How physiotherapy can treat overuse injuries in tennis players


How physiotherapy can treat overuse injuries in tennis players

With the Australian Open just around the corner, we’ve been hearing a lot about tennis players lately. Today we’re going to be looking at overuse injuries in tennis players, but not the kind of Instagram or Twitter overuse we’ve become accustomed to.

Why are tennis players susceptible to overuse injuries?

Tennis play is a mix of overhead motions, quick starts and stops with short explosive bursts of motion, and a dynamic exchange of intricate strokes and serves.[1] Athletes are susceptible to a variety of injuries because of these repetitive stresses.

Tennis is a demanding sport on both the lower and upper body, with overuse injuries of the shoulder, elbow and knee making up around two-thirds of all tennis injuries.

Muscle activation during the serve and forehand is focused on the subscapularis, the pectoralis major, and the serratus anterior.[2] A common overuse injury in tennis players is rotator cuff tendonitis.

The backhand involves largely the middle deltoid, supraspinatus, and infraspinatus.[3] This repetitive loading of the rotator cuff, particularly the supraspinatus and infraspinatus, leads to overuse injury due to the repetitive eccentric muscular activation. Wrist extensor activity is heavy in all strokes, which could help explain this joint’s predisposition to injury.[4]

Common tennis injuries:

It is important for your physio to understand the chronology of your symptoms, prior injuries, biomechanics, training schedule and roundabout time spent practicing types of strokes.

Your Fixio physio will ask you a number of questions on your first visit to help work out the root cause of your injury and any other exacerbating factors. This allows us to help build a profile of the injury and lets us get stuck into creating your personalised recovery program.

Please try and think of these things[5]:

  • When your symptoms began
  • If any motion or activity makes the pain better or worse
  • Any recent direct injuries

Depending on what your physio deems is necessary for your recovery, you will receive any combination of the following treatments:

  • Hands on treatment
  • Dry needling / acupuncture
  • Joint mobilisations
  • Trigger point release
  • Myofascial release
  • Scar tissue management
  • Stretching
  • Active rehabilitation
  • Pilates
  • Strength training
  • Posture retraining
  • Muscle re-education
  • Goal setting sessions

Top tips for avoiding tennis injuries

  1. Use the right equipment
  2. Take breaks
  3. Exercise
  4. Stretch
  5. Warm-up and warm-down
  6. Practice
  7. Get a biomechanical assessment from your physio

Whether you’re a beginner or an advanced player, tennis is a very physically demanding sport. At Fixio, we understand tennis players and the intricacies of overuse injuries and can help you get back on court feeling strong and pain free ASAP.

Make a booking to speak with us on (02) 8964 4086 or send an email to

[1] Kovacs MS. Applied physiology of tennis performance. Br J Sports Med. 2006;40:381–5 discussion 386.

[2] Kovacs M, Ellenbecker . An 8-stage model for evaluating the tennis serve: implications for performance

enhancement and injury prevention. Sports Health. 2011;3:504-513.

[3] Ryu RK, McCormick J, Jobe FW, et al: An electromyographic analysis of shoulder function in tennis players. Am J Sports Med 16:481-485, 1988

[4] Chow JW, Carlton LG, Lim YT, et al Muscle activation during the tennis volley. Med Sci Sports Exerc 31:846-854, 1999

[5] Manske R, Ellenbecker . Current concepts in shoulder examination of the overhead athlete. Int J

Sports Phys Ther. 2013;8:554-578.


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