From Court to Laboratory: Tennis-Specific Research 2025
- STMS
- 11 hours ago
- 4 min read
In this issue of Sports Health (in collaboration with the Society for Tennis Medicine and Science [STMS]), we are very pleased to offer a subset of tennis-specific research from a multidisciplinary perspective. Tennis - a unique sport played on 4 primary surfaces worldwide - is one of the most demanding sports technically, physically, and mentally; taken together, this creates very specific, repetitive, whole-body demands that result in both characteristic musculoskeletal adaptations and injury patterns.1-3 For perspective, on average, each point in tennis involves 4.2 directional changes and players traveling <6 meters in 80% of shots involving the lower body.4 In addition, each point is initiated by an overhead service motion that creates posterior shoulder eccentric loading, with concomitant valgus loading at the elbow.5
While all the tennis-specific articles featured in this special issue have extreme relevance for elite-level sports medicine and sports science application to optimized care of tennis players, the purpose of this editorial is to call attention to several of these articles, and emphasize their importance. Few topics are as important in sports medicine today as the art and science of clinical decision making for return to sport.6 This is understandably an elemental, yet truly complex, question, and an expectation that all athletes have when recovering from an injury. The 2 papers highlighting upper extremity performance tests, by Cools et al and Stubbe et al, present high-level population-specific descriptive information that can be used by clinicians during this critical stage of return-to-sport testing and decision making.
Another parameter that becomes important when playing a sport that demands a lot of travel, sometimes across time zones, is sleep. The paper by Maynard et al highlights the stressors involved in the international and global characteristics of high-level competitive tennis play, and their effect on sleep - this most important of recovery metrics. Their study, using wearable technology, provides a much-needed addition to the tennis-specific literature on this important and relevant topic.
Several papers in this issue provide important information about the high numbers of recreational tennis players who train and compete at many levels. The study by Render et al provides insight into the Tennis 10+ program, which is similar to the warm-up protocols used in soccer (European football), and its effect and application in tennis. This has widespread application for both injury prevention and performance enhancement.
The paper by Tan et al provides exceptional clarification on diagnostic imaging techniques for lateral humeral epicondylitis. More commonly referred to as tennis elbow, lateral epicondylitis is most common in recreational tennis players, and results from overload imparted to the extensor muscles of the forearm, often from improper kinetic chain mechanics and force generation.
The adolescent player is of huge interest in many aspects. Thurber et al provide insight into early specialization - one of the biggest challenges we face in tennis, being a sport that demands a lot of repetition at an early age. The need for guidelines to support a sound coaching strategy is crucial, and this paper gives us specific volumes of training and competition load to keep the young player safe. Furthermore, Johansson et al provide, to some extent, new insights into the challenge that well-trained and stronger adolescent players may not always be protected from shoulder injury/complaint as load increases with more powerful action.
As tennis evolves, research must follow and, in the paper by Robin et al, the combination of motor imagery before the serve action and breathing during the movement to increase performance was investigated. This information is of huge interest as the serve is arguably one of the most important shots in tennis.
Noncompleted matches, such as walkovers and defaults, in professional Women’s tennis are investigated in the article by Peña et al. Understanding the epidemiology of noncompleted matches is essential for optimizing competition structure and injury-prevention strategies.
In summary, this issue of Sports Health in collaboration with the STMS highlights some of the important topics that tennis faces but also underpins the need for more in-depth research on tennis medicine and science. If we, as researchers, can have an impact on the tennis environment, then the likelihood of a sustainable career of the player is increased, benefiting all stakeholders involved.
—Fredrik Johansson, PhD*
School of Sports Sciences and Health, Sophiahemmet University, Stockholm, Sweden
—Todd S. Ellenbecker, DPT, MS, OCS, CSCS, FAPTA
Banner Sports Medicine, Scottsdale, Arizona, ATP Medical Services, Scottsdale, Arizona
Competing Interests
The authors report no potential conflicts of interest in the development and publication of this article.
The authors and editorial team would like to thank the Society for Tennis Medicine and Science for their collaboration in bringing together this focus section that supports the health and performance of all tennis players worldwide.
ORCID iD
Fredrik Johansson https://orcid.org/0009-0007-3909-7160
References
1. Ellenbecker TS, Windler G, Dines D, Pluim B, Renstrom P. Updated musculoskeletal screening results of male professional tennis players. Aspetar Sports Med J. 2024;13:308-314.
2. Pluim BM, Staal JB, Windler GE, Jayanthi N. Tennis injuries: occurrence, aetiology, and prevention. Br J Sports Med. 2006;40(5):415-423. 16632572; PMCID: PMC2577485.
3. Dines JS, Bedi A, Williams PN, et al. Tennis injuries: epidemiology, pathophysiology, and treatment. J Am Acad Orthop Surg. 2015;23(3):181-189. 25667400.
4. Armstrong C, Peeling P, Murphy A, Reid M. Navigating the court: a comparison of distance demands between sexes in grand slam tennis. J Sports Sci Med. 2024;23(1):1-7.
5. Roetert P, Groppel JL. World Class Tennis Technique. Champaign IL: Human Kinetics; 2001.
6. Shrier I. Strategic assessment of risk and risk tolerance (StARRT) framework for return-to-play decision-making. Br J Sports Med. 2015;49(20):1311-1315.