Tennis – Injuries and Prevention Most injuries in tennis are classified as overuse. The most common injuries involve the rotator cuff, biceps tendon in the shoulder, tendonitis of the elbow/wrist, low back, abdominal muscle strains, leg muscle cramps, and plantar fasciitis. Calf strain and Achilles injuries are also common. What leads to more injuries in recreational players versus elite players? Elite players use their legs and trunk as much as their arms to generate power and speed. The recreational player uses these muscle groups less and are more likely to place more stress on their shoulder girdle muscles. Proper equipment for Tennis Racquets  Oversized racquets are best because they have larger sweet spots and therefore reduce the number of off-center hits, thereby reducing the vibration and shock.  The 12-12.5 ounce weight range is ideal.  Graphite and titanium racquets are lighter; this allows players to position the racquet more quickly and decreases the chance of hitting late.  A racquet handle that is too large or small may produce excessive force through the elbow/forearm/wrist/hand. However larger grips are more forgiving with certain conditions (e.g. arthritis of the hand and fingers)  String tension is a very individual preference; however, it is suggested that for players with established elbow symptoms, the racquet should be strung at 52-55 pounds.  Low tension in the strings decreases shock, increases power, and decreases control.  High tension in the strings increases shock, decreases power, and increases control. Shoes  Heels should be snug-fitting to prevent slipping  Heel and toe areas should have adequate cushioning  Arch should provide soft support  Toe box should have adequate depth to prevent toenail injuries Heat and Humidity Heat cramps are painful muscle spasms that occur because of excessive dehydration and electrolyte loss during sweating. A build-up of metabolites occurs in the muscle, associated with losses of salt and potassium, and dehydration. Prevention of Heat Disorders Hydration is the most important preventative measure (e.g. water, electrolyte drinks and juice). It is recommended that a player should drink 400-600 mL (2-3 glasses) of fluid at least 30 minutes before play and 200-300 mL (1-2 glasses) every 15 minutes during play (at change of ends). You should avoid caffeine and alcohol because they act as diuretics. Eating pretzels before play will help with the loss of salt that occurs when sweating and can help to prevent cramps. Cooling of the body occurs by evaporation so expose skin to air and avoid dark, tight clothing. General Fitness Tennis combines several different aspects of fitness. These are aerobic endurance, balance, flexibility and strength. Deficits in any of these areas can predispose a player to injury; i.e. an unfit player with poor flexibility will be slower getting to the ball and will tend to lunge and hit the ball late; this in turn will result in poor swing mechanics and potential injury. Flexibility Stretching is an important part of injury treatment and prevention, and for stretching to be effective, it must be done on a regular basis. It is best to stretch when you are warmed-up and before and after activity. Stretching should not be painful and should be performed slowly with control (no bouncing). A bouncy movement or stretching too vigorously activates a stretch reflex, causing the muscle to contract involuntarily, and tightening the muscles you are trying to stretch. There is no golden rule for how long to hold a stretch but it is generally advised a 20-60 second hold is sufficient as long as there is no discomfort.