Tennis is BACK, and I would say with pain rather than a bang! In the clinic I have seen 3-4 tennis injuries this week alone. This rise has coincided with Ireland's easing of Covid restrictions however I always see more tennis fans/players around this time. As Wimbeldon is drawing to a close this weekend, a tournament that I have always enjoyed, it typically inspires new memberships or reignites those old passions to get your racket and shoes out and hit the court.
Tennis is an overall safe and low-risk sport, it does have risk associated with its own unique set of acute (new) and persistent injuries (longstanding). Within the last several years, there have been numerous studies on the epidemiology (causes) of injuries in tennis players at various levels. The most recent I could find was a study by Micahel Fu et al (2018) published in Current reviews in musculoskeletal medicine.
Their findings were consistent with previous literature, that acute injuries tend to occur in the lower extremities, while persistent / overuse injuries more often affect the upper extremities and trunk.
So what causes us to get injured? There are several reasons for this and a study published in the British journal of sports medicine by Pluim & Drew (2016) highlighted the main aspects as follows:
Establish a basic fitness level.
Minimise week-to-week or session-session changes.
Try to avoid peaks in your load.
Make sure you maintain a correct work-rest balance.
Avoid troughs in training - be consistent.
Don’t over do it!
This all sounds simple in theory but in the Pros and amateurs alike it's typically big changes in playing time or what we call loading that triggers issues. At the start of an outdoor tennis season, players typically start to compete on a regular basis (2–3 matches on 1 day) and suddenly can increase the hours of tennis from 2–3 h per week to 4–6 h a day! It’s no surprise then that injuries occur with this change in load.
Establishing a base fitness is the most important aspect in starting any sport. It has been obvious in the weeks where I have been seeing patients with tennis related injuries that they have lost a bit of sharpness due to the year of intermittent training, and unfortunately some of them have not kept up some of the exercise needed to keep them fit for tennis. If you are thinking of getting back in the game, start with building your base fitness level perhaps with a couch to 5km and some strengthening exercises focusing on both the upper limb and legs, typically at home this can be achieved by completing press ups, squats, lunges or even the footwork.
As mentioned, the hours of tennis can increase exponentially and this is typically thought of as session-session changes, going from 1hr to 4hrs is a 400% increase! Take another example to put that in perspective, say you walk 5km week 1 and then decide to increase this by 400% that would be 20km, do that again week 3 - and you would be up to 80km!
Avoiding peaks can be difficult as tennis can be somewhat unpredictable, but just think about your training week, maybe we shouldn’t say yes to singles, doubles, mixed doubles and a coaching session during the week.
Recovery is as important as the sporting reps, ensure that you are resting appropriately. I look at this by discussing the rate of perceived exertions (RPEs). If your game was a 9/10 that’s hard and would need more rest than a coaching session of 2-3/10. This is a score that you decide so it can be helpful to keep notes on how challenging some of your games were which may indicate a spike in loads or a lack of recovery time.
Avoiding troughs is probably most apt to the patients I’ve been seeing as they all have had long periods away from the sport and now have launched right back into it. This is a key factor in injuries. Minimise this by starting with 2-3 games per week and building on that, keeping an eye on RPEs and court time. Build up consistency in attendance for a number of weeks if not months and you’ll be in a better place to make things harder.
Finally not over doing it goes for all sports, I don’t know how many times I have heard “oh I was working on my serve with my coach for 100 repetitions and then played for an 1hour”, if ever that's a recipe for injury this is it. Serving in particular requires the most of our efforts and thus would be thought of as a strenuous repetition (RPE 7-8) even if cardiovascularly you don’t feel puffed.
Should you be starting out and would like some advice about what things to be working on, or you’ve sprained your ankle to you have had a niggly low back or shoulder for some time, the team at Sandycove Physiotherapy will assess and work out the best route to get you playing your best tennis hopefully injury free!
Feel free to ask me any questions via email. On that note a final fact…
Why do tennis players make terrible partners?
Because to them, love means nothing….