Sheldon Simon, MD, Professor of Orthopedics at the Icahn School of Medicine at Mount Sinai

Injuries continue to be a big issue in tennis, as shown most recently by the surprising number of top players who were forced to withdraw from the year’s first major, the Australian Open. Some parents whose kids are just learning the game may be wondering about the chances an injury could sideline their child.

Sheldon Simon, MD, Professor of Orthopedics at the Icahn School of Medicine at Mount Sinai, offers some suggestions about being on the lookout for minor problems before they turn into major problems. Mount Sinai Health System is the official medical services provider of the United States Tennis Association (USTA) Eastern Section and the US Open.

We’ve all seen those young superstars, the ones smashing the ball with a racquet that seems almost bigger than they are and who seem completely comfortable on the court. That’s by far the exception rather than the rule.

Most young tennis players have a lot to learn, and they are still growing and gaining strength, which means they are especially susceptible to injuries, in particular those caused by overuse. Also, more and more kids are specializing in one sport at an early age, which means far less cross-training and more stress on specific areas of the body.

One of the unique things about tennis is how much you repeatedly use some of the more vulnerable parts of your body, notably your wrist, elbow, and shoulder. It’s not hard to develop an irritation at these critical points, especially if you’re still learning a complex technique, and when being just slightly off can mean the difference between a clean stroke and an off-center hit that causes plenty of vibration and stress.

Those repetitive strains can lead to wrist sprains and a form of tendonitis better known as tennis elbow. In more severe cases, this can lead to stress fractures. Stress fractures are tiny cracks in the bone caused by repetitive motion or overuse. Stress fractures may cause a persistent pain that may seem like a sprain but that can persist for as much as eight to ten weeks. In cases like this, it’s best to see a doctor; your child may need a cast for the injury to heal properly.

In this regard, tennis is very different from other non-contact sports like basketball and baseball, which place very different demands on a young body. The racquet that allows young players to apply quite a force to the ball can also magnify the impact of that force on the weakest links in the body if the ball is not struck properly.

Young people learning tennis may also be more likely to get injured because they don’t yet have the feel for the game, which can leave them lunging around the court, resulting in sideways movements that can lead to twisting of the ankle and ankle sprains.

What’s more, adults and experienced players generally know when to call it quits. Not so with some young kids. The most important thing for anyone to do if they are experiencing pain on the tennis court is to stop and listen to their body when it says they’ve had enough. Young people, though, can be pretty stubborn—especially if they are trying to keep up with other kids who may have had lots more instruction and practice—and they may end up straining themselves.

Parents need to be aware if their young star is having some pain or stiffness, and then reduce the amount of play until the problem begins to recede. At this early stage, I don’t suggest much in the way of medication; ice afterwards is best. Once they are ready to return to playing, try reducing the time of play and gradually increase it day by day. If the discomfort doesn’t go away in a few days, you may want to talk with your doctor.

Even if your child isn’t planning to play college tennis and turn pro, tennis is terrific exercise and a great lifetime sport. So make sure your young players don’t overdo it, and if they do once in a while, be sure to take a break and talk with your doctor if the problems don’t go away quickly.

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