Lateral Epicondylitis

Lateral epicondylitis tends to affect recreational tennis players. Often, these players demonstrate an over-reliance on their wrist and forearm to produce power, rather than transferring the power that was generated in the legs, trunk, and shoulder. Other common factors that may be at play include weak ness in shoulder external rotation, decreased wrist extension range of motion, or generalized wrist weakness.

Medial Epicondylitis

Medial epicondylitis is more common with high level players due to an overload on the serve and forehand or volley and overhead. It can also occur in players who use s double backhand stroke. Other common contributing factors include stiffness with elbow flexion and pronation (turning hand in) and weakness with shoulder internal rotation.

Rotator Cuff Tendinopathy

Rotator cuff problems often affect players who have general shoulder joint looseness, called multi-directional instability, on the racquet side. Rotator cuff tendinopathy is typically a result of the repetitive muscular demands of the tennis stroke. It can be further impacted when there is weakness in the muscles that stabilize the shoulder blade (scapula), an imbalance in strength and flexibility of the shoulder external and Internal rotators, or a lack of flexibility in the upper spine (thorax) and chest muscles.

Biceps Problems

Biceps tendinopathy often affects the upper shoulder in a similar pattern as occurs with rotator cuff tendinopathy (see the paragraph above). Again, there is often muscular imbalances in the shoulder rotators, along with weakness in the muscles that stabilize the scapula.

Back Pain

A commonly overlooked injury related to court sports is low back pain. It is the hidden injury as people often think it is just “part of the sport,” and it can disguise itself as sciatica or pain into the leg. Court sports require a high demand of repetitive spinal movement including forward and backward bending, side-bending, and rotation. A lot of the power for the stroke is generated from this movement, thus requiring an incredible amount of core strength. The main goal among court sport enthusiasts aiming to minimize back pain is to gain core stability with dynamic loading and to maximize hip strength. Left unchecked, back pain can progress to more serious spine conditions such as impaired health in the discs and joints.

Patellar (knee cap) Problems

Changes in the way the knee cap (patella) glides along the front of the knee joint can lead to pain in the front of the knee, a condition known as patellofemoral syndrome. Normally, the knee cap glides up and down in a groove within the thigh bone (femur). When the knee cap slips too far to the outside of the knee, extra pressure builds behind the knee cap, which can lead to pain and inflammation on the inside edge of the knee cap. Due to the repetitive loading associated with frequent jumping and cutting movements, stability throughout the lower extremity needs to be optimal. Stiffness of the IT Band (along the side of the thigh), weak inner quadriceps muscles, and weak hip rotators are all common contributing factors to patellofemoral pain.

Achilles Problems

Pain along the Achilles tendon is common with court sport players due to the repetitive muscle action of the calf muscle during running, jumping, and the abrupt stopping and cutting movements. Achilles tendinopathy is often due to weakness in the core and hips, along with decreased flexibility of the calf muscle. Players with weak hips can attempt to gain stability and power from the calf muscles resulting in overuse, leading to inflammation in the tendon. Poor shoes or a need for orthotic support can also be important contributing factors to Achilles tendinopathy.

Ankle Sprain

Ankle sprains are the most common court sport injury, mainly due to the intense cutting movements and repetitive jumping nature of these sports. Ankle sprains are managed initially with the R.I.C.E. (rest, ice, compression, and elevation) protocol during the acute phase. This progresses to ankle strengthening and finally rebuilding the dynamic stability of the ankle joint. When an ankle has been sprained, the passive stability of the joint is compromised, and it is at greater risk of being sprained again. Thus, rebuilding the strength and active stability of the joint is imperative.