Avoiding tennis elbow and common tennis injuries

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Tennis is a great sport for fitness at any age, but its repeated swings, quick changes of direction and serves can strain the body. This guide covers the most common problems and how to reduce the risk. It is general information, not medical advice. If you have pain that does not settle, see a doctor or physiotherapist.

Tennis elbow

Tennis elbow, or lateral epicondylitis, causes pain on the outside of the elbow. It affects the tendons that attach the forearm muscles to the bone and is caused by overuse. Despite its name, it is common in people who do not play tennis at all. Typical signs:

Pain on the outside of the elbow, sometimes spreading down the forearm.
Pain when gripping, lifting or twisting, for example opening a jar.
Weakness in grip.

According to the NHS, tennis elbow usually gets better with rest and self-care, but it can last a long time, sometimes more than a year.

What the NHS suggests

Rest from activities that make it worse.
Simple exercises and a forearm strap or brace may help.
Pain relief such as paracetamol or anti-inflammatory gel, after checking it is suitable for you.
See a GP if pain continues after resting and self-care for around two weeks, or sooner if it is severe. Physiotherapy may be recommended, and in many areas you can refer yourself to a musculoskeletal service.

Reducing the risk of tennis elbow

Technique: hitting late or with a stiff wrist increases strain on the forearm. A coach can help.
Equipment: a racket that is too heavy, too light or too stiff, a grip that is the wrong size or very tight strings may contribute. Softer strings at moderate tension are often more comfortable.
Grip pressure: hold the racket firmly enough to control it, but not tightly.
Strength: forearm and wrist strengthening, guided by a physiotherapist, supports the tendons.
Gradual increases: avoid sudden jumps in how much you play.

Shoulder problems

Serves and overheads place repeated stress on the shoulder.

Warm up the shoulder before serving.
Build serving volume gradually.
Strengthen the shoulder blade and rotator cuff muscles.
See a professional if you have pain when lifting the arm or at night.

Wrist injuries

Heavy topspin strokes and mishits can strain the wrist. Pain that persists or swelling needs assessment.

Knee and ankle injuries

Sudden stops and changes of direction can cause ankle sprains and knee problems.

Use tennis shoes with lateral support.
Avoid playing on wet or uneven courts.
Strengthen the legs and practise balance exercises.
If an ankle swells badly or you cannot bear weight, seek medical advice.

Back pain

The serve and rotation in groundstrokes involve the back. Core strength, good technique and a gradual build-up help.

Calf and Achilles strains

These are common in players returning after a break. A gradual return and calf strengthening reduce the risk. Sudden sharp pain at the back of the ankle, as if someone kicked you, needs urgent medical assessment.

General prevention

Warm up with light movement and practice strokes before playing.
Cool down and stretch gently afterwards.
Stay hydrated, especially in warm weather.
Rest between hard sessions.
Listen to your body. Pain that changes your movement or stroke is a signal to stop.
Get a professional opinion for pain that persists rather than playing through it.

Returning after injury

A physiotherapist can create a plan to return gradually, with strengthening and progressively more tennis. Rushing back is a common cause of repeated injury. How do you keep your arm and body healthy for tennis? Share your experience in the comments.