Disclaimer: This article is for general educational purposes only and does not constitute medical advice. Always consult a qualified health professional for advice specific to your condition. © 2026 Better Physiotherapy Bundoora.
Tennis demands explosive power, rapid direction change, and sustained overhead loading — creating a distinct injury profile that benefits from physiotherapy tailored to the sport's specific demands.
Common Tennis Injuries
Tennis Elbow (Lateral Epicondylalgia)
Despite the name, most people with tennis elbow have never played tennis. In actual tennis players, it is typically caused by the backhand stroke — particularly a one-handed topspin backhand with poor technique (hitting late, leading with the elbow). Treatment involves progressive extensor tendon loading, technique assessment, and equipment review (grip size, string tension). See our detailed article on tennis elbow physiotherapy.
Shoulder Injuries
The serve is the most shoulder-demanding stroke in tennis — generating ball velocities over 200 km/h in elite players. Amateur players achieve similar relative loading for their body weight. Common serving shoulder conditions:
- Rotator cuff tendinopathy — from high-volume serving and overhead shots
- GIRD — glenohumeral internal rotation deficit; tight posterior capsule from accumulated serving that increases anterior shoulder load
- Shoulder impingement — from scapular fatigue during extended play
Knee Injuries
Rapid direction change on hard courts generates significant patellofemoral load. Patellar tendinopathy (“jumper's knee”) and patellofemoral pain are common in competitive players. Court surface matters — hard courts generate more joint load than clay or grass.
Ankle Sprains
Lateral ankle sprains from the multidirectional movement of tennis are common. A full proprioceptive rehabilitation program after every significant sprain reduces recurrence risk.
Calf Strains (“Tennis Leg”)
The classic sudden push-off calf tear during play. Most common in players over 35. Medial gastrocnemius is the most frequently torn structure. Progressive eccentric calf loading is the cornerstone of rehabilitation.
Equipment Considerations
Equipment issues contribute to many tennis injuries. Key factors to review with your physiotherapist: racquet weight and head size (heavier racquets increase forearm extensor load), string tension (higher tension increases vibration and elbow stress), grip size (a grip too small or too large alters forearm biomechanics), and shoe wear (worn cushioning and sole patterns increase lower limb loads).
Frequently Asked Questions
Can I play tennis with tennis elbow?
In most cases, yes — with appropriate load modification. Completely stopping tennis delays recovery by removing the progressive loading the tendon needs. Your physiotherapist will advise on a modified training program (reducing volume, avoiding aggravating stroke patterns), combined with a tendon loading exercise program that runs parallel to continued play.
My shoulder hurts when I serve. What could it be?
Serving requires explosive internal rotation and reaches peak ball-throwing velocity in the racquet arm — placing significant stress on the rotator cuff, shoulder labrum, and AC joint. Serving shoulder pain commonly involves: rotator cuff tendinopathy, subacromial impingement, GIRD (internal rotation deficit from tight posterior capsule), or labral injury. A thorough physiotherapy assessment identifies the specific structure involved.
How can I prevent tennis injuries?
Key injury prevention strategies for tennis players: progressive load management (avoid too much, too soon — particularly returning to play after a break), specific rotator cuff and scapular strengthening, adequate warm-up before play, appropriate equipment (racquet weight, string tension, grip size), and addressing any technique errors that contribute to overload.
What is the best way to treat a tennis calf injury?
The classic "tennis leg" calf injury (typically medial gastrocnemius tear) occurs with a sudden push-off or direction change. Initial management: RICE (rest, ice, compression, elevation) for 48 hours, then progressive calf loading and neuromuscular rehab. Grade 1 injuries return in 1–2 weeks; Grade 2 in 3–6 weeks. Return to court should include baseline-to-net movement before full match play.
Ashley Haleel
Physiotherapist & Owner — Better Physiotherapy Bundoora