Watching the world’s most talented tennis players compete at Wimbledon inspires many to pick up a racquet and get playing. Combining the excitement of playing tennis, with the longer nights and warmer weather of summer, results in a sharp rise in people attending physiotherapy clinics with tennis related injuries.
What are some common Tennis Injuries?
Here’s our tennis injury list for the most common tennis related injuries we see in our clinics.
At this time of year (Wimbledon), we see many patients suffering from a multitude of injuries directly related to playing tennis. All of these injuries have one thing in common, they all involve tendons!
What is Tennis elbow?
Tennis elbow refers to an irritation of the tendons of the outer elbow. These tendons anchor the wrist extensor muscles to the bone and are responsible for cocking the wrist back. Repetitive gripping of a tennis racquet and in particular the motion of a backhand swing/volley during tennis can overload this tendon, causing pain.
What is Shoulder Impingement Syndrome?
Shoulder impingement syndrome refers to pain emanating from the tendons of the rotator cuff (muscles of the shoulder which guide and steer arm movements) or from the bursa that sits above these tendons (a bursa is a fluid filled sack which provides a friction reducing surface for movement to occur). This is often descibed by patients as a “tennis injury in the upper arm”. Shoulder impingement can be due to many reasons; however, the over-head action of a tennis serve places these tendons under considerable strain and is a common cause of shoulder pain in tennis players.
What is Tennis Leg?
Tennis leg refers to a tear of the inner portion of the calf muscle (medial gastrocnemius). This injury involves the junction between the medial gastrocnemius part of its tendon that runs within the muscle belly itself (called the aponeurosis). Tennis leg often occurs when sprinting to return the ball and causes a sudden sharp pain in the back of the lower leg.
What is Achilles Tendonothapy?
Achilles Tendinopathy refers to pain originating from the Achilles tendon at the back of the ankle. The Achilles tendon is a strong powerful tendon pushing you forwards during walking and running. It can be placed under considerable pressure when playing a dynamic sport such as tennis, especially if this is a new hobby.
Why are tennis injuries so common?
Tendons do not react well to sudden changes in activity levels. When a tendon is subjected to repeated periods of unexpected activity (for instance, taking up tennis after watching Wimbledon!) injury is inevitable.
The unprepared tendon is unable to cope with the new elevated demand placed upon it and, as the load continues to increase, the pressure on the tendon structure also builds.
A stressed tendon responds to this by producing an inflammatory reaction. Inflammation of the tendon is called tendinitis. Repeated periods of inflammation without adequate recovery effects the tendon’s ability to heal. Sub-optimal tendon healing results in a thickened and weakened tendon. A thickened and weakened tendon is known as a tendinopathy.
How are tendon injuries diagnosed?
Tendon injuries can be diagnosed by a physiotherapist using a combination of clinical testing (testing your movements and strength) and using diagnostic ultrasound.
Diagnostic ultrasound has been proven to be the gold standard diagnostic tool for diagnosing tendon injury and has been recommended over MRI for assessing shoulder, elbow, and Achilles’ tendon conditions.
At Complete all our clinical specialists are fully qualified advanced practitioner physiotherapists and musculoskeletal sonographers. This unique blend of experience ensures you get the most accurate diagnosis possible. When the correct diagnosis is made the most effective treatment course can be prescribed.
How are tennis related tendon injuries treated?
Tendon injuries are a very common cause of musculoskeletal pain, especially in the sporting population. A tendon and its corresponding muscle need to be able to withstand the demands placed upon it to remain pain free, strong and healthy.
Rehabilitation for a tendon requires modification of activity and specific exercises. Rehabilitation can be undertaken with a course of physiotherapist, and in most cases is successful. However, in some cases rehabilitation alone isn’t enough to manage the symptoms, especially in cases where there is an associated bursitis. In these cases, an ultrasound-guided steroid injection may be considered to allow pain free rehabilitation to proceed.
Steroid injections for a tendon injury?
In most cases, injections are not needed for tendon injuries, as a structured rehabilitation programme is usually the most effective approach.
Steroid injections are not injected into tendons, as current research suggests this may negatively affect tendon structure. However, we do sometimes inject corticosteroid into the bursa (the fluid-filled cushion near the tendon) if it is inflamed. This is known as bursitis, and treating it with a steroid injection can provide a pain-free window of opportunity to begin or progress rehabilitation more effectively.
At Complete, we take tendon rehabilitation seriously. Every injury is carefully assessed by a clinical expert. If bursitis is suspected alongside your tendon injury, you may be offered an ultrasound-guided steroid injection into the bursa to reduce pain and inflammation, allowing for better tolerance of exercise therapy.
PRP (platelet-rich plasma) injections are also offered in certain cases, particularly for rotator cuff injuries. PRP may be helpful where there is a rotator cuff tear, supporting tendon healing and/or reducing pain. These injections are also ultrasound-guided to ensure precision and safety.
If an injection is offered, it is vital that you begin physiotherapy within two weeks to address the root cause of the problem and prevent recurrence.
All procedures at Complete are performed by experienced clinicians under ultrasound guidance, meaning you can receive an accurate diagnosis and targeted treatment without a GP referral or lengthy wait.
If you would like to know more or would like to book an appointment. Please contact us on 0207 4823875 or email injections@complete-physio.co.uk.