Osteopathy adds a holistic, hands-on approach to healing tennis injuries

Many tennis injuries result from load transfer problems rather than local tissue failure.  For example, tennis elbow is often linked to poor shoulder control, thoracic stiffness or grip overload.  Rotator cuff pain can also be driven by poor scapular mechanics or rib/thoracic restrictions. 

Tennis injuries are multi-factorial:

A 2025 systematic review on tennis-serve injury risk factors identified a large set of associations (technique/biomechanics, physical qualities, load-related factors) linked to injury risk in tennis players.  This suggests that technique and load capacity have a much higher impact than simply local tissue failure. 

Osteopathy’s whole-body assessment fits perfectly with tennis biomechanics because it:

•  Screens joints above and below the injury

•  Looks at movement efficiency

• Assesses load distribution through the kinetic chain

• Identifies compensations & muscle imbalances early

Osteopathy bridges hands-on care with active rehab.  Instead of focusing only on passive treatment or only exercise prescription, Osteopathy sits in the middle.  Osteopathy does this by restoring movement manually, reinforcing it with exercise rehab and integrating the treatment plans into sport-specific loading.

What this may look like for tennis players:

1. Treat → then retrain serve mechanics
2. Improve thoracic rotation → then integrate into forehand drills
3. Reduce elbow load → then rebuild forearm capacity

Tennis brings on a wide range of demands to the body including: thoracic rotation, shoulder external rotation, scapular control, wrist/forearm load tolerance, hip rotation and power transfer.  Osteopathy can add value by addressing these demands through joint mobilisations and manipulation techniques to restore range of motion.  Soft tissue work to reduce overload patterns and specifically assess and treat hip dysfunctions to improve transfer power. 

When tennis demands gradually increase, fatigue increases and changes movement.  Tennis injuries often don’t happen in the first set, they happen when fatigue builds up and allows for compensation to occur.  As fatigue starts to impact players, they show reduced trunk rotation, raise their arm higher on serves, exhibit less knee flexion in their stances and strokes become more arm dominant. 

Osteopathy is not only valuable for assessing and treating injuries in tennis players but also helps with match durability.  Osteopaths address fatigue by restoring efficiency so less energy is wasted and they improve joint motion, so technique holds longer.

An important role for Osteopaths in tennis is to apply treatments and rehab with a preventative approach.  Tennis injuries have a high recurrence rate, as they involve repetitive strokes, asymmetrical loading and frequent technique faults, especially amongst amateurs.  Osteopaths approach these issues by detecting early overloading patterns, aiming to maintain joint mobility throughout the year, managing spiking variations with load and addressing compensations before they become symptomatic issues.

Visit one of our Ace Certified Osteopaths today for a whole-body overview to proactively get your body in the best shape to perform on the tennis court.

By Dr Katie Murray – Osteopath, Ace Sports Clinic