Tennis players need a combination of speed, agility, flexibility and power to become successful at the sport. As with any overhead sport, it is not unusual to have shoulder and elbow pain, but tennis can be especially hard on the torso and lower body as well. Whether you are a serious competitor or a weekend warrior, there are a few key areas to keep supple and strong to avoid injury and improve skill.
Feet & Ankles: The ability to move laterally and sprint is essential for a tennis player. But how can you do this effectively with stiff, painful ankles and feet? My favorite way to mobilize feet and ankles is using a lacrosse ball. Mobilizing the fascia on the bottom on the feet can decrease foot pain and allow for more range of motion of your big toe- which is a big deal for push off! Pressure-based soft tissue work to the calves can decrease tightness and pain in these areas as well. Many people ask if a tennis ball would be sufficient, but it’s too soft! Our recommendation is using a lacrosse ball for 2 minutes in each area, per side, daily. Try it before and/or after a match and see which timing works best for you!
Hips: Pain in the hips can occur with faulty movement patterns or tightness elsewhere, but I want to focus on hip strength. I’m always surprised when athletes come in and have poor balance on one foot or less than ideal hip strength. Running and cutting is essentially moving from single leg stance on one side to single leg stance on the other. Without balance and control in this position, your knee will take a beating. Do you ever have sore knees? Don’t blame your knee, first look at your hip! A great exercise for single leg balance and hip strength/control is the single leg deadlift. There are many ways that you can adapt it to make it more or less challenging. When you try it, notice what happens at the knee. With poor control and strength at the hip, your knee may be moving in towards the other or shaking a bit. This is not ideal and likely the root of the knee issues. Work these into training days, 8-10 repetitions for 2 sets will be a good place to start. They can be sneaky and make you quite sore the next day!
Thoracic spine: Having the ability to rotate the torso is important for power production in concert with the hips. A stiff spine will disrupt the power couple and the hips will have to compensate. As mentioned before, dysfunction at the hips can then cause knee pain. Disrupting this kinetic chain can have severe effects on your tennis game! My go-to for thoracic spine rotation is the open book. This works well as a warmup exercise. As you rotate through the exercise, be sure to keep the knees stacked so that the rotate comes from the spine and not the pelvis turning!
Shoulder: Undoubtedly, shoulder strength is an important variable for efficient strokes but it can also directly affect elbow pain. Similar to the hip and knee relationship, if there is shoulder weakness then the elbow can take the brunt of the force. The rotator cuff is made up of four small muscles that stabilize the shoulder joint. Without strength of these muscles, the prime mover muscles then must take over for stabilization. When this happens, there will be less power production at the shoulder. Dysfunction at the shoulder can effect nerves passing through the area with may cause elbow pain. To keep the shoulder stabilizers strong and healthy, the exercise that will give you the most bang for your buck is the WY negative using a small band. This covers external rotation (cocking back before serving), overhead stabilization and posterior cuff control during deceleration. What was that last part? The muscles at the back of the shoulder work to slow the shoulder after the acceleration to hit the ball. A good indicator of dysfunction here is pain at the back of your shoulder.
Elbow: The elbow is effected so often by tennis that it was named after the sport! Tennis elbow, or lateral epicondylalgia, is pain at the outside part of the elbow. Its sibling, golfer’s elbow, is pain at the inside of the elbow. Despite the names, tennis players are susceptible to both. As mentioned before, it can be coming from up the chain- cervical spine or shoulder. The pain can also be coming from down the chain- wrist. The forearm muscles that move the wrist connect from the elbow and run to the hand. After hundreds of reps during a match or practice, forearm muscles can become irritated and tight. The triceps also crosses the elbow joint and can be a culprit with elbow pain. This muscle extends the elbow, so are very active with backhands and serves. Early on, the best focus of your time with elbow discomfort is soft tissue work using a lacrosse ball. After pinning down the ball in an area of tension, it is important to move the wrist and elbow to give the muscles a stretch.
If you are a tennis player looking to improve your game or ebb nagging pain, give these self-management techniques a try! By keeping the body mobile and strong you will have less pain and improved function. At Athletes’ Potential we work with multiple tennis athletes in all skill ranges that want to get back to the court quickly and feel better than ever. Not sure? Give us a call. We would love to chat with you and find the best fit.
Thanks for reading!
Dr. Jackie, PT, DPT, OCS, CSCS
Dr. Danny and Dr. Jackie's views on performance improvement, injury prevention and sometimes other random thoughts.