Common Senior Tennis Injuries: Tennis Elbow, Rotator Cuff, Achilles, And How To Prevent Them

Tennis injuries in senior players are well documented. A 2014 American Journal of Sports Medicine review of recreational players age 60 and older found that five injuries account for about 80 percent of all time-loss complaints among senior tennis players in the United States. The five are lateral epicondylitis, commonly called tennis elbow, rotator cuff strain or tear, Achilles tendinopathy or rupture, knee meniscus tear or osteoarthritis flare, and lower back muscle strain. Each has well-studied prevention strategies that work and are easy to apply.

Tennis elbow is pain on the outside of the elbow at the bony point where the forearm extensors attach. It is caused by repeated backhand strokes hit with a stiff wrist and an off-center contact point. The prevention is a two-handed backhand, a softer string at lower tension, a counter-balanced racket with a heavier handle, and a forearm strap worn during play. The Cyriax forearm brace is the standard model. Most senior players who switch from a one-handed to a two-handed backhand see elbow pain reduce within four to six weeks.

Rotator cuff issues affect the front of the shoulder during overhead serves and overhead smashes. The supraspinatus tendon is the most often injured of the four rotator cuff tendons. Prevention is a slower serve motion, no overheads when fatigued, and a daily rotator cuff strength routine using a light resistance band. The standard physical therapy band exercises are the external rotation, the internal rotation, the scaption, and the row, done in three sets of 15 repetitions per day.

Achilles tendinopathy is pain at the back of the heel that builds over weeks. A full Achilles rupture, by contrast, is sudden and feels like a kick from behind. Prevention is calf stretching for 60 seconds twice a day, eccentric calf raises three sets of 15 per day, and a court warm-up that includes five minutes of slow jogging before the first ball is hit. Senior players should never skip the warm-up, especially in cold weather.

Knee meniscus tears and arthritis flares are caused by sharp lateral cuts and stop-and-start motions. Prevention is the use of doubles instead of singles, supportive court shoes with strong lateral support such as the Asics Gel Resolution or the New Balance 996, knee sleeves on bad days, and avoidance of clay courts after a fresh rain when the surface is slick.

Lower back strain is the catch-all injury for the senior player who serves with a hard back arch or who reaches for a low volley with a bent waist. Prevention is core strength work twice a week, a serve motion that uses the legs and shoulders rather than the back, and a daily five-minute back stretch routine. Sources include the American Journal of Sports Medicine 2014 review, the United States Tennis Association sports science pages at usta.com, the American Academy of Orthopaedic Surgeons at orthoinfo.aaos.org, and the Mayo Clinic at mayoclinic.org.