5 Tennis Tips (For When You Have Back Pain)

Back pain doesn't have to mean "game, set, match" for your tennis playing days.

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Unlike endurance running or elite weightlifting, tennis is comparatively a leisurely sport that can be enjoyed by people of all ages. If you’re new to playing tennis, you should know that it will still require you to be fairly light on your feet with quick, and oftentimes, twisting movements.

Men playing tennis without back painDoes tennis serve up some back pain for you? Here are some tips to enjoy the game with less pain.

If you’re already struggling with back pain, you may find it difficult to play tennis at times. According to one 1988 study, 38% of tennis players surveyed missed at least one tournament due to low back problems. In a 2016 study, experts concluded that tennis players with low back pain can’t move their muscles as easily as those without back pain.

You might be wondering: does tennis cause back pain? How does one get in a good tennis match with existing or chronic back pain? Cordelia W. Carter, MD, Director of the Women’s Sports Health Center at NYU Langone Health is here to cover these questions and more.

1. Know the Risks

Like any sport, tennis is not without its risks when it comes to back pain. Some of the aspects of tennis that might worsen back pain are repetitive motions and what Dr. Carter calls “asymmetric distribution of force,” which means all that power you put behind your serves and volleys isn’t evenly dispersed in the body.

“This has the potential to cause strains and sprains that are painful, but not necessarily dangerous,” Dr. Carter says. She adds that one injury sports medicine physicians worry about in particular is the kick serve, when a player hits the ball upward toward a point high above the net. This repeatedly puts a hyperextension force through the spine. 

“As a result, overuse injuries including stress fractures of the spine, known as spondylolysis, may result,” Dr. Carter cautions.

But since it’s an aerobic activity, Dr. Carter says that there are also gains to be had when playing tennis.

She says, “Being physically active is essential for both mental and physical wellness. The hormones released with exercise and physical activity may help mitigate musculoskeletal pain as well as any negative emotions like depression and anxiety that may result from experiencing pain. Don’t avoid activity altogether.”

2. Do Some Prep Work

If you’re new to tennis and you don’t want to further injure your back, you can take some precautions. Think of it as “pre-hab.”

This includes:

  • Working on endurance and strengthening your core muscles in ways that don’t aggravate your back
  • Easing into tennis by not playing for extended periods when starting or for multiple days in a row
  • Gradually increasing duration, frequency, and intensity

“Additionally, focus on proper skill acquisition rather than trying to generate too much force/power as you’re beginning,” Dr. Carter advises. “Trying to ‘kill’ the ball has likely resulted in at least one rotator cuff injury.”

3. Focus on Specific Exercises  

Dr. Carter says that it’s important to maintain an off-court fitness regimen that focuses on core and “peripelvic strengthening,” which includes movements such as planks, side planks, bridges, and clamshells.

Woman keeping core strong to play tennis without back painKeep your core strong to stay on your game.

“Prevention is key,” she says. “Warm up gradually prior to play and maintain good hydration during and after.”

4. Pay Attention to Your Body

Although it’s easy to get your head in the game when playing tennis, it’s essential to still be mindful of your body and its needs.

“During a game, paying attention to heat and humidity and ensuring adequate rest and hydration is probably most important for overall health and for preventing muscle cramping,” Dr. Carter says. “Also, checking in with your body and taking a break to stretch if pain symptoms are starting up is important rather than ‘playing through the pain’ and ending up with a bigger problem later.”

Additionally, it’s beneficial to pay close attention to your form, something that can improve with the help of a tennis instructor. Also, know that implementing modifications is perfectly acceptable if you want to avoid worsened back pain. Dr. Carter says that a couple modifications could be “moving your feet around the ball to avoid a backhand if that is painful or simplifying your serve.”              

5. Cool Down and Address Pain

After your match, Dr. Carter emphasizes hydrating and cooling down, which can include a bit of walking or swimming, two things that are better than sitting down and allow the musculoskeletal system to gradually recover.  

Also, be sure to do some spinal exercises afterwards, like cat/cow poses.

Lastly, Dr. Carter says that anti-inflammatory medications, such as ibuprofen or naproxen, may be helpful for alleviating mild pain. Applying an anti-inflammatory cream or gel, like Voltaren or arnica, can help as well.

Should You Play Tennis?

As stated by Dr. Carter, there are some people who shouldn’t play tennis. They include the following conditions:

  • Active bony injury (fracture/ stress fracture)
  • Spinal instability (diagnosis of spondylolisthesis), unless cleared by your doctor
  • Acute disc herniation
  • Acute postoperative setting from spine surgery
  • Spinal condition involving nerves and/or the spinal cord (i.e., significant numbness or weakness in the legs or feet that might cause another injury)

Be sure to speak with your doctor before adding some tennis matches to your schedule, but as Dr. Carter says, generally, the majority of tennis-related back pain is the result of strains and sprains that are uncomfortable, but not dangerous.

“If you’re thinking about it, get out and play,” Dr. Carter affirms. 

Updated on: 07/13/21
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