Tennis is a great social game where friends and foes alike can battle it out on the courts through skill, decision-making and in some cases, a stroke of luck. It’s also a sport where injury can plague players in the long term making it not so enjoyable. The three major problems I often see are shoulder pain, elbow pain and knee pain.
Shoulder and elbow pain in tennis players is often caused by poor technique, overuse and poor muscle control. Poor technique can put certain structures in the shoulder and elbow under extra strain which over time can lead to injury.
For example, the position you put your wrist in, particularly for a back hand, can put increased strain on the tendons that run up to the elbow which can increase the risk of developing the classic “tennis elbow”. This painful condition is caused by a disorganisation of the collagen fibres in the tendon meaning they don’t deal with load as well.
The treatment for this problem is relative rest and increasing the strength of the tendon through gradual and controlled loads. Treatment may also include taping, dry needling and soft tissue release.
Shoulder pain can come from a number of structures, but in many tennis players it is caused by impingement on the rotator cuff which can lead to tendinopathy and tears.
This may be caused by poor control in the muscles that control the position of the shoulder blade on the ribs making it difficult for players every time they need to perform a serve or overhead smash.
Tennis involves a lot of lunging and therefore a lot of loads through the knee joint. Where there is a muscle imbalance around the hip or the knee, the knee cap may not articulate with the bone in your thigh smoothly as the knee bends causing irritation, swelling and pain.
It is also important to balance the overall loads that are placed upon our joints across the day and across the week. If you work in a job that requires a lot of wrist, elbow and shoulder movements under heavy load, then injuries that were once niggles may escalate into something more or they may hang around for the whole tennis season. It may be important to cut back on your tennis.
As well as preventing injuries, physiotherapists can assist in diagnosing your tennis injuries so that a specific strengthening and stretching program can be developed for the specific demands of the sport. They can also assist you in managing the loads you put through your body so as to allow your injuries to settle. Don’t let a niggle become a season off the sport you love!
The challenge is also to find a fitness professional who tailors your workout to you. Crossfit is fantastic as it is functional fitness, and the beauty of this is that it can be modified accordingly. It is crucial, however, that your trainer is open to suggestions and addresses your concerns and is aware of the problems that many women and men face when exercising in this way. Look for a trainer who does ask about pelvic floor concerns and function, not just one that wants you to dive in and lift more and more weight.
Liaison between your fitness professional and your women’s health physiotherapist is also crucial to optimise your experience. A blanket approach of “strengthening the pelvic floor muscles” is simply not enough. We know that for many women they do not actually know how to correctly activate their muscles, and certainly do not do this optimally with heavy lifting.
An exercise savvy women’s health physiotherapist will have many options to help you to exercise safely and not simply advise you to seek an alternative.
So, rest assured, we want you to exercise, not stop.