Common Tennis Injuries: How to Prevent Them & What Helps

Tennis is a very rewarding sport in countless ways, with numerous and far-ranging benefits. These include improvements in cardiovascular strength, muscles, and bones, as well as improved immunity, mental health, and overall sense of joie de vivre. Like any sport, however, tennis carries its own risks of injury, and many players have found themselves with sores, aches, pains, and other more serious conditions through repeated playing. Fortunately, common tennis injuries are treatable and even preventable through the right interventions, training, and equipment. 

Learn Common Tennis Injuries

Playing tennis too often or improperly can lead to soreness, aches, and even injury to many parts of the body, including the arms, elbows, chest, shoulders, the calves, ankles, and more. With this guide, you will learn about tennis-related injuries and best practice tips on how to prevent and treat them.

Ankle Sprains

One of the most common tennis-related injuries is ankle sprains. Ankle sprains are the single most reported injury in college tennis, comprising 144 of 615 total injuries in 2022 as reported by coaches. An ankle sprain involves a tear of the lateral ligaments, usually the anterior talofibular ligament or sometimes the calcaneofibular ligament. It commonly happens on the hard split step and the sudden change of direction on the wide ball. On clay courts, you may sprain your ankle if your foot catches instead of sliding.

Ankle sprains are accompanied by a sudden pain on the outside of the ankle and swelling within an hour, usually followed by bruising on the foot. If you find yourself limping or feeling pain when you put the full weight on your foot, then it is likely you have suffered an ankle sprain. Some ways to deal with ankle injuries include:

• Start moving and loading early within pain limits
• Short cooling in the first hours 
• Brace or taping for the first months back on court 
• Balance and proprioception training on one leg 

Getting high-quality tennis court shoes is also recommended. These shoes tend to offer better support and are designed specifically to handle quick side steps and lateral movements that are most common in tennis and other racquet sports, preventing most ankle rolls. Cushioned socks can also help protect your feet from impact.

Nike Everyday Cushioned Training Low Socks (6 Pairs)

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Tennis Elbow

So common as to receive its own moniker, tennis elbow refers to an overuse injury caused by degeneration in the common extensor tendon located on the outside of the elbow. Every time you grip the handle and stabilize the wrist against ball impact, it loads up the tendon. If you have a racquet with a heavy head or a too-small grip, that also drives the load up. Ways to tell if you have tennis elbow include:

• Your grip feels weak 
• Pressing on the outer epicondyle feels tender
• Pain occurs on the bony point at the elbow’s outside, radiating into forearm
• Backhand and shaking hands hurt more than serving
• Elbow feels stiff and sore in the morning, loosening with movement

Rest and physical therapy can lessen the symptoms of tennis elbow. Other ways include doing progressive strength work for the wrist extensors and opting for backhands and shorter sessions. Opting for racquets with lighter heads and softer strings is also highly recommended.

Tennis elbow braces and arm bands provide effective relief from the pain of this condition. For more information, check out our elbow braces guide and our treatment and recovery guide.

Mueller Elbow Sleeve Large

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Shoulder Injuries

Sprain or injury to the rotator cuff tendons – particularly the supraspinatus and the infraspinatus – is common in tennis. This is typically caused by thousands of serves and overheads, which lead to tendon tissue and the capsule at the shoulder degenerating. Symptoms include:

• Pain deep in the shoulder or on the outer upper arm, especially when serving
• Pain when lying on the injured shoulder at night
• Difficulty reaching overhead or behind the back
• A pinching sensation when executing an arc of motion

To ease a shoulder injury, try using your legs and trunk more in your serve to avoid putting the load on your shoulder. Avoid stacking heavy serving days back-to-back; capping serves per session is also recommended. If the pain blocks rehabilitation, then a corticosteroid injection may be needed to reduce pain in the short term.

Wrist Injury

In this serve-heavy sport, wrist injuries are common. Pain on the thumb side and the little finger side are the most affected sites. Heavy topspin swings and off-center hits that twist the racquet in the hand can cause pain in this area; western and semi-western forehand grips and two-handed backhands can also load the tendons. Signs that you have an injured wrist include:

• A weak grip
• Pain when opening a jar or turning a door key
• Swelling over the back of the wrist after playing

Load reductions and grip changes can calm irritation. Maintaining a flatter, less extreme grip also lowers the load on these tendons. If your tendon sheath problems are truly dire, then getting a wrist support or splint for a short period can help. You should also watch your string tension and racquet weight, as a stiff racquet transmits more shock to the wrist.

Plantar Fasciitis

This injury is no walk in the park. The plantar fascia is a thick sheet of connective tissue that connects the heel bone to the base of the toes. This sheet supports the arch of the foot and absorbs shock. When you push off, it tightens like a bowstring, and repeated stopping and sprinting on hard courts can disintegrate this tissue.

Symptoms of plantar fasciitis include sharp heel pain, especially in the morning or after sitting. The inner front edge of the heel bone may be tender if you press on it. If the pain worsens after a long match and standing on hard courts, then you may have this condition.

Wearing tennis shoes with plenty of cushion and support can help ease plantar fasciitis symptoms. Some excellent options include the New Balance Fresh Foam X CT-Rally v2, which offers excellent midsole cushioning and a wide forefoot, and Babolat SFX 4 All Court for exceptional ankle support.

New Balance Fresh Foam X CT-Rally v2

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Babolat SFX 4 All Court

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For more options, visit our blog on the best tennis shoes for plantar fasciitis. You can also explore our inventory of plantar fasciitis relief socks for extra cushioning to the heel and arch, as well as the best tennis socks overall.

Back Pain

Unfortunately, back pain is a problem for tennis players. Extension, side bend, and rotation in the serve compress the small facet joints in the back of the vertebra. Repeated serve loading in adolescent players can also produce a stress injury of the bone. Symptoms can include:

• Pain when arching backward or reaching overhead
• Aching or stiffness low in the back, often after serving
• Difficulty turning in bed or getting out of a chair
• Pain spreading to the buttock

The answer to dealing with back pain is a little counterintuitive, but it is to keep moving. Gentle activity within limits speeds recovery, and bed rest only makes it worse. You can also improve hip and thoracic rotation range in your serves so as not to overload the lumbar spine. Building torso and hip strength and endurance will also help keep the tension off your back.  

Muscle Strains

When the muscle fibers tear at or near the junction where muscle becomes tendon, this is known as a muscle strain. The most common muscle strain is the medial gastrocnemius tearing during an explosive push off toward a wide ball, an occurrence so common it even has a name: Tennis leg. Hard deceleration and lunging to a low ball can damage the quadriceps as it contracts.

Signs of muscle strain include:

• Swelling and later bruising
• Difficulty sprinting, climbing stairs, and pushing off
• Pain when stretching the muscle 
• A tender spot in the muscle belly you feel by pressing your finger

If your calf becomes hot, tight, and swollen like a clot or if you feel a sudden pop, see a doctor immediately.

Ways to Lower Risk of Injury

There are many ways to lower the risk of injury on the tennis court. Following these key tips will allow you to mitigate and even avoid the worst damage to your body. 

• Always warm-up and cool downWarming up gradually increases blood flow and mobility while cooling down speeds up recovery. Sudden bursts, repetitive movements, and directional changes demand readiness, which can go hard on your body.
• Do warm-up cardioExercises include dynamic stretches – arm circles, leg swings, and torso twists – and gentle tennis movements like feet drills, half-swings, and side-stepping. Spend five to 10 minutes on light cardio like jogging, skipping, and multi-directional changes.
• Rest to prevent overuse & monitor your loadTry to incorporate at least one full rest day a week and incorporate fitness training at least three times per week. Avoid nonstop tennis every day. It’s recommended that you stick to a weekly schedule.
• Practice performance movement patternsImprove footwork and stability with balance boards, agility drills, and proprioception exercises. Weak movement biomechanics contribute to ankle sprains, knee, back, and muscle strains.
• Recover with good nutrition, sleep, & hydrationHydration, sleep, and nutrition support muscle recovery and brain function. Eat well before, during, and after training or an event to improve your performance but also your rate of recovery. The right amounts of protein and carbohydrates can help you maintain steady energy levels, sustain lean muscle mass growth, and restore muscle glycogen.
• Do strength trainingDoing exercises such as heavy calf raises and Nordic hamstring curls can target the tissues that fail the most in tennis. You should also increase playing hours and match density gradually, as overuse injuries tend to increase at the beginning of a season, tournament week, or training camp.
• Get the right equipment & apparelThe proper equipment and apparel for your body and playing style is necessary to avoid the worst injuries. A racquet’s weight, grip size, string tension, and string type can affect the shock the arm takes on. Replacing your court shoes based on hours played is also recommended, since much heel and forefoot pain in players are the result of a worn midsole. Choose the sole pattern for the surface you play on, such as hard, grass, or clay courts.

When to Seek Medical Help

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Sores and aches are an inevitable part of any sport, but they can quickly become serious if left neglected or untreated. Looking out for early signs of injury and dealing with them accordingly will help nip these problems early in the bud. Common injuries that can occur while playing tennis include tennis elbow, ankle sprains, muscle strains, back, wrists, and shoulder injuries, etc.

Tennis Express aims to be your one-stop shop for all things tennis. We help fans, novice players, and seasoned professionals alike with our excellent services, years of tennis expertise at our blog, and, of course, our high-quality inventory. Stay safe!