Tennis Injuries: Tennis Elbow, Shoulder, Wrist and When to See a Pro

This article contains affiliate links: if you buy through them we may earn a commission, at no extra cost to you. Learn more.

Saturday doubles at the club, third set, and your partner shakes out her forearm between points. “Just the elbow again.” On the next court a high school player limps to the bench holding his calf. At Melbourne Park, a tour pro calls the trainer for a shoulder at 4–all. Tennis injuries look different at every level, but they come from the same few places: the elbow, the shoulder, the wrist, the low back, the ankle and the calf. This page explains each one in plain language. You’ll learn what the research says about equipment, technique and training, and which signs mean it’s time to stop and get checked.

This is general information, not medical advice. If you’re hurt, see a sports medicine doctor, a physical therapist (PT) or a certified athletic trainer (AT). For the big picture of the sport, start at our tennis hub.

How often tennis players get hurt

The American Academy of Orthopaedic Surgeons (AAOS) says more than 21,000 people were treated for tennis injuries in 2007 in US hospitals, clinics and doctors’ offices. In NCAA college tennis, a study of six seasons (2009–10 to 2014–15) found about 4.9 injuries per 1,000 athlete-exposures (one player in one practice or match) for both men and women. Matches were riskier than practice. About half of the injuries were to the legs (47.0% in men, 52.4% in women), about a quarter to the arm and shoulder, and about one in six to the trunk and back.

Patterns change with level. At the Australian Open from 2011 to 2016, women were injured more often than men. The shoulder was the most common area for women, while men most often hurt the knee, ankle and thigh. Stress fractures more than doubled over those years. In Australia’s national junior program (ages 13 to 18), the low back was both the most common and the most serious injury area, with the shoulder second. Injury rates rose with age, from 2.0 per 1,000 hours at 13 to 2.9 at 18.

The most common tennis injuries

Tennis elbow (lateral epicondylitis)

The injury named after the sport is pain or burning on the outside of the elbow, often with a weaker grip. It hurts when you hold a racquet, turn a doorknob or shake hands. AAOS explains that it comes from overuse of a forearm muscle that extends the wrist (the ECRB), which develops tiny tears where it attaches to the elbow. Most people who get it are 30 to 50 years old, and many have never played tennis. AAOS says about 80 to 95% of patients do well without surgery.

A classic 1979 study of more than 500 recreational players found that the risk rose with age and with more hours played per day. A larger grip size was linked to more tennis elbow in older players. Among players who had already had it, changing stroke technique and racquet type helped prevent it from coming back. The forearm brace was the least successful of the strategies they tried. The one-handed backhand often gets the blame. In a 2026 survey of 445 players, elbow pain was more common with a one-handed backhand at first glance. After the researchers allowed for age, sex and hours played, the backhand style itself was no longer linked to it.

Shoulder pain from serving and overheads

The serve is the hardest stroke on the body, and the shoulder takes most of it. A 2025 review of 29 studies looked at injury risk in the serve. It linked injury to shoulder rotation strength and internal rotation range of motion on the hitting side, weekly tennis volume, age, body mass and height. A study of amateur players with shoulder pain found tighter back-of-shoulder tissue and weaker external rotation than in pain-free players. That’s why shoulder care in tennis means strengthening the rotator cuff and shoulder blade muscles and keeping your range of motion, not just stretching. Our tennis training guide shows how players build that in.

Wrist pain and your grip

Modern topspin puts a lot of stress on the wrist. In a study of 370 non-professional players, 13% reported a wrist injury, and most of those (30 of 50) involved the extensor carpi ulnaris (ECU) tendon on the little-finger side. The grip mattered. Western and semi-Western forehand grips were linked to pain on the little-finger side. The Eastern grip was linked to pain on the thumb side. Those players missed about 69 days of competition on average. If heavy topspin hurts your wrist, have a coach check your grip and a PT check the tendon.

Calf strains (“tennis leg”)

You push off for a drop shot and feel a sharp pain in the inner calf, like you’ve been hit by a ball. “Tennis leg” is usually a tear where the inner calf muscle (the medial gastrocnemius) meets its tendon. Imaging reviews note that it can look like an Achilles tendon rupture, a blood clot (deep vein thrombosis) or a burst Baker’s cyst. So a sudden, painful calf deserves a same-day check, especially if it’s swollen or you can’t push off. A 2026 review says most cases are managed without surgery, with recovery generally taking 6 to 12 weeks.

Ankle sprains

Lateral movement, quick stops and the odd ball underfoot make ankle sprains common in tennis. The National Athletic Trainers’ Association (NATA) calls a previous sprain the most consistent risk factor. It recommends tape or a brace for practices and matches for athletes who have sprained an ankle before, plus a balance and strength program lasting at least three months. AAOS adds tennis shoes with good support. Our ankle brace guide compares options, and the evidence on braces is laid out on our basketball injuries page.

Low back pain

Every serve combines arching, twisting and side-bending, thousands of times a season. In elite juniors the lumbar spine was the top injury area. AAOS advises against arching your back more than needed on serves and overheads: bend your knees and rise onto your toes instead, so your body weight stays balanced. It also suggests heel inserts on hard courts. Back pain in a growing player that gets worse with serving, or that lasts more than a couple of weeks, should be checked by a sports medicine doctor.

Equipment: racquet, strings, grip and shoes

• Racquet and strings: AAOS says stiffer racquets and looser strings often reduce stress on the forearm. Oversized racquets may contribute to tennis elbow, and a smaller head may help keep it from coming back.
• Grip size: a larger grip was linked to more tennis elbow in older players in the 1979 study. Have a pro measure your hand rather than guessing.
• A dry handle: AAOS suggests keeping the handle dry to prevent blisters. A fresh overgrip like Tourna Grip Original is a cheap way to do that.
• Shoes and socks: supportive tennis shoes, plus two pairs of socks or padded tennis socks (AAOS).
• Elbow straps: AAOS says a brace over the back of the forearm may help relieve symptoms. A 2020 review found low-quality evidence that forearm straps reduce pain while gripping, right when you wear them. Think of a strap as a comfort aid while you sort out the cause with a PT, not a fix.

Many players keep a counterforce strap like the McDavid Tennis Elbow Strap in the bag. PTs often use a rubber bar like the THERABAND FlexBar for forearm strengthening, and a lace-up brace like the ASO EVO is a common pick after an ankle sprain. Your doctor or PT can tell you which, if any, fits your case.

Prevention: what helps, and what the evidence can’t promise

Here’s an honest finding: tennis has very little trial evidence on injury prevention. A 2006 review found no randomized trials of prevention in tennis at all. When Dutch researchers built a 12-week, app-based program for adult club players (TennisReady) and tested it on 579 players, injury rates were almost the same as in the control group (37% vs 38%). Few players stuck with it. That doesn’t mean prevention is pointless. It means the program only works if you actually do it, and that the basics matter:

• Warm up first. AAOS suggests 3–5 minutes of jumping jacks, cycling or jogging in place, then gentle stretches held for 30 seconds. Cold muscles are more prone to injury.
• Build volume slowly. Weekly tennis volume shows up as a risk factor for both the shoulder and the elbow. Avoid jumping from one match a week to daily play.
• Strengthen the shoulder, forearm, core and legs through the year, not just when something hurts.
• Get your technique and gear checked by a coach if pain keeps coming back in the same place.
• Protect young players. Our youth tennis page covers schedules and rest for juniors.

Head injuries: they’re rare in tennis, but a ball to the head at the net or a hard fall can cause a concussion. Follow the CDC HEADS UP rule: if a player seems dazed or confused, or has a headache, dizziness or nausea after a blow, take them off court and don’t let them return that day until a healthcare provider clears them. Call 911 for danger signs such as repeated vomiting, a worsening headache, seizures or unusual drowsiness.

When to see a doctor, PT or athletic trainer

• A sudden pop or sharp pain in the calf or heel, especially with swelling or trouble pushing off.
• You can’t put weight on a foot, or a joint looks out of shape.
• Elbow, wrist or shoulder pain that keeps coming back, wakes you at night or weakens your grip.
• Back pain in a junior player that gets worse with serving.
• Any concussion signs.

A sports medicine physician diagnoses the problem and manages most injuries without surgery. A physical therapist guides rehab and the return to the court. Athletic trainers are health care professionals who work with physicians, and many high schools and colleges have one.

Tennis injury FAQs

What is the most common injury in tennis?

It depends on the level. In NCAA tennis about half of injuries are to the legs. Women at the Australian Open most often hurt the shoulder, and elite juniors most often hurt the low back. In recreational players over 30, tennis elbow is the classic complaint.

Does an elbow strap help tennis elbow?

AAOS says a brace over the back of the forearm may help relieve symptoms, and studies show a small, short-term drop in pain while gripping. The evidence is low quality, and in an older study braces were the least successful way to prevent tennis elbow from coming back. Use one for comfort and have a PT work on the cause.

Can my racquet or strings cause tennis elbow?

They can play a part. AAOS notes that stiffer racquets and looser strings often reduce stress on the forearm, and oversized racquets may contribute. A grip that’s too large was linked to more tennis elbow in older players.

What is tennis leg?

A strain or tear of the inner calf muscle where it meets its tendon, usually during a sudden push-off. Because it can look like an Achilles rupture or a blood clot, get it checked the same day.

Is the one-handed backhand bad for your elbow?

Not on its own, according to a 2026 survey of 445 players. Elbow pain looked more common with the one-handed backhand at first glance, but the link disappeared once age, sex and hours played were taken into account.

Warm up, build your hours slowly, keep the shoulder strong and get the first twinge checked before it costs you a season. Keep going with our training, match-day and recovery guides, or see our resistance bands guide for shoulder work.