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Injuries and Playing Surfaces in Professional and Recreational Tennis

4/17/2018

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By Patrick Aubone, CTPS & Dr. Mark Kovacs, CTPS, MTPS
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Headed into the professional clay court season, common perception is that in tennis surface matters. As we get older, clay courts are the surface of choice. “It’s easier on the body” is the most repeated phrase. “Hard courts hurt my knees and my back” is often heard. But what if the injuries were not a result of the playing surface?  Most players over time get some type of overuse injury. Whether it’s the playing arm, the back, or the knees and ankles, everyone gets “niggles.”
           
A recent 2016 study in Netherlands evaluated 4 different surfaces and their injury rates over a 6 month period. Hard courts, clay courts, sand filled artificial grass and red sand filled artificial grass were used. The average age of the participants was 49 years old. 20,000 adults were invited to participate, 18% (3656) participated. There were 4047 injuries (53%) reported by 1957 participants. 80% of the injuries were overuse injuries and 20% were acute injuries. Participants who played on multiple surfaces suffered from overuse injuries compared to those who played on one surface. The researchers concluded that there was no significant injury prevalence of injury with the different surfaces.
 
This study shows that unless a player suffers a freak injury such as Bethanie Mattek-Sands at the 2017 Wimbledon or David Goffin at the 2017 French Open, the grand majority of injuries are due to overuse and not surface type. Essential to maintaining a healthy body is rehabbing minor injuries and strength training to prevent injuries. Rest is vital for the body. More is not always better.
           
Another study evaluated the influence of tennis court surfaces on player perception and biomechanical response. The researchers noted that there was a difference in the way players stood on a hard court compared to a clay court. Players on a hard court were in a more upright position. This allowed the athlete to be more on their toes in anticipation of sliding. They did note that players with previous clay court experience may experience a reduction of injury as a result of reduced loading on the knees and lower limbs.
           
Research is clearly showing that playing surface has limited correlation with injuries in tennis. The injuries reported were preexisting injuries. Past injuries from other sports or accidents can be exacerbated because of the start/stop nature of the sport. The forces generated can place extra stress on the body and cause flare ups in injuries that were not properly rehabbed
So how much is too much in professional and recreational tennis?
           
Professional players travel 25-35 weeks a year between tournaments, preseason camps, and home visits. Recreational players play between 2 and 3 times a week. While some individuals can argue that Courier, McEnroe and Lendl all played 85+ matches in the past, there are many variables that have changed. For recreational players, you have to worry about outside stress from home and work. The professional athletes are stronger, faster and fitter than ever. Matches are going 4+ hours in Grand Slams with the winner having 36 hours to recover before playing again. The physical toll on the athlete’s body after these matches is tremendous. In recreational players recovery can take a few days depending on how much outside weight lifting and endurance training is done. Technology has played a part in developing more powerful racquets allowing players to hit harder and add more spin to the ball.  
 
3 Takeaway points
  1. Injury prevention begins before you step on court and does not stop when you leave the court. Stretching, foam rolling, dynamic warmup all help.
    1. Basic Injury Prevention Exercises for Tennis http://itpa-tennis.org/itpa-blog/basic-injury-prevention-exercises-for-tennis
  2. Stress Management – outside stressors such as work and family can have a negative impact on the body. Meditation, reading a book or any activity that activates the parasympathetic nervous system will greatly reduce stress levels.
  3. Technology- USE IT! With the advances in technology today there are a lot of tools that can speed recovery not just from an injury standpoint but also after a practice or match. Just make sure you use technology that has a track record of success and has evidence based support.

​Here are another few nice resources from the iTPA
Are You Helping or Hurting Your Young Tennis Players? - http://itpa-tennis.org/itpa-blog/april-19th-2013
 
Sources:
The influence of tennis court surface on player perceptions and biomechanical response
https://www.ncbi.nlm.nih.gov/pubmed/26699792
 
Injury rates in recreational tennis players do not differ between different playing surfaces
https://www.ncbi.nlm.nih.gov/pubmed/28209569

Common sports injuries in young tennis players
https://www.ncbi.nlm.nih.gov/pubmed/9777684


Alternating Hot and Cold Water Immersion for Athlete Recovery: A Review
http://www.sciencedirect.com/science/article/pii/S1466853X03001226

Preventing overtraining in athletes in high intensity sports and stress recovery management
http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0838.2010.01192.x/full
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