Staying Healthy for the Transition from Indoor Winter Tennis to Outdoor Play

As spring welcomes the outdoor season, tennis enthusiasts potentially face unwelcome injuries if they do too much too soon and fail to take proper precautions to transition from indoor to outdoor play. For many players, an hour a week indoors is not enough to prepare for the many hours they will spend outdoors during the first spring weekend. Each year, more than 78,000 tennis-related injuries are treated in hospitals, doctors’ offices, clinics, ambulatory surgery centers and hospital emergency rooms, according to the American Academy of Orthopaedic Surgeons.

Players can be at greater risk for injury in the spring, especially when the weather is still cool and if they start out too intensely without any pre-season conditioning, says Kevin Plancher, M.D., a leading NY-area orthopedist and founder of the Orthopedic Foundation for Active Lifestyles, a non-profit organization dedicated to advancements in research and education for orthopedics and sports medicine.  The key areas tennis players need to watch out for are the upper body, particularly the shoulders, wrists and elbows, and the lower body, especially the hamstrings, knees and Achilles, according to Dr. Plancher.

The repetitive motion required by the serve and overhead can be stressful on the shoulder, which can result in soreness and can lead to a more serious injury such as a torn rotator cuff, says Dr. Plancher. Similarly the elbow and wrist are also at risk. Tennis elbow, which Dr. Plancher explains as an inflammation of the tendon that attaches to the ulna (top part of the elbow), one of the three bones that make up the elbow joint, is a common overuse injury among tennis players, particularly those over 30. Wrist strains are also common.

To avoid these injuries, Dr. Plancher recommends players start the outdoor season gradually, limiting their court time initially and building up slowly. Since muscles and tendons are more likely to break down in the cold, Dr. Plancher advises a thorough warm up prior to playing. Ideally, players should also take the time to work on strength and flexibility, particularly for the shoulder muscles, forearms and wrists, before the outdoor season begins. Also check your equipment, advises Dr. Plancher. The wrong sized grip or incorrect racquet weight can also add more stress to the arm. He also believes in the importance of good technique. Arrange a couple of sessions with your pro to make sure you haven't developed any poor habits over the winter. Incorrect technique can also contribute to injury.

The constant change of direction and quick stop and start movements on the tennis court can attribute to lower body injuries such as a hamstring tear, Achilles injuries or a number of knee problems. Again, Dr. Plancher recommends a regimen of stretching during the pre-season to develop a good range of motion of the joints and a strengthening program with a special focus on the muscles surrounding the knees, such as the quadriceps.  He also advises a thorough warm-up before playing. The warm up should get the blood flowing and could include light jogging or skipping followed by leg swings or lunges. Dr. Plancher also suggests players to do a shoe check to make sure their tennis footwear has not worn out over the winter and there is enough cushioning to absorb shock and protect the feet and ankles. When starting out, he recommends playing on a soft surface which is more forgiving on the joints. And finally, he advocates stretching carefully after playing, concentrating on the hamstrings, calves and Achilles.

For the most effective transition from indoor to outdoor tennis this season, Dr. Plancher recommends the following:

1. Start slowly especially when the temperature is still cool.
2. Embark on a pre-season program of strength and flexibility training.
3. Warm up thoroughly prior to playing.
4. Check equipment, especially racquets and shoes.
5. Stretch after playing.
6. For sore muscles, follow the RICE technique: Rest, Ice, Compression and Elevation.

Source: Plancher Orthopaedics & Sports Medicine