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Racquet sports — such as tennis, pickleball, squash, racquetball, and badminton — help young athletes develop fitness, agility, coordination, and mental focus. Each sport varies in court size, racquet design, and pace, offering unique physical and strategic challenges. For instance, tennis builds endurance and powerful strokes on a large court, while squash demands quick reflexes and sharp movement in a smaller space.

Starting racquet sports early promotes cardiovascular health, strength, and hand-eye coordination, while also enhancing concentration and decision-making skills. Beyond physical benefits, these sports foster sportsmanship and social connections through clubs and competition, encouraging long-term engagement.

As with any sport, racquet sports come with some risk of injury. Fortunately, by taking precautions — choosing the right equipment, staying physically fit, and warming up and cooling down before and after playing — you can enjoy the many benefits of these sports while avoiding injury.

What are the most common injuries in tennis, pickleball, and other racquet sports?

Most racquet sports injuries are overuse injuries caused by overtraining. Improper technique can also put athletes at risk of injury. Fortunately, most of these injuries can be addressed with ice, rest, proper technique, and improved conditioning.

How do kids, teens, and young adults get injured playing racquet sports?

  • Overuse injuries: Playing too much too soon, without gradually building strength and endurance, puts excessive strain on muscles and joints.
  • Sudden movements: Abrupt changes in direction can cause ankle and lower leg injuries.
  • Shoulder strain: Overhead serves in tennis may strain the muscles around the shoulder.
  • Improper racquet grip: Using a racquet grip that’s too large or too small can lead to wrist or elbow injuries.
  • Hard playing surfaces: Playing on surfaces like asphalt increases the risk of back injuries due to impact and lack of shock absorption.
  • Collisions: In sports where players are in close proximity — such as pickleball, squash, and racquetball — there is a higher risk of facial injuries from being struck by a ball or another player’s racquet.

Tennis elbow: One of the most common injuries in racquet sports

Tennis elbow is an overuse injury of the forearm muscles on the outside of the elbow. These muscles are the reason you can extend your wrist or bend it backward, and you use them every time a ball hits your racquet. Improper technique — particularly the one-handed backhand — is a leading cause of tennis elbow. Using a racket with the wrong grip size can also contribute to tennis elbow.

Strengthening the muscles in the forearm, along with a regular warm-up routine, can decrease the risk of tennis elbow. Reducing stroke speed, using your legs, and meeting the ball in front can also help. Treatment for tennis elbow often includes rest, anti-inflammatory drugs (ibuprofen), and wearing a brace on the forearm. More serious tennis elbow injuries may require physical therapy or surgery.

How can you prevent tennis and racquet sport injuries?

  • Conditioning: Strong core muscles, shoulders, and legs can stabilize your joints and support strong volleys.
  • Proper technique: Practicing good form with the help of a coach not only reduces the risk of injury, it can improve your game.
  • Equipment
    • Racquet: Ensure your racquet matches your needs by selecting the right weight, a grip size comfortable for your hand, and string tension that helps reduce stress on your elbows and shoulders.
    • Footwear: Use shoes made specifically for racquet sports. They should offer strong heel support, stabilize your ankles to prevent rolling, and limit excessive side-to-side movement. Also, pick shoes that are designed for the surface you play on, for instance, indoor court shoes aren’t suitable for outdoor asphalt or clay courts.
    • Eye protection: Wearing protective goggles is essential to guard against eye and facial injuries, especially in fast-paced sports like squash and racquetball.
  • The court
    • On outdoor courts, check for cracks or holes that might cause you to trip.
    • Clear away loose balls and other objects from the court and the area around it.
    • If playing outdoors at night or anytime you play indoors, be sure the court is well lit.
    • Mop up wet spots to avoid slips and falls.
  • Warm up and cool down
    • Try jumping jacks or running in place for five to 10 minutes to get the blood flowing.
    • Stretch your arms, wrists, shoulders, and legs. Hold each stretch for at least 30 seconds.
    • Cool down with light stretches to help your body recover.

How we care for tennis and racquet sports injuries at Boston Children’s Hospital

As the largest and most experienced pediatric and young adult sports medicine practice in the country, the Sports Medicine Division at Boston Children's combines personalized care with innovative treatment for each athlete we treat.

Our Sports Medicine team consists of sports medicine physicians, orthopedic surgeons, physical therapists, podiatrists, athletic trainers, sports psychologists, dietitians, and many others who collaborate in every aspect of our patients’ care and their recovery.

The Micheli Center for Sports Injury Prevention, part of Boston Children’s Sports Medicine Division, offers private training, return-to-sport training, ACL injury prevention classes, and an ACL Return-to-Play program.