Treating Tennis Injuries And Tendinopathy: Advice From An Expert


Tennis is one of the most popular sports all over the world. People of all ages enjoy this great sport, which is played on a variety of surfaces including grass, clay and hard courts. Since tennis requires repetitious movements, injuries are common among players. Below are some of the most common injuries associated with this sport.


Tendinitis is one of the most common types of tennis injuries. Tendons are cords in the body that connect muscle to bone and they are susceptible to becoming inflamed with repetitious movements. Tendinitis is also common in baseball pitchers, golfers and painters. Anyone who performs similar movements on a regular basis is susceptible to developing this condition, however, it is most common in people over 40 years of age. In tennis players, tendinitis most often affects the elbow, shoulder and wrist. The most common symptoms associated with tendinitis are:

  • painful tendons in affected areas
  • strength loss
  • reduced joint movement.


Like tendinitis, tendinopathy is a condition that affects the tendons but it is considered to be chronic instead of acute. Mid-tendon injuries also known as non-insertional tendinopathy are the most common types of tennis injuries. They can occur near the:

  • shoulder
  • elbow
  • ankle
  • knee

The primary symptoms of tendinopathy include joint redness, pain in the affected joint, morning stiffness and crunching feeling in the joint upon movement. In addition to sports, this condition can also be cause by trauma, diseases that cause inflammation such as arthritis and aging.

Professional Treatment

If you have persistent joint pain that is not resolved in a few weeks with self-care, it may be time to see your doctor. To make an accurate diagnosis, your doctor will ask you some questions regarding your medical history. Be sure to include any pre-existing medical conditions, medications you take and the date of symptom onset. After taking a history, your doctor will examine you to determine your pain level and range-of-motion. He may also order diagnostic tests such a series of X-rays, CT scan or MRI.

Once a diagnosis of tendinitis is made, your doctor may refer you to physical therapy. Therapists are trained to reduce pain, increase range-of-motion and help you return to normal activity. They can also instruct you in ways to avoid re-injuring your joint after recovery. In severe cases, your doctor may recommend surgery to repair the affected tendon if the damage is severe.


Preventing tennis injuries is the best way to avoid losing time away from the sport. The best way to accomplish this goal is to get proper joint rest, use correct form while playing and avoid increasing workout intensity more than 10 percent weekly. Never ignore joint pain, as prompt treatment can greatly reduce the length of recovery in most cases.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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