A NARRATIVE REVIEW ON TENNIS-RELATED UPPER LIMB PATHOLOGIES

B. Bauchiero¹ , S. Spadafora¹, S. Legrenzi² , V. Salini³, G. Placella³

¹ Università Vita-Salute San Raffaele, Piazza Ospedale Maggiore 3, Milan, Italy
² Department of Orthopedic Surgery and Traumatology, ASST GOM Niguarda, Milan, Italy
³ Vita-Salute University, IRCCS San Raffaele Hospital, Milan, Italy

Correspondence to:

Journal of Orthopedics 2025 January-April; 17(1): 46-58
https://doi.org/10.69149/orthopedics/2025v17iss1_7

Received: 2 March 2025 Accepted: 11 April 2025

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Abstract

Tennis players are frequently affected by musculoskeletal injuries due to the repetitive nature of the sport, improper technique, and physical stress. The shoulder is one of the most commonly injured areas, particularly in non-professional players, where rotator cuff tendinopathy, impingement, and labral tears are prevalent. These injuries are often linked to faulty stroke mechanics, especially in overhead shots. The elbow is another critical area, with conditions such as tennis elbow (lateral epicondylitis) affecting non-professional players aged 30 to 50, primarily due to poor backhand technique and incorrect racket grip. This condition arises from microtrauma to the extensor carpi radialis brevis and extensor digitorum tendons. In contrast, epitrochleitis (medial epicondylitis) occurs more commonly in professional players and results from stress on the forearm flexors during forehand strokes and serves. Pathologies of the wrist and hand, including tenosynovitis of the extensor carpi ulnaris, De Quervain’s disease, and triangular fibrocartilage complex (TFCC) injuries, are also prevalent, often caused by excessive wrist rotation, improper grip, and overuse of topspin strokes. De Quervain’s disease affects the tendons at the radial styloid and is characterized by swelling and restricted movement of the thumb and wrist. TFCC injuries associated with wrist rotation are often caused by combined impacts and loading. Additionally, fractures of the hook of the hamate, though rare, are seen in players who relax their grip during powerful strokes. Early diagnosis, based on clinical tests such as Cozen’s, Maudsley’s, and Finkelstein’s tests, as well as imaging modalities like ultrasound and MRI, is crucial. Conservative treatments, including rest, physical therapy, anti-inflammatory medications, and technique adjustments, are effective in most cases. Surgical intervention is rarely necessary but may be required for persistent or severe injuries. Preventative strategies, such as using proper equipment, and technique, and maintaining physical conditioning, are key to reducing the risk of common tennis injuries.

Keywords: muscle, tendon, tennis elbow, tennis injuries, upper limb