One wrong step can change an entire tennis match. Take Elena Rybakina’s example, who had to stop during her quarterfinal against Iga Swiatek at the 2026 Cincinnati Open after a left ankle injury flared up. Unable to continue, she retired from the match, sending Swiatek into the last four and leaving her own US Open preparations in doubt.
Rybakina’s withdrawal is a reminder of how quickly the physical demands of tennis can affect a player’s ability to continue. Tennis repeatedly requires players to generate power, move quickly across the court, and control sudden changes in direction. These demands will be on display at the 2026 Singapore Tennis Open, where headline players such as Jessica Pegula, Mirra Andreeva, and Amanda Anisimova will compete at pace across the court.
While recreational players might not experience the same intensity, they still rely on many of the same movement patterns. As these actions place different stresses on the body, injuries can happen suddenly during a single incident or develop gradually through repeated loading over time.
How Do Tennis Movements Put Stress on Your Body?
Different movements in tennis place different demands on the body. Serving and striking involve the whole body, with force generated and transferred through the body into the racquet while placing substantial demand on the shoulder, elbow, and wrist. By comparison, sprinting, stopping, pivoting, and lunging place more of the workload through the hips, knees, ankles, and feet. As players shift between these actions, different muscles, joints, and tendons work together to produce movement, maintain stability, and absorb force.
Here’s how some of the key movements in tennis affect your body:
- Serving – Places significant stress on the shoulder, elbow, and wrist through repeated overhead movement and forceful acceleration.
- Repeated strokes – Can strain the forearm, elbow, and wrist through frequent gripping, swinging, and racquet control.
- Sprinting – Increases the workload on the hips, knees, ankles, and feet as you accelerate across the court.
- Sudden stops – Require the hips, knees, and ankles to absorb force as you decelerate and bring your body under control.
- Pivoting – Calls on the hips, knees, and ankles to manage rotational forces and maintain stability as you redirect your body.
- Lunging – Loads the hips, knees, and ankles as you extend to reach difficult shots.
- Push off and landing – Transfers force through the ankles and feet as you propel yourself towards the ball and regain your footing.
Your body can usually accommodate these demands during play. But tennis can also leave little time to adjust when a movement doesn’t go as planned, such as an awkward landing or an unexpected shift in direction. In those moments, the force placed on a muscle, tendon, ligament, or joint can exceed what it can tolerate, which is why some injuries can happen suddenly.
What Happens When There’s a Sudden Injury During a Tennis Game?
When one of these movements goes wrong, there’s often a clear moment when you notice it. You might plant your foot and feel your ankle roll, or change direction and feel a sharp pull in your thigh. These are examples of acute injuries. Despite the name, this isn’t an “Aww, that’s an adorable little bump you’ve got there” situation. In sports medicine, an acute injury usually refers to one that happens during a specific incident or movement.
What follows depends on the structure involved. A ligament might be sprained or torn, including a knee ligament such as the anterior cruciate ligament (ACL), while a muscle or tendon might be strained. Pain might be felt straight away, followed by swelling, weakness, reduced movement, or an inability to continue playing. However, not every problem follows this pattern. Some develop without a single incident, becoming more noticeable as repeated stress builds over time.
Why Does Pain Sometimes Build Up Gradually When Playing Tennis?
Overuse injuries can develop when the same musculoskeletal structures are loaded repeatedly across tennis games and training. At first, discomfort might settle once you stop playing. However, as the problem develops, you might feel sore the following morning or notice the symptoms returning sooner during your next session. How much and how often you play can contribute, while technique, fatigue, recovery, and the way force moves through the body might also influence where problems arise.
Depending on where those repeated demands are concentrated, some examples include:
- Rotator cuff related shoulder problems – Repeated serving and overhead shots can place sustained demands on the shoulder.
- Tennis elbow – Repeated racquet strokes and gripping can aggravate pain around the outer elbow.
- Wrist tendinopathy – Frequent gripping, striking, and racquet control can repeatedly load the tendons around the wrist.
- Lower back problems – Repeated rotation and extension during serves and groundstrokes can place added stress on the lower back.
- Hip related problems – Lunging, reaching for wide shots, and frequent changes in direction can repeatedly load the muscles and tendons around the hip.
- Patellar tendinopathy – Repeated loading through the knee during acceleration, stopping, and court movement can contribute to pain around the patellar tendon.
- Achilles tendon problems – Frequent push offs and rapid movement around the court can repeatedly load the Achilles tendon.
Do note that not every problem that becomes painful during tennis develops from repeated loading alone. Existing foot conditions such as bunions can also become more symptomatic during play, particularly with repeated push offs, changes in direction, and pressure from footwear around the forefoot.
Whether the problem has developed gradually through repeated loading or an existing condition is becoming more troublesome, the way your symptoms change over time can be important. If discomfort takes longer to settle, becomes more persistent, or starts affecting movement away from the court, it’s worth having the problem assessed by an orthopaedic specialist at a centre experienced in sports injuries, where further investigation can be considered if needed.
Unsure What You Might Have Injured While Playing Tennis?
It can be frustrating when pain after a tennis game doesn’t go away, especially when you aren’t sure whether it started during one particular moment on court or gradually became more noticeable as you kept playing. When the cause isn’t obvious and the discomfort continues, an assessment can help clarify what might be going on.
At Oxford Orthopaedics, this begins with a review of how the problem started and a physical examination of the affected area. Where further investigation is indicated, advanced imaging is used to help identify the structures involved and determine the extent of the injury. With a clearer diagnosis, our orthopaedic specialists can advise on the treatment approach best suited to the problem and guide your return to tennis. If the pain is still getting in the way of daily movement or impeding your return to the court, please contact the clinic to book an appointment.
