Alex has given me hope when I thought my Ironman race season wouldn’t happen due to chronic Achilles issues.
Declan, London

Tennis Injuries – Don’t Just Treat The Symptom!

Summer is coming and Wimbledon is here! As a result we have decided to write a mini blog post discussing tennis injuries, where they tend to occur and potential reasons for them.

Tennis requires huge amounts of force to be produced by the shoulder and the elbow in order for adequate racquet head speed.  This results in a tendency for overuse injuries to occur in these areas. The fact we see injuries at the shoulder may lead us to think we should just treat the shoulder and the shoulder will get better….

As with anything, it isn’t quite that simple. Although it is important to treat shoulder injuries locally (it is common to see reduced internal rotation of the lead shoulder) we must also look at the contribution of the kinetic chain. When looking at the kinetic chain, we are referring to everything from the foot and ankle, right the way through to the racquet hand. In throwing like actions it has been calculated that the leg, hip and trunk contribute to over 50% of total force production! As a result, a stiff hip, weak thigh or restricted ankle could be a big driver to our shoulder and elbow pain.

This production of force from the lower limb comes with it’s own negatives – the fact that it actual gets injured more than the upper limb! These injuries tend to more acute such as thigh/calf pulls and ankle sprains.

Can you see how this could become a viscous cycle? A tennis player is gradually overloading their shoulder, they then get an ankle sprain, this ankle sprain recovers well, they get their pain and swelling back to normal but there are subtle reductions in strength – now the rest of the kinetic chain has to find additional force production from somewhere and now the overload to the shoulder increases!

If you have an injury remember it is so important to fully rehab it, but then also test all areas of the kinetic chain from a mobility, stability and force production standpoint. There is every chance your shoulder injury is because of a stiff hip, weak ankle or poor grip strength!

How would you test these components? Would you like to see ways in which you could self test some of the key areas required? Maybe you would like to pop down to the clinic and ensure that you are not carrying a suboptimal area? If you have any additional questions then please feel free to get in touch.

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