Tennis Knee Workout

Mahalo to Connor Hyde, DPT from Jaco Rehab for sharing this article with us.

Joint health is critical to any individual, especially athletes and tennis players. The average tennis player will sprint, slide and shuffle over 3 miles in the course of 2 sets. For more competitive players this number may be even higher, and for those of us who choose to “wave off” our opponents’ drop shots, we will probably see this number dip. Either way, while we are on the court our knees take a beating, which is why it is important to build up strong thigh and hip muscles to ensure healthy knee joints throughout our playing career. 

What is the Knee?

The knee works primarily as a hinge joint with a small degree of rotation involved. The motion is primarily affected by muscles involving the thigh, hips, and lower leg. Inside the knee are stabilizing ligaments and a rubbery cartilage called the meniscus which acts as a shock absorber for where the shinbone and thighbone meet. In front is the kneecap, which helps the thigh muscles gain leverage when extending the leg.  

Function of the Knee

The knee plays an important role in supporting the body in an upright position. It helps to lower and raise the torso, provides stability, shock absorption, and propels the body forward. The generation of force production in tennis begins at the knee and is translated upward. Proper knee positioning while playing tennis has significant effects on the body’s center of gravity, core body work and trunk rotations, which affect racket swing speed. 

Common Knee Issues

Tennis is a demanding sport with repetitive and sharp movements in all directions. Most knee injuries are an indirect result of these stresses and overuse. One study found that peak forces exceed 4.2 times a person's bodyweight during serves and forehand shots. This can lead to injuries such as:

  • Patellar Tendinopathy (Jumpers knee): Overuse to the tendon underneath the kneecap causing pain with knee bending such as jumping or walking downstairs. The pain is caused by microscopic tears in the tendon and the concurrent inflammation may lead to swelling under the kneecap. 

  • Patella-femoral pain: Pain in the front of the knee and in and around the kneecap typically caused from increased friction underneath the kneecap. Defined as an overuse injury it may also be contributed to improper tracking of the kneecap, cartilage damage and weakness and stiffness of surrounding muscles. 

  • Meniscal injuries: Typically caused by forcefully twisting or rotating the knee while the foot is planted. Many people have small meniscus tears and and have no symptoms which requires no immediate treatment. Symptoms of a significant meniscal tear includes joint line swelling, popping sensations, pain twisting, unable to straighten knee or your leg feels locked it may be time to see you local Doctor or PT. 

  • Arthritis: The most common arthritis I see is osteoarthritis (OA) that occurs after middle age. This is a progressive condition that slowly wears away at the joint cartilage and affects over 12% Americans. Symptoms include periodic inflammation, red and warm skin, morning pain and stiffness and swelling. It is best to get ahead of this injury with proper rehabilitation and “pre-habilitation.”

Dealing with Knee Pain

Knee pain is something that thousands of people deal with daily. Many times we can have non-specific knee pain develop without any traumatic incident which our bodies do an amazing job healing on its own. However, if you have had chronic knee pain or are dealing with pain that is limiting you in your daily living or holding you back on your goals, it is best to see a professional. Here at Jaco we are able to provide a progressive overload of muscles and joints in order to specifically adapt imposed demands that will increase your body’s strength and resilience 

Importance of Strength

Strengthening for rehab or to build strong knees for injury prevention can look very different depending on the individual. When addressing the knees it is important to not only strengthen the thigh muscles but also to strengthen the hips and hamstrings. Strong hip muscles help to stabilize the knees and allow for proper tracking of the kneecap. In this video is a series of moderate level exercises to perform on court with no equipment (besides a bench) required. These exercises target each muscle above your knee and will lead to stronger and healthier joints. You can’t go wrong getting strong!

On Court Exercises: 

Perform all for 8-15 repetitions for 2-3 rounds. The goal is to feel muscle fatigue by the end of your repetitions. 

  1. Bulgarian split squats

    • Elevate your back leg with your front foot inline with your knee about a yard in front. Slowly lower your body to the ground while keeping your front knee stable. 

  2. Single leg box squats

    • Stand on one foot with your opposite leg a few inches off the ground. Use your arms in front as counter balance. Keeping your hips level slowly lower your body to the bench while keeping your knee stable. Stand back up using one or both of your legs. 

  3. Single leg hip thrust

    • Lay with the bench just under your shoulder blades. Raise one leg with the opposite leg planted on the ground making about a 90° angle. Keep your chin tucked and eyes looking to your chest. Elevate your hips by squeezing your glutes until your body is parallel to the ground. 

  4. Single leg RDL

    1. On your plated foot start with knee slightly unlocked. Keep your back straight and slowly hinge at the hips while keeping them level. Let your arms drop to the bench until you feel a pull in your hamstring. Slowly raise back to starting position

  5. Side-lying hip abduction

    • On your side, allow you top leg to lower straight to the ground. Make sure to keep your torso, hip and knee all in one straight line. Bring you leg back up as high as you can without rotating your pelvis. Performing this on the bench allows for increased range of motion to work the lateral hip muscles more.

  6. Squat jumps

    • Since tennis is such a dynamic sport I like to mix in explosive movements to strength training. Squats jumps are a great tool to work on power and force. With feet shoulder width apart lower into a squat. Next explode into the air making sure you full extend your knees. As you land, dip into a squat as you recoil for the next jump. 


About the Author:

Connor is a New Hampshire native and state champion tennis player with over 20 years of experience playing and teaching tennis. A college tennis player at University of Redlands, he now resides in Honolulu and practices physical therapy at JACO Rehab.

For any questions or if you have an injury you want evaluated, please visit jacorehab.com or email them at info@jacorehab.com.


References

D'Lima, Darryl D, et al. “Knee Joint Forces: Prediction, Measurement, and Significance.” Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine, U.S. National Library of Medicine, Feb. 2012, www.ncbi.nlm.nih.gov/pmc/articles/PMC3324308/.

Fu, Michael C, et al. “Epidemiology of Injuries in Tennis Players.” Current Reviews in Musculoskeletal Medicine, Springer US, Mar. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC5825333/.

Perry, Arlette C, et al. “Can Laboratory-Based Tennis Profiles Predict Field Tests of Tennis Performance?” Journal of Strength and Conditioning Research, U.S. National Library of Medicine, Feb. 2004, www.ncbi.nlm.nih.gov/pubmed/14971970.

Reason, Leigh. “The Average Running Distance of a Tennis Player.” Chron.com, 9 Nov. 2016, livehealthy.chron.com/average-running-distance-tennis-player-5441.html.

Christine Nip