Home - Health and Nutrition - Back Pain on Young Tennis Players. Lower Back Pain, (Spondylolysis): causes, prevention and treatment. PART I

Back Pain on Young Tennis Players. Lower Back Pain, (Spondylolysis): causes, prevention and treatment. PART I

Posted on September 11, 2014 in Health and Nutrition


Back pain is one of the most common injuries in sports, including tennis. Young tennis players have a higher risk of lower back pain or structural injury compared with other athletes from the same age. Some studies that correlate back pain and tennis suggest that back injuries result in about a month and a half of lost training time. A study conducted by Hass on 143 professional tennis players concluded the back pain was responsible for 38% of those players not being able to compete in at least one tournament a year.

Even though there is still much to investigate about the back pain on young players, there is something we already know. Although there are several factors, generally these injuries are repetitive stress injuries. We know the fast and repeated rotation of the lower back during strokes and the hyperextension during serves can be associated with the high injury rates amongst tennis players.


The causes of lower back injuries vary, but they always tend to center around repetitive movements. Futher, bad technique predisposes the player to potential injuries in that area. Tennis players produce different movements while playing, but we will focus on the biomechanical movement, which is the one linked to lower back pain, also called spondylolysis.

SpondylolysisSpondylolysis is defined as a fracture or softening of the bones from the plate where the spine merges with the facet joint. The fifth lumbar vertebra is the most affected (Chart 1). It can have two sources:

  • Congenital: the plate does not ossify during the bone maturation process and remains as it is during the youth sporting life.
  • Repetitive Stress: caused by repetitive micro-trauma. This repetition impedes the correct resolution of the micro-fractures on the vertebra.

This injury affects 5% of the sedentary population and up to 15% of the active population; it is really common in tennis. It can appear during childhood.

Chart 1 - Modified by Soler and Calderon in 2000

Chart 1 – Modified by Soler and Calderon in 2000


The three segments of the spinal column are affected by tennis, but more commonly the lumbar zone is affected. Sharp flex, extensions and rotations produced while playing tennis are associated to technique defects, especially during serves. Another factor is the lack of physical preparation. All these explain the suffering of the spinal column on tennis players.

Because the serve is fundamental to success in tennis, we repeat it frequently while training and on tournaments.

The serve motion transitions from a standing neutral position to extension or hyperextension of the spine. There is also rotation towards the opposite side of the body. This movement requires more strength absorption from the lower back region compared to other tennis movements. We also need to remember that there is more than one serve type, and depending on the serve, the absorption from core’s joints and muscles will be different.

Stay tuned, part II is coming soon! Meanwhile, go have a look on Tennis Warehouse Europe’s therapy and recovery products.

Juanjo Moreno
Physiotherapist at Equelite