Tennis Medicine
Program

Know The Risk Factors

Playing tennis has many health benefits. These include improved lipid profiles (cholesterol), bone mineral density and cardiovascular (heart and blood vessel) health. How much is enough for health? To meet the American College of Sports Medicine exercise guidelines, you can play moderate to vigorous tennis:

  • 2.5 hours per week for adults
  • 7 hours per week for junior players

Tennis is a physically demanding sport, and many types of injuries can happen. Injuries may have several causes or factors, including:

  • Age
  • Skill level
  • Volume of play
  • Prior history of injury
  • Sports specialized training

Are you at Risk for a Tennis-Related Injury?

We used our published research evaluating thousands of tennis players to find injury risk factors. These factors provide evidence-based recommendations to identify players who have higher risk for serious injury.

We have presented these recommendations nationally and internationally at tennis coaching, tennis medicine and sports medicine conferences. Early recognition and treatment may prevent prolonged absences from tennis. They can also help avoid later stage, more debilitating problems.

Check your Risk with the Following Tables

Junior Competitive Player Level of Risk

Junior players have a higher risk of injury to the low back, shoulder, elbow, wrist and hip.

Level of risk Athlete risk factors Common areas/conditions Return to play Appointment needed
High

• Specialized
• High weekly volume >10-16 hours
• High amount of competition (>40 matches/yr or >12 tournaments/year)
• Higher level
• Prior injury (back, shoulder, elbow, wrist)
• Rapid growth
• Older, male
• >4th match in tournament
• High risk technique/strokes
• No dynamic warm up
• No injury prevention techniques

 • Spondylolysis
• Stress fractures
• Growth plate
• OCD
• Hip impingement		 Reduce/stop Immediate/earlier appointment
Intermediate • Low specialize
• Intermediate growth
• Intermediate weekly volume (6-10 hrs/week)
• Moderate competition (6-12 tournaments/year)
• Some at risk/technical flaws in strokes
• Occasional or limited dynamic warm up
• Occasional or limited injury prevention		 • Apophysitis
• Apophyseal
• Avulsions
• Instability		 Limited/moderate alterations in play Routine appointment
Low • Multiple sports
• Recreational play (minimal competition)
• Low volume (<6 hrs/week)
• Static growth
• Minimal technical flaws in strokes
• Regular dynamic warm up
• Regularinjury prevention techniques/exercises		 • Patellofemoral
• Muscle strain
• Tendonitis		 Limited or no alterations in play Monitor or appointment as needed

Adult Player Level of Risk

Adults have a higher risk of injury to the elbow, low back, shoulder and knee.

Level of risk Athlete risk factors Common areas/conditions Return to play Appointment needed
High

• 10 or more hrs/wk
• High weekly volume >10-16 hours
• Advanced level (NTRP 4.5 +)
• Prior injury or >6 weeks of symptoms
• >40 years old
• Regular competition
• Prior surgery
• No dynamic warm up
• No dynamic warm up
• No injury prevention techniques
• Poor technique

 • Elbow
• Low back
• Shoulder (rotator cuff)
• Knee		 Reduce/stop Earlier appointment
Intermediate • 6-10 hrs/week
• Intermediate level (NTRP 3.0-4.0)
• Prior injury or >2- 6 weeks of symptoms
• >30-40 y/o
• Occasional competition
• Prior surgery
• Occasional or limited dynamic warm up
• Occasional or limited injury prevention techniques/exercises
• Some technical flaws on strokes		 • Elbow
• Low back
• Shoulder (rotator cuff)
• Knee
• Foot/ankle
• Wrist		 Modify amount/volume Routine appointment
Low • <6 hrs/week
• Beginner (NTRP 2.5 or not rated)
• No prior injury or <2 weeks of symptoms
• >30-40 years old
• Limited or no competition
• Regular dynamic warm up
• Regular injury prevention techniques/exercises
• Minimal technical flaws on strokes		 • Elbow
• Low back
• Shoulder (rotator cuff)
• Knee
• Foot/ankle
• Wrist		 Limited or no alterations in play Monitor or appointment as needed