There was a high absolute risk (12.9%) of stress fractures in elite tennis players over a two year period. Junior players were at highest risk. The lesions are a major cause of disruption both of training and of competition. Risk factors should therefore be identified and prevention emphasised.

Rectus abdominis muscle strains are common and debilitating injuries among competitive tennis players. Eccentric overload, followed by forced contraction of the non-dominant rectus abdominis during the cocking phase of the service motion is the accepted injury mechanism. A tennis-specific rehabilitation program emphasising eccentrics and plyometric strengthening of the abdominal wall muscles, contributes to the complete functional recovery in tennis players, and could help reduce recurrences.

Background: High demands imposed to the shoulder during tennis activity can decrease the efficiency of static and dynamic constraints. Subtle or frank instability of the glenohumeral joint may occur, and long term degenerative changes may be expected. Objective: To determine and compare the prevalence of primary glenohumeral osteoarthritis in senior tennis players and matched controls. Study design: Cross sectional controlled study. Methods: 18 asymptomatic senior tennis players were studied (17 male; mean (SD) age, 57.2 (8.8) years) with no history of shoulder surgery or major trauma. There were 18 matched controls. Radiographs were used to determine glenohumeral osteoarthritic changes: joint space narrowing, humeral and glenoid subchondral sclerosis, humeral and glenoid juxta-articular cysts, osteophytes, humeral and glenoid flattening, humeral posterior displacement and glenoid posterior erosion. Findings were classified as normal, minimal, moderate, or severe changes. Results: 33% of the players (95% confidence interval (CI), 13% to 59%) had osteoarthritic changes in their dominant shoulder (n = 6; five with minimal changes, one with moderate changes), and 11% of the controls (95% CI, 1% to 34%) had articular degeneration on their dominant side (n = 2; both minimal changes) (p = 0.04, Wilcoxon test). The osteoarthritic group was significantly older than the players without degenerative changes (p = 0.008). Conclusions: The prevalence of glenohumeral osteoarthritis in the dominant shoulder was greater in former elite tennis players than in sedentary controls. Prolonged intensive tennis practice may be a predisposing factor for the development of mild degenerative articular changes in the dominant shoulder.

The case of a strain injury of the internal oblique abdominal muscle in a professional tennis player is presented. This uncommon lesion resulted from eccentric, unbalanced trunk rotation. Magnetic resonance imaging helped to confirm the diagnosis. Tennis specific core strengthening is crucial for rehabilitation and recurrence prevention.

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