Occupational Health: Tennis Players

Overview of the Role

Tennis is a sport of extreme asymmetrical loading — the dominant arm undergoes cumulative high-velocity loading patterns across hundreds of thousands of service and groundstroke repetitions throughout a competitive career, while the body simultaneously demands high-speed agility, explosive lower limb power, and rapid multi-directional change. The resulting injury profile reflects both the asymmetrical upper limb loading and the lower limb demands of court coverage.

Physical Demands and Musculoskeletal Load

The tennis service motion is one of the most biomechanically demanding upper extremity actions in sport — requiring rapid sequential activation from lower limb drive through trunk rotation to shoulder internal rotation at velocities exceeding 2000 degrees per second in elite players. The wiper forehand produces similar internal rotation velocities with significant topspin-driven wrist ulnar deviation. Repeated court coverage demands rapid deceleration, directional change on hard and clay surfaces, and explosive push-off loading of the lower limb.

Common Injuries and Conditions

Lateral epicondylalgia (tennis elbow — though more common in recreational than elite players) from forearm extensor overload in the backhand stroke. Shoulder internal impingement and SLAP labral tears from the extreme shoulder external rotation at the late cocking phase of the serve. Stress reactions of the ulna from repetitive forearm loading. Knee patellofemoral pain and patellar tendinopathy from the explosive quadriceps demands of split-step landing and court coverage. Ankle sprains from directional change on varied court surfaces.

Preventative Strategies: Exercises and Stretches

Rotator cuff strengthening with particular emphasis on posterior rotator cuff — infraspinatus and teres minor — addresses the internal impingement and capsular posterior tightness that develops with serve-dominant training. Eccentric wrist extensor training prevents and rehabilitates lateral epicondylalgia. Lower limb plyometric training and landing mechanics coaching address patellar tendinopathy risk. Asymmetrical dominant-side trunk rotation flexibility stretching (anterior and posterior capsule) alongside non-dominant rotational strengthening addresses the thoracic and lumbar rotation asymmetry that develops over a tennis career.

When to Seek Clinical Assessment

Seek assessment from a myotherapist or allied health professional when: symptoms persist for more than two to three weeks despite self-management; pain begins to affect work performance, sleep, or daily activities; you develop tingling, numbness, or weakness in the hands or limbs; or you notice postural changes that are becoming fixed. Early intervention consistently produces better outcomes than waiting for a condition to become chronic. Many occupational injuries respond well to a short course of targeted manual therapy combined with ergonomic advice and exercise rehabilitation — preventing the progression to chronic, complex presentations that require significantly longer management.