, balance/proprioception (heel raises, resisted bands, single-leg balance progressions). Multiple NHS trusts provide clear progressions.

  • Brace/tape for return to play if instability persists.

3) Achilles tendinopathy & rupture

• Typical signs: Morning stiffness and insertion/mid-portion Achilles pain; sudden “pop” for ruptures.
  Epidemiology: Tendinopathy affects ~150,000 people/yr in the UK; ruptures occur most in recreational athletes aged 30–50.

  Rehab options:

  • Heavy calf loading (progressive double → single-leg heel raises; then heavy-slow resistance), 12+ weeks minimum.

  • Gradual return to sprinting/hopping only after pain and strength benchmarks improve.

  • Rupture care: pathways vary (surgical vs functional bracing); return-to-sport rates after repair are generally high, but timelines vary ~3–13 months.

4) Rotator cuff–related shoulder pain / impingement

• Typical signs: Pain with serves/overheads, reaching across or behind your back.
  Why it happens: Overload + shoulder/scapular control deficits.

  Rehab options:

  • Rotator cuff & scapular strengthening (external rotation, elevation, rows/scapular setting), 2–3×/week. NHS booklets show simple progressions.

  • Technique & volume tweaks: reduce serve count temporarily; resume gradually.

5) Patellar tendinopathy (“jumper’s knee”)

• Typical signs: Front-of-knee pain with squats, lunges, jump-landings, or low volleys.
  Rehab options:

  • Progressive tendon loading (isometrics → eccentrics → heavy-slow resistance), avoid deep painful compressive angles early; cross-train (bike/swim) while symptoms settle.

  • Time course: expect weeks to months; many leaflets suggest 6–12 weeks for early improvement and up to 6–9 months total.

6) Wrist overload (sprain or De Quervain’s)

Typical signs: Pain at the radial wrist/thumb with topspin forehands or heavy gripping.
Rehab options:

• Relative rest + gradual mobility/strength; short-term splinting may help in acute stages.

• Specific thumb/wrist exercises (isometrics → banded abduction/extension) once pain allows.

7) Low back pain (and adolescent spondylolysis)

Typical signs: Generalised low-back ache after serving; in juniors, persistent focal pain may indicate a pars stress injury.
Rehab options:

• Keep moving: early, gentle mobility and progressive strengthening; choose exercise you’ll stick to (walking, swimming, yoga/Pilates).

• Adolescents with persistent pain (>2 weeks) should be assessed; most spondylolysis cases are managed conservatively (rest from sport, core stability, graded return).

Smart prevention

Warm up properly (3–5 minutes of pulse-raising + dynamic mobility + a few shadow swings). The LTA has simple routines you can copy.

• Progress your load: add only ~10–20% weekly to total hitting or serve volume; schedule lighter days after matches. (Matches carry higher acute injury risk than practice in many cohorts.)

• Balance your body: 2–3 short strength sessions/week (calves, quads/glutes, rotator cuff/scapular, trunk).

• Mind the surface & shoes: change worn shoes; consider mild ankle support if you’ve had sprains.