Beyond the Baseline: A Multifactorial Review of Tennis Injuries
DOI:
https://doi.org/10.12775/QS.2026.52.69033Keywords
tennis injuries, epidemiology, biomechanics, overuse injury, lower extremity, upper extremity, serve mechanics, injury prevention, kinetic chain, core stabilityAbstract
Background: Tennis is widely practiced globally across all ages and skill levels. The sport involves high-speed strokes, rapid directional changes and complex kinetic-chain movements, placing substantial demands on the musculoskeletal system. Repetitive and asymmetrical actions, especially during the serve, increase the risk of acute and overuse injuries. Aim: To provide an overview of the epidemiology, mechanisms, risk factors, as well as prevention strategies for tennis-related injuries across recreational, junior, and elite players, highlighting research gaps. Material and Methods: A systematic review was conducted using PubMed, focusing on English-language peer-reviewed studies. Epidemiological and biomechanical assessments, intervention trials and professional injury surveillance data were analysed to summarize injury patterns, mechanisms, risk factors with preventive strategies. Results: Injuries are most frequent in lower extremities, followed by upper extremities
and trunk, with muscle–tendon injuries predominating. Shoulder injuries result from repetitive overhead actions, while ankle sprains and patellar tendinopathy arise from acute trauma or chronic overload. Risk factors include prior injury, kinetic-chain deficits, workload spikes, court surface and sex differences. Prevention requires workload management, kinetic-chain conditioning, serve-specific biomechanics, core stability, functional screening, combined with psychological support. Conclusions: Tennis injuries are multifactorial, with the serve central to risk due to kinetic-chain demands. Effective prevention includes physical conditioning, technique optimization, workload regulation and psychosocial strategies. Future research should prioritize prospective studies evaluating multifactorial prevention programs and functional screening, integrating biomechanics, workload, and psychosocial factors across ages, sexes, along with competition levels.
References
[1] International Tennis Federation, „ITF global tennis report,” ITF, London, 2024.
http://itf.uberflip.com/i/1529940-itf-global-tennis-report-2024-summary/7?
[2] H. Patel, S. Lala, B. Helfner i T. T. Wong, „Tennis overuse injuries in the upper extremity,” Skeletal Radiol., tom 50, nr 4, pp. 629-644, 2021.
https://doi.org/10.1007/s00256-020-03634-2
[3] M. C. Fu, T. S. Ellenbecker, P. A. Renstrom, G. S. Windler i D. M. Dines, „Epidemiology of injuries in tennis players,” Curr Rev Musculoskelet Med, tom 11, nr 1, pp. 1-5, 2018.
https://doi.org/10.1007/s12178-018-9452-9
[4] J. Bradley, B. L. Langdown, D. Bowmaker i S. Kerr, „Injury Risk Factors of the Tennis Serve: A Systematic Review and Meta-Analysis,” Adv Rehabil Sci Pract, tom 14, 2025.
https://doi.org/10.1177/27536351251374616
[5] J. S. Dines, A. Bedi, P. N. Williams, C. C. Dodson, T. S. Ellenbecker, D. W. Altchek, G. Windler i D. M. Dines, „Tennis injuries: epidemiology, pathophysiology, and treatment,” J Am Acad Orthop Surg., tom 23, nr 3, pp. 181-189, 2015.
https://doi.org/10.5435/JAAOS-D-13-00148
[6] N. L. Myers, A. D. Sciascia, W. B. Kibler i T. L. Uhl, „Volume-based Interval Training Program for Elite Tennis Players,” Sports Health, tom 8, nr 6, pp. 536-540, 2016.
https://doi.org/10.1177/1941738116657074
[7] G. D. Abrams, P. A. Renstrom i M. R. Safran, „Epidemiology of musculoskeletal injury in the tennis player,” Br J Sports Med., tom 46, nr 7, pp. 492-498, 2012.
https://doi.org/10.1136/bjsports-2012-091164
[8] B. M. Pluim, C. W. Fuller, M. E. Batt i et al., „Consensus statement on epidemiological studies of medical conditions in tennis, April 2009,” Br J Sports Med., tom 43, nr 12, pp. 893-897, 2009.
https://doi.org/10.1136/bjsm.2009.064915
[9] B. M. Pluim, J. B. Staal, G. E. Windler i N. Jayanthi, „Tennis injuries: Occurrence, aetiology, and prevention,” Br J Sports Med..
[10] V. Moreno-Pérez, J. Priesto, J. Del Coso, J. E. Lidó-Micó, M. Fragoso, F. J. Penalva, M. Reid i B. M. Pluim, „Association of acute and chronic workloads with injury risk in high-performance junior tennis players,” Eur J Sport Sci., tom 21, nr 8, pp. 1215-1223, 2021.
https://doi.org/10.1136/bjsm.2009.064915
[11] R. P. Rice, K. Roach, N. Kirk-Sanchez i et al., „Age and Gender Differences in Injuries and Risk Factors in Elite Junior and Professional Tennis Players,” Sports Health., tom 14, nr 4, pp. 466-477, 2022.
https://doi.org/10.1177/19417381211062834
[12] S. O'Connor, Huseyin, O. R., E. F. Whyte i P. Lacey, „A 2-year prospective study of injuries and illness in an elite national junior tennis program,” Phys Sportsmed., tom 48, nr 3, pp. 342-348, 2020.
https://doi.org/10.1080/00913847.2020.1714512
[13] M. R. Abadi, I. S. Widyahening, N. C. Sudarsono i A. J. Tobing, „Incidence Rate of Musculoskeletal Injuries among Professional Tennis Players during 2019 International Tournaments in Indonesia,” J Sports Sci Med., tom 20, nr 2, pp. 268-274, 2021.
https://doi.org/10.52082/jssm.2021.268
[14] M. S. Amor-Salamanca, E. M. Rodríguez-González, D. Rosselló, M. de Lluc-Bauza i et al., „Risk Factors and Prevention of Musculoskeletal Injuries in Adolescent and Adult High-Performance Tennis Players: A Systematic Review.,” Sports (Basel), tom 13, nr 10, p. 336, 2025.
https://doi.org/10.3390/sports13100336
[15] S. Layouni, I. Dergaa, H. Ghali, H. İ. Ceylan, V. Stefanica, M. Neguez i et al., „Epidemiology of Tennis-Related Injuries Among Competitive Youth Players in Tunisia: Frequency, Characteristics, and Management Patterns,” Medicina (Kaunas), tom 61, nr 8, p. 1478, 2025.
https://doi.org/10.3390/medicina61081478
[16] B. Minghelli i J. Cadete, „Epidemiology of musculoskeletal injuries in tennis players: risk factors,” J Sports Med Phys Fitness., tom 59, nr 12, pp. 2045-2052, 2019.
https://doi.org/10.23736/S0022-4707.19.09842-6
[17] J. G. Dakic, B. Smith, C. M. Gosling i L. G. Perraton, „Musculoskeletal injury profiles in professional Women's Tennis Association players,” Br J Sports Med., tom 52, nr 11, pp. 723-729, 2018.
https://doi.org/10.1136/bjsports-2017-097865
[18] D. T. Gescheit, S. J. Cormack, R. Duffield, S. Kovalchik, T. Wood, M. Omizzolo i M. Reid, „Injury epidemiology of tennis players at the 2011–2016 Australian Open Grand Slam,” Br J Sports Med., tom 51, nr 17, pp. 1289-1294, 2017.
https://doi.org/10.1136/bjsports-2016-097283
[19] J. Maquirriain i R. Baglione, „Epidemiology of tennis injuries: An eight-year review of Davis Cup retirements,” Eur J Sport Sci., tom 16, nr 2, pp. 266-270, 2016.
https://doi.org/10.1080/17461391.2015.1009493
[20] I. McCurdie, S. Smith, P. H. Bell i M. E. Batt, „Tennis injury data from The Championships, Wimbledon, from 2003 to 2012,” Br J Sports Med., tom 51, nr 7, pp. 607-611, 2017.
https://doi.org/10.1136/bjsports-2015-095552
[21] K. Sell, B. Hainline, M. Yorio i M. Kovacs, „Injury trend analysis from the US Open Tennis Championships between,” Br J Sports Med., tom 48, nr 7, pp. 546-551, 2014.
https://doi.org/10.1136/bjsports-2012-091175
[22] B. Montalvan, V. Guillard, S. Ramos-Pascual, van Rooij F., M. Saffarini i A. Nogier, „Epidemiology of Musculoskeletal Injuries in Tennis Players During the French Open Grand Slam Tournament From 2011 to 2022,” Orthop J Sports Med., tom 12, nr 4, 2022.
https://doi.org/10.1177/23259671241241551
[23] J. Krueckel, D. Szymski, J. Lenz, J. Fluegel, J. Weber i et al., „Tennis Injuries Among German League Players: Investigating Patterns and Epidemiology of Acute and Chronic Injuries,” Open Access J Sports Med., tom 15, pp. 67-75, 2024.
https://doi.org/10.2147/OAJSM.S460907
[24] R. C. Lynall, Z. Y. Kerr, A. Djoko, B. M. Pluim, B. Hainline i T. P. Dompier, „Epidemiology of National Collegiate Athletic Association men's and women's tennis injuries, 2009/2010-2014/2015,” Br J Sports Med, tom 50, nr 19, pp. 1211-1216, 2016.
https://doi.org/10.1136/bjsports-2015-095360
[25] K. C. Chung i M. E. Lark, „Upper Extremity Injuries in Tennis Players: Diagnosis, Treatment, and Management,” Hand Clin., tom 33, nr 1, pp. 175-186, 2017.
https://doi.org/10.1016/j.hcl.2016.08.009
[26] G. Di Giacomo, N. de Gasperis i A. Constantini, Tennis: Epidemiology and Injury Mechanism, Cham: Springer, 2016, pp. 19-23.
https://doi.org/10.1007/978-3-319-14815-1_3
[27] J. Majewska, G. Kołodziej-Lackorzyńska, B. Cyran-Grzebyk, D. Szymczyk, K. Kołodziej i P. Wądołkowski, „Effects of Core Stability Training on Functional Movement Patterns in Tennis Players,” Int J Environ Res Public Health., tom 19, nr 23, 2022.
https://doi.org/10.3390/ijerph192316033
[28] A. van der Sluis, M. S. Brink, B. M. Pluim, E. A. L. M. Verhagen, M. T. Elferink-Gemser i C. Visscher, „Self-regulatory skills: Are they helpful in the prevention of overuse injuries in talented tennis players?,” Scand J Med Sci Sports., tom 29, nr 7, pp. 1050-1058, 2019.
https://doi.org/10.1111/sms.13420
[29] S. Martin, U. Johnson, A. McCall i A. Ivarsson, „Psychological risk profile for overuse injuries in sport: An exploratory study,” J Sports Sci., tom 39, nr 17, pp. 1926-1935, 2021.
https://doi.org/10.1080/02640414.2021.1907904
[30] S. Li, Q. Wu i Z. Chen, „Effects of Psychological Interventions on the Prevention of Sports Injuries: A Meta-analysis,” Orthop J Sports Med., tom 8, nr 8, 2020.
https://doi.org/10.1177/2325967120928325
[31] U. Johnson i A. Ivarsson, „The psychological dimensions of sports injury risk: models, mechanisms, and interventions,” Frontiers in sports and active living, tom 7, 2025.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Wiktoria Tłoczek, Daria Twardowska, Wiktoria Śliwa, Wiktoria Szlachta, Dominik Kret, Aleksandra Zdziebko, Kamil Dziuk
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 11
Number of citations: 0
