Tennis Injuries & The Kinetic Chain

Do you have nagging or recurring injuries that seem to not go away? Tennis elbow, shoulder pain from Rotator Cuff Tendinitis or Impingement Syndrome, low back strains and hip pain are among the most common injuries in tennis players. Injuries can happen because you are training way too much, you are not preparing or recovering properly for tennis, or because you have weaknesses or “weak links” in your kinetic chain that cause undo stress on your body, specifically your elbow and shoulder. Tennis players can develop weak links and imbalances in flexibility, strength, and mobility, which can adversely affect tennis performance.

Overuse Injuries and the Kinetic Chain in Tennis

Approximately 50% of tennis injuries are caused by overuse. Once an injury or pain occurs and if not adequately rehabbed, weaknesses or “weak links” can persist within the body’s kinetic chain. The kinetic chain is a combination of successively arranged joints that create a coordinated movement. For example, in the tennis serve, there is a loading phase where you must bend your knees, which allows your hips and trunk to counter-rotate. The loading phase allows you to absorb the ground reaction forces (GRFs) and to store much needed kinetic energy that you will use to propel yourself up to strike the ball. During the cocking and acceleration phases of the tennis serve, the kinetic energy is released, it is transferred from the ground into your feet, through your knees, into the hips and spine, up the shoulder and out the racket so you can strike the ball. Remember that song, “your hip bone is connected to your knee bone, the knee bone is connected to your ankle bone.” Well, it’s true! The best way to maximize power and minimize load to your muscles and joints is through efficient use of the kinetic chain. Research in sports and tennis medicine suggests that assessing and correcting the muscular asymmetries in your kinetic chain may reduce the risk of tennis related injuries, like tennis elbow.

Weak Links in The Kinetic Chain Can Cause Injury & Pain

Weak links are inevitable in tennis because it is an asymmetrical sport. It is common that injuries or pain that you are dealing with may be a result of deficits within the kinetic chain that may be above or below the actual location of your pain or injury. Over 50% of the power you generate in your tennis serve comes from your core and lower extremities (abdominals, gluteals, low back muscles). So, it is common that we find weaknesses in the core and in the scapular stabilizers (the muscles around your shoulder blade). If your core and trunk muscles are not strong enough, you will not be able to transfer ground reaction forces up the kinetic chain, which will decrease racket and ball speed. So, in order to generate the same amount of force and ball speed in the presence of weak links in the trunk, core, and hips, you will inevitably overuse some other part of the body, often the low back, shoulder, and elbow causing strains, tendinitis, and tears. It’s what I refer to as “muscling the ball”.  You are overusing your arm rather than using your legs and core to help you push the ball. So, if you are struggling with shoulder pain or tennis elbow, likely you have some hidden weak links in your musculoskeletal system that are actually limiting you and are the cause of your pain.

How Do We Assess For Weak Links?

Neurac Weak Link Testing utilizes The Redcord Suspension for the examination and treatment of neuromuscular weak links. Redcord is unique because you exercise while suspended in ropes and bungee cords. Studies have shown that injury, pain and inactivity disturb our brain’s capacity to switch on the right muscles at the right time and with the right amount of strength. This loss of neuromuscular function diminishes our “local” muscle control, often leading to decreased quality of movement and increased musculoskeletal pain causing our “global” muscles to take over (compensate) and eventually become stressed, strained and painful. The Neurac Method is an active, pain-free treatment through which high levels of neuromuscular stimulation restores functional movement patterns. The treatment method helps reactivate your muscles and focuses on changing the way the brain and muscles communicate. By using Redcord and The Neurac Method, you will experience a decrease in pain and improved function in less time than conventional treatment methods.

Sports Physical Therapists Can Help

Physical Therapists with knowledge of tennis can assess and correct weaknesses in the kinetic chain and can educate you on proper tennis dynamic warm-up and cool-down, proper on-court mechanics, and recovery strategies to effectively treat pain and injuries, minimize future injuries, and enhance your performance lengthening your tennis career. Weak Link Testing should be an integral component of the physical therapy evaluation of any tennis player. If you are having elbow, shoulder, or back pain, or simply want to improve your flexibility, joint and spinal mobility, and just perform better, contact Dr. Baudo Marchetti to help get you back on the court.

Dr. Melissa Baudo Marchetti, PT, DPT, SCS, MTC is a Board Certified Sports Clinical Specialist at One on One Physical Therapy, a multidisciplinary private practice in Atlanta, GA. For nearly 5 years she was a full-time Sports Physical Therapist for the WTA Tour and is a Tennis Medicine Expert. She teaches a Sports PT Course and assists in teaching Orthopedics within the Division of Physical Therapy at Emory University. Dr. Baudo Marchetti’s email address is Learn more by visiting