Tennis injuries and how to prepare for the season

Club tennis has a seasonal injury pattern that is almost comic in its reliability. The courts dry out, the leagues start, and people who have not swung a racket since September play three sets on a Saturday morning. The following week we see them.

None of it is mysterious. Tennis asks for repeated overhead loading, fast changes of direction and a great deal of work from one arm, and it asks for all of it at once after a winter of doing none of it.

The elbow

Tennis elbow is the injury the sport gave its name to, though most people who get it do not play tennis. It is pain on the outer side of the elbow, tender to touch, worse when you grip, and often first noticed lifting a kettle rather than hitting a ball.

In players it is usually driven by backhand technique, grip size or string tension, combined with a sudden increase in playing. It is a tendon problem, which means it responds to graded loading rather than to rest alone, and it is slow. Six weeks to a few months is a realistic timeframe, and the people who do worst are the ones who rest completely until it feels better and then return to the same volume that caused it.

A racket that is strung too tightly or a grip that is too small are both worth checking, since they are cheap to change.

The shoulder

The serve is the demanding part. It takes the shoulder to the end of its range under speed, repeatedly, and the muscles that control the shoulder blade have to keep the joint in a good position throughout.

Pain at the front or outside of the shoulder when serving or hitting overheads, particularly if it is worse lying on that side at night, usually points at the rotator cuff or at impingement. These respond well to treatment, and they respond better early. A shoulder that has been sore for a season is a longer job than one that has been sore for a fortnight.

The calf

The one that ends seasons. A sudden, sharp pain in the calf when pushing off, often described as feeling like being kicked from behind, is a calf tear, and it is common in players over forty. It is not the same as a cramp and it does not get better by walking it off.

The best protection is unglamorous. Calf strength, built with heel raises done properly and progressively, several weeks before the season starts.

What preparation actually looks like

Six weeks of preparation matters more than a good warm up on the day, though you should do both. Build calf and leg strength, work on shoulder and upper back mobility, and play yourself back in rather than starting with a full match. Two shorter hits in the first week will spare you a month later.

If you have an old injury that flares every season, that is the thing to deal with in February rather than in May.

Getting it treated

Martin Dyer and Gill Onslow are both keen tennis players and treat a good deal of tennis in the clinic, and Martin has spent many years working with players at the Wimbledon Championships in the week before the tournament begins.

Sports injury assessment and treatment covers the diagnosis and hands on work, strength and conditioning programmes the preparation, and return to sport rehabilitation the part people skip, which is making sure the arm or leg is actually ready for competitive play rather than merely pain free at rest.

Whether you play in a league or hit socially once a week, the assessment is the same and so is the advice. Come in while it is a niggle.