Tennis Physiotherapy.
The physical demands of tennis
Tennis is a sport of explosive multidirectional movement, repeated high-velocity overhead and groundstroke mechanics, rapid deceleration after each shot, and the sustained physical demands of matches that can last several hours. The combination of asymmetric upper limb loading from the dominant arm, high-impact court surfaces, and the repetitive nature of stroke mechanics creates a distinctive injury profile spanning the elbow, shoulder, wrist, knee and spine.
At Articulate Physiotherapy in Tarragindi, we work with tennis players from social club level through to competitive and representative performers — managing both the acute injuries that interrupt competition and the chronic overuse injuries that are the occupational reality of high-volume tennis training.
Common tennis injuries
Lateral epicondylalgia (tennis elbow) — despite affecting people across many sports and occupations, tennis elbow takes its name from tennis for good reason. The backhand groundstroke — particularly with a one-handed backhand — places significant eccentric demand on the wrist extensor muscles at their common extensor origin at the lateral epicondyle. High-volume play, poor technique, inappropriate string tension and grip size all contribute. See our dedicated tennis elbow page for the full management approach — which is built around progressive tendon loading rather than rest.
Shoulder injuries — rotator cuff tendinopathy and impingement from the repetitive overhead serve and overhead smash, SLAP tears from the biceps anchor loading of the serve deceleration phase, and glenohumeral internal rotation deficit (GIRD) — the posterior capsule tightness that develops in the dominant arm of overhead athletes — are all common in competitive tennis players. The serve is the highest-load stroke in tennis and the primary driver of shoulder injury, combining extreme external rotation in the cocking phase with explosive internal rotation at ball contact and significant deceleration loading in the follow-through.
Knee injuries — patellofemoral pain and patellar tendinopathy from the repeated split-step, deceleration and explosive lateral movement of court coverage, and ACL injuries from pivoting and rapid direction change — are significant in competitive players who perform high volumes of court movement.
Ankle injuries — lateral ankle sprains from the rapid lateral movement and direction changes of court coverage — are the most common acute injury. The hard court surface increases ankle sprain risk compared to clay, and recurrence without adequate proprioceptive rehabilitation is common.
Lower back pain — from the repeated trunk rotation and lumbar hyperextension of the serve and overhead strokes, combined with the asymmetric loading of predominantly one-sided play — produces lumbar facet joint and paraspinal overuse presentations that are particularly common in high-volume servers. Spondylolysis should be considered in any adolescent tennis player presenting with back pain, particularly those with high serve volumes.
Wrist injuries — De Quervain's tenosynovitis and extensor carpal ulnaris tendinopathy from the wrist extension and radial/ulnar deviation demands of groundstrokes, and triangular fibrocartilage complex (TFCC) injuries from the rotational forces of the forehand — are common in frequent players.
Calf strains and Achilles tendinopathy — from the explosive push-off demands of court movement, particularly in older players and those returning from periods of inactivity — are common with abrupt increases in playing frequency.
How can physiotherapy help?
Physiotherapy for tennis injuries addresses the specific stroke mechanics and movement demands of the sport alongside the general principles of upper limb and lower limb rehabilitation.
Shoulder rehabilitation for tennis players addresses the rotator cuff and periscapular strength asymmetries, the posterior capsule tightness and the scapular control deficits that develop from asymmetric high-volume serving. The deceleration strength of the posterior rotator cuff — the primary braking mechanism of the serve follow-through — is the most important training target for shoulder injury prevention in tennis. Posterior capsule stretching — the sleeper stretch — addresses the GIRD that is a consistent finding and risk factor in overhead tennis players.
Tennis elbow management is built around progressive tendon loading — heavy slow resistance wrist extensor exercises performed in a pain-guided protocol — rather than the passive treatments and avoidance that historically produced poor outcomes. Equipment assessment — string tension, grip size, racquet head size and string type — is an important adjunct that addresses the mechanical contributors to lateral epicondyle loading.
Lower limb rehabilitation addresses the knee and ankle presentations specific to tennis — quadriceps and gluteal strengthening for patellar tendinopathy, proprioceptive retraining and ankle strengthening for ankle sprain recurrence prevention, and lower limb power development for court movement performance.
Lumbar rehabilitation addresses the trunk rotation and lumbar extension demands of the serve — thoracic mobility, hip flexibility and lumbopelvic stabiliser work all reduce the compensatory lumbar loading that drives back pain in tennis players.
Dry needling manages the forearm extensor, periscapular and paraspinal trigger points common in tennis players. Clinical Pilates provides trunk rotation, hip stability and shoulder stabiliser work directly relevant to tennis performance. Real time ultrasound guides deep stabiliser retraining where pain has disrupted normal muscle activation patterns.
Our physiotherapists Mauricio Bara and Eliane Machado both have experience in tennis-related injuries and are members of the Australian Physiotherapy Association. Mauricio's APA Sports Physiotherapist credentials and Eliane's biomechanics research background are directly relevant to the stroke mechanics assessment and return-to-court programming central to tennis injury management.
To book or find out more, call us on 07 3706 3407 or book online below. We see patients from across Brisbane's southside including Tarragindi, Coorparoo, Holland Park, Greenslopes and Mt Gravatt.
Tennis is a sport of explosive multidirectional movement, repeated high-velocity overhead and groundstroke mechanics, rapid deceleration after each shot, and the sustained physical demands of matches that can last several hours. The combination of asymmetric upper limb loading from the dominant arm, high-impact court surfaces, and the repetitive nature of stroke mechanics creates a distinctive injury profile spanning the elbow, shoulder, wrist, knee and spine.
At Articulate Physiotherapy in Tarragindi, we work with tennis players from social club level through to competitive and representative performers — managing both the acute injuries that interrupt competition and the chronic overuse injuries that are the occupational reality of high-volume tennis training.
Common tennis injuries
Lateral epicondylalgia (tennis elbow) — despite affecting people across many sports and occupations, tennis elbow takes its name from tennis for good reason. The backhand groundstroke — particularly with a one-handed backhand — places significant eccentric demand on the wrist extensor muscles at their common extensor origin at the lateral epicondyle. High-volume play, poor technique, inappropriate string tension and grip size all contribute. See our dedicated tennis elbow page for the full management approach — which is built around progressive tendon loading rather than rest.
Shoulder injuries — rotator cuff tendinopathy and impingement from the repetitive overhead serve and overhead smash, SLAP tears from the biceps anchor loading of the serve deceleration phase, and glenohumeral internal rotation deficit (GIRD) — the posterior capsule tightness that develops in the dominant arm of overhead athletes — are all common in competitive tennis players. The serve is the highest-load stroke in tennis and the primary driver of shoulder injury, combining extreme external rotation in the cocking phase with explosive internal rotation at ball contact and significant deceleration loading in the follow-through.
Knee injuries — patellofemoral pain and patellar tendinopathy from the repeated split-step, deceleration and explosive lateral movement of court coverage, and ACL injuries from pivoting and rapid direction change — are significant in competitive players who perform high volumes of court movement.
Ankle injuries — lateral ankle sprains from the rapid lateral movement and direction changes of court coverage — are the most common acute injury. The hard court surface increases ankle sprain risk compared to clay, and recurrence without adequate proprioceptive rehabilitation is common.
Lower back pain — from the repeated trunk rotation and lumbar hyperextension of the serve and overhead strokes, combined with the asymmetric loading of predominantly one-sided play — produces lumbar facet joint and paraspinal overuse presentations that are particularly common in high-volume servers. Spondylolysis should be considered in any adolescent tennis player presenting with back pain, particularly those with high serve volumes.
Wrist injuries — De Quervain's tenosynovitis and extensor carpal ulnaris tendinopathy from the wrist extension and radial/ulnar deviation demands of groundstrokes, and triangular fibrocartilage complex (TFCC) injuries from the rotational forces of the forehand — are common in frequent players.
Calf strains and Achilles tendinopathy — from the explosive push-off demands of court movement, particularly in older players and those returning from periods of inactivity — are common with abrupt increases in playing frequency.
How can physiotherapy help?
Physiotherapy for tennis injuries addresses the specific stroke mechanics and movement demands of the sport alongside the general principles of upper limb and lower limb rehabilitation.
Shoulder rehabilitation for tennis players addresses the rotator cuff and periscapular strength asymmetries, the posterior capsule tightness and the scapular control deficits that develop from asymmetric high-volume serving. The deceleration strength of the posterior rotator cuff — the primary braking mechanism of the serve follow-through — is the most important training target for shoulder injury prevention in tennis. Posterior capsule stretching — the sleeper stretch — addresses the GIRD that is a consistent finding and risk factor in overhead tennis players.
Tennis elbow management is built around progressive tendon loading — heavy slow resistance wrist extensor exercises performed in a pain-guided protocol — rather than the passive treatments and avoidance that historically produced poor outcomes. Equipment assessment — string tension, grip size, racquet head size and string type — is an important adjunct that addresses the mechanical contributors to lateral epicondyle loading.
Lower limb rehabilitation addresses the knee and ankle presentations specific to tennis — quadriceps and gluteal strengthening for patellar tendinopathy, proprioceptive retraining and ankle strengthening for ankle sprain recurrence prevention, and lower limb power development for court movement performance.
Lumbar rehabilitation addresses the trunk rotation and lumbar extension demands of the serve — thoracic mobility, hip flexibility and lumbopelvic stabiliser work all reduce the compensatory lumbar loading that drives back pain in tennis players.
Dry needling manages the forearm extensor, periscapular and paraspinal trigger points common in tennis players. Clinical Pilates provides trunk rotation, hip stability and shoulder stabiliser work directly relevant to tennis performance. Real time ultrasound guides deep stabiliser retraining where pain has disrupted normal muscle activation patterns.
Our physiotherapists Mauricio Bara and Eliane Machado both have experience in tennis-related injuries and are members of the Australian Physiotherapy Association. Mauricio's APA Sports Physiotherapist credentials and Eliane's biomechanics research background are directly relevant to the stroke mechanics assessment and return-to-court programming central to tennis injury management.
To book or find out more, call us on 07 3706 3407 or book online below. We see patients from across Brisbane's southside including Tarragindi, Coorparoo, Holland Park, Greenslopes and Mt Gravatt.
