Tennis Injuries
Movement assessment can identify how serving, stroke technique and court movement load the body.
Tennis injuries may develop suddenly or build gradually through repeated serving, gripping, rotation, sprinting, lunging and braking. Commonly affected areas include the shoulder, elbow, wrist, lower back, groin, knee, calf, Achilles tendon and ankle.
The right management depends on the injured structure, how symptoms behave, recent workload and the demands of your playing level. Pain during a specific stroke or court movement can guide an assessment, but it does not confirm a diagnosis by itself.
Explore Racquet Sports Injuries
Compare similar loading patterns or return to the broader racquet-sports hub.
What Tennis Action Triggers Your Pain?
The action that brings on pain can help identify the body region and loading pattern that needs assessment.
Serving or overhead strokes
Pain during the loading phase, acceleration or follow-through may involve the shoulder, upper arm, back or trunk.
Backhand, forehand or repeated gripping
Repeated grip force, off-centre contact and stroke volume can load the elbow, forearm, wrist and hand.
Lunging, rotating or changing direction
Wide balls and rapid recovery steps place demand on the hip, groin, thigh and knee.
Push-off, landing or sudden braking
Explosive starts and abrupt stops can overload the calf, Achilles tendon, ankle and foot.
Why Do Tennis Injuries Happen?
Tennis is repetitive and explosive. Serves and overheads load the shoulder, trunk and wrist. Groundstrokes add repeated grip force and rotation. Split steps, sprints and recovery movements load the hips, knees, calves, ankles and feet.
Injury risk may rise when a player increases serving, training or match volume faster than their body can adapt. Previous injury, reduced strength, poor recovery, unsuitable footwear, court-surface changes, grip size and stroke technique may also contribute. Fatigue can alter timing and movement control, which may shift more load to the elbow, wrist, shoulder or lower limb.2,3
Key point: the painful area is not always the only factor. A tennis assessment may also consider stroke load, trunk rotation, shoulder capacity, grip demands, calf strength, ankle control and next-day symptom response.
Common Tennis Injury Zones and Loading Actions
This visual summary shows where common tennis actions may place repeated demand. It is an education guide, not a diagnosis.
Common Tennis Injuries by Body Region
The conditions below are common examples rather than a complete list.
Shoulder and upper arm
Serving and overhead strokes require repeated high-speed shoulder rotation and control.
Elbow, wrist and hand
Repeated hitting, racquet vibration and grip force can irritate upper-limb tissues.
Hip, thigh and knee
Lunging, rotating and recovering from wide balls can load the lower limb in several directions.
Calf, ankle and foot
Repeated acceleration, push-off, landing and braking can overload the lower leg and foot.
Who Is More Likely to Get Injured?
Both recreational and competitive players can develop tennis injuries. Recreational players often have problems after returning from a break, increasing match play quickly or playing through recurring pain. Competitive players face higher cumulative loads, more serving volume and shorter recovery periods.
Previous injury is an important consideration. Junior players may also experience problems when growth, training and tournament demands increase together. Reduced serve speed, altered footwork, loss of confidence or increasing next-day soreness can appear before a player stops completely.3,4
How Can Physiotherapy Help?
A physiotherapist can assess the painful area and the tennis actions that provoke symptoms. Depending on the presentation, this may include shoulder strength, elbow and wrist loading, trunk rotation, landing control, calf capacity, ankle stability and court movement.
Management may include education, exercise rehabilitation, strength testing, load planning, movement retraining and a staged return-to-court program. A sports injury physiotherapy plan may also guide serving volume, hitting drills, gym work and return to match play.
An Accredited Exercise Physiologist may support longer-term conditioning and strength after the initial diagnosis and symptom-control phase. Massage may assist comfort and recovery for some players, but it does not replace assessment or progressive rehabilitation when an injury keeps returning.
When Should You Seek Assessment?
Arrange prompt assessment if you:
- felt a pop or sudden tearing sensation
- cannot bear weight normally
- lost strength suddenly
- have marked swelling, deformity or locking
- have numbness, persistent tingling or worsening neurological symptoms
Assessment is also sensible when pain lasts, keeps returning, changes your serve or footwork, or prevents normal training. Repeated ankle giving way, persistent Achilles or calf pain, and ongoing shoulder, elbow or back pain deserve early review.
How Can You Reduce Tennis Injury Risk?
Warm-up
Build from general movement to court footwork, controlled hitting and progressive serving.
Strength
Train calf, leg, trunk, shoulder and forearm capacity across the week.
Technique
Review stroke mechanics, grip size, string set-up and footwear when symptoms recur.
Recovery
Increase court load gradually and monitor next-day soreness, fatigue and movement quality.
Returning Safely to Tennis
A safe return usually starts with controlled hitting and planned movement drills. From there, progress court coverage, stroke speed and serving volume before returning to unrestricted matches.
Useful progression markers include tolerable next-day symptoms, restored strength, confident braking and direction change, and the ability to complete sport-specific drills with good technique. Your plan should match your injury, playing level and competition demands.
Related Racquet and Sports Guides
Racquet Sports Injuries
Compare common demands across racquet sports.
Squash Injuries
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Injury Prevention Essentials
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Tennis Injury FAQs
What are the most common tennis injuries?
Common tennis injuries include tennis elbow, rotator cuff pain, wrist tendinopathy, ankle sprains, calf strains, Achilles tendon problems and lower back pain. The pattern varies with playing load, technique, footwear and previous injury.
Why do tennis injuries keep coming back?
Symptoms may recur when players return too quickly, keep training through pain or miss the strength and workload progressions needed for tennis. Technique, equipment, recovery and rapid changes in serving or match volume may also keep overloading the same area.
Can physiotherapy help tennis injuries?
Physiotherapy may help identify the main pain driver, restore strength and movement control, guide workload and build a gradual return-to-court plan.
Should I stop playing tennis when I have pain?
Not every injury requires complete rest. However, continuing unchanged can aggravate some problems. Modify the painful activity and seek assessment when symptoms are sharp, worsening, persistent or changing how you move.
How can I reduce my risk of tennis injuries?
Use a progressive warm-up, build strength, increase court and serve volume gradually, wear suitable shoes and address recurring pain early. Monitor how you feel later that day and the following morning.
When should I see a physiotherapist for tennis pain?
Consider an assessment when pain lasts, keeps returning, affects your serve or footwork, causes swelling or stops normal training. Seek prompt care after a pop, sudden weakness, marked swelling or inability to bear weight.
What To Do Next
If a tennis injury is limiting your training, matches or recovery, a physiotherapist can assess the problem, explain your options and guide a graded return to court.
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References
- Montalvan B, Decatoire A, Rousset P, et al. Epidemiology of musculoskeletal injuries in tennis players during the French Open Grand Slam Tournament from 2011 to 2022. Orthop J Sports Med. 2024;12(4):23259671241241551.
- Bradley J, Langdown B, Coker B, et al. Injury risk factors of the tennis serve: a systematic review and meta-analysis. Adv Rehabil Sci Pract. 2025;14:27536351251374616.
- Amor-Salamanca MS, Rodríguez-González EM, Rosselló D, et al. Risk factors and prevention of musculoskeletal injuries in adolescent and adult high-performance tennis players: a systematic review. Sports. 2025;13(10):336.
- Layouni S, Dergaa I, Ghali H, et al. Epidemiology of tennis-related injuries among competitive youth players in Tunisia. Medicina. 2025;61(8):1478.
