Injury Prevention for Tennis Players

Tennis is a challenging sport that requires agility, strength, speed, balance and endurance. Although tennis players have less risk of injury than do soccer players, runners or even golfers, they are susceptible to a variety of shoulder, elbow, wrist, knee, ankle, hip and spine injuries. An estimated two-thirds of these injuries stem from over use and from lack of conditioning, and, therefore, are preventable. 

According to the Tennis Industry Association, there has been a 10 percent growth in recent years in the number of “frequent” (defined as a minimum of 21 times a year) American tennis players, up to 5.31 million people. That number means that tennis injuries have increased as well. If this summer has found you back on the courts, it’s important that you learn some information and strategies so that you can avoid being left on the sidelines with an injury.

Overuse injuries most often affect the tennis player’s shoulders, wrists or elbows. At our Wellness Center, we feature three key conditioning tools –the TRX, the Power Plate and Pilates – to assist you in tennis conditioning, as well as injury prevention. We offer this guide as a way of learning more about common tennis injuries and how you can take steps to prevent them.

First, let’s look at the most common tennis injuries:

Image used via WTA Tennis

Tennis Elbow

The most frequent tennis injury, “tennis elbow” comes from the overuse of the muscles that extend and bend the wrist. Prevention of this painful condition involves strengthening of the wrist muscle and any surrounding muscles and warming them up with a regular exercise routine of flexing and extending the wrist against light resistance.  Tennis players also need to be aware of certain technical components such as grip size and proper racquet-holding technique to prevent wrist orelbow pain.

There are many cases whereby pain in the elbow is misdiagnosed. NYCPT’s Enrique Garcia, DPT, recommends a thorough evaluation, including an assessment of the joints above and below the area of pain, to properly pinpoint the root cause of pain. Even if the elbow hurts locally, it can be the result of a rotator cuff or due to scapular weakness.

Shoulder Injuries

Shoulder injuries are generally due to improper conditioning and poor strength of the rotator cuff muscles. The rotator cuff helps to position the shoulder properly in the shoulder socket, and when it is weak, there can be some increased movement of the ball in the socket, which irritates and inflames the surrounding tissues. Players with shoulder issues will experience pain with overhead motion such as when they serve the ball, and the pain may persist off the court, possibly interfering with daily activities.

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Stress Fractures

Stress fractures are common with youth tennis players and are often the result of a player increasing his or her training time too rapidly. When the muscles weaken and tire, more stress is placed on the bone.  These “breaks,” which can occur in the leg (tibia or fibula) or in the foot (the navicular or the metatarsals), are really painful cracks in the bone rather than an actual break of the bone.  Preventative measures include proper strength and endurance training.

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Muscle Strains

Tennis involves quick, sudden movements that can cause muscle strain if the player has not sufficiently warmed-up and stretched his or her muscles prior to hitting the court.

Today’s game of tennis involves a faster pace and more explosive power than ever before.  Strength training and conditioning should involve building the body’s core muscles as well as improving balance, flexibility and range of motion.

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Now let’s look at NYCPT’s tools and how they can help you get your tennis game to the next level:

Image used via Shane McGeorge

TRX Suspension Training

Created by and for the elite Navy SEALs, TRX Suspension Training develops strength, balance,flexibility and core stability all at the same time. Using the force of gravity and their own body weight, athletes can modify an exercise’s intensity simply by changing their position.

Benefits of the TRX for tennis players include:

  • Increased rotational strength for a more powerful swing 
  • Enhanced flexibility and mobility 
  • Developed core stability

Mark Kovacs, PhD, who is the United States Tennis Association’s (USTA) Manager of Sport Science, calls the TRX a “versatile, cost effective training tool that can aid tennis players in the gym as well as when traveling to tournaments.”

In fact, Grand Slam champion Maria Sharapova’s coach incorporates both Pilates and TRX into the tennis pro’s workout to improve her strength and coordination, as well as to develop her core strength for maximum shot power and to build rotational strength for a powerful swing.

Image used via PowerPlate


With Power Plate technology, you can experience a total-body workout in less than 30 minutes. The PowerPlate uses scientifically-proven vibration technology to naturally stimulate up to 95 percent of your muscle fibers while you exercise.

Results for tennis players include:

  • Increased overall fitness
  • Better strength
  • Improved muscle tone
  • Greater flexibility
  • Higher bone density
  • Enhanced range of motion
  • Improved circulation and lymphatic systems 

Tennis great Serena Williams, who is known for her power and speed on the court, trains with the PowerPlate and has this to say: “Off-court training is as important to me as on-court. With the Power Plate, I’m able to accelerate my off-court training and maximize the benefits.

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Originally created as a rehabilitation tool, Pilates focuses on core strength development and thereby improves coordination, balance and flexibility.

Many elite tennis players have found that Pilates helps them both to improve their game and to avoid injury. Because of the very nature of a racquet game, many tennis players experience an imbalance between the musculature of their dominant and non-dominant side. By performing Pilates, these athletes are able to develop and strengthen both sides of their bodies.

Scottish professional tennis player Andy Murray started using Pilates after he began experiencing back pain. He credits Pilates with not only helping him to feel better but also to think better.  Since he began using Pilates, Murray, 27, reports that he has been waking up in the morning without the soreness or stiffness he had been experiencing before.

NYCPT’s Clinical Pilates Specialist, Matt Nelson, who has worked with numerous competitive tennis players, adds that when working with tennis players it is extremely important to train unilaterally to bilaterally back to unilaterally to restore balance between the left and right upper extremities.

He also stresses the importance of training eccentrically – supination and pronation and wrist extension control in slow down, especially the powerful wrist flexion force behind a tennis serve and the follow through required each time, repeatedly. In addition, he recommends assessing and working on contralateral hip flexor extensibility. Similar to the motion of pitching, tennis serves require the same emphasis and approach as that of MLB pitchers.

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Not all tennis injuries can be prevented, but with proper preparation, many can be.  By using this information and the tools at NYCPT, we hope you will be able to avoid injury and play tennis better than ever before. Our team of professionals stand ready to help you get on the court and stay there this season.