Dr. Kevin Toss DC, DACBSP
Diplomate American Chiropractic Boards Sports Physicians
Staten Island, NY - 718-966-7000
Clifton, NJ - 973-777-2536
Tennis is a sport for which the risk of injury might be more than one would expect. The act of serving alone places such high demand and torque on the human frame that it is no wonder tennis is associated with a multitude of sport-related injuries.
When looking at the biomechanics of a tennis serve, the body is first placed into a hyper-extended and arched backward position. This “wind-up” creates maximal elastic potential energy which then thrusts the body forward during the “follow-through” as the momentum is now converted into kinetic energy while the body recoils and flexes forward. This allows the ball to be hit with great power and velocity so as to become an offensive weapon. Tennis serves are routinely clocked at over 100 miles per hour with world-class athletes serving as high as 150 mph.
Athletes may serve on average 8 serves per game with the goal to win 6 games per set and anywhere between 3 and 5 sets per match. Needless to say, a tennis player may serve several hundred times per day, and perhaps, for multiple days consecutively, if playing in a tournament. These repetitive actions place severe stress on the body.
It has been estimated that 50% of all tennis players will at some point experience shoulder and rotator cuff problems. These include tendonitis, bursitis, muscle tears, joint dislocations, labral tears, stress fractures and sprains and strains. It is also very common to injure the biceps, latissimus dorsi, serratus anterior, triceps and pectoralis muscles in addition to the classical rotator cuff and shoulder injury.
While the upper extremity and shoulder motions are stressful in and of itself, they represent only about 20% of the force needed to serve a tennis ball. The lower extremity generates approximately 50% of the force necessary to serve a tennis ball through actions of the hips, legs, trunk and core. It is the movements created by muscles in the lower extremity that allow for the weight transfer from the back leg on the wind-up to the front leg during follow-through. Such repetitive movements can lead to painful syndromes such as hip bursitis, tendonitis, muscle tears, sprains, strains, knee meniscal tears, and the joint degeneration commonly seen in arthritis of the hip and knee.
Tennis is commonly associated with lower back pain and sciatica due to the stress placed on spinal joints and the twisting and torquing motions that the body undergoes. Wrist and elbow pain syndromes such as carpal tunnel and tennis elbow commonly occur as a result of constant gripping of the racquet. Often times, a tennis player may experience foot and ankle overuse injuries such as plantar fascitis and Achilles tendonitis from the constant pounding on the playing surface.