When you watch a tennis tournament, sometimes, it can make picking up a racket again. It looks very tempting, especially if you used to play regularly. The problem is that your first session back can feel deceptively good. You remember the strokes, your timing starts coming back, and before long, you are already serving harder or agreeing to another match later in the week.
Your shoulder and elbow, however, may not be ready for the same workload they handled before your break.
And if you stopped playing because of a previous injury? This is particularly important. Returning to tennis is not simply about waiting until the pain disappears. Your shoulder, elbow, and forearm need to gradually rebuild the strength and capacity required for repeated serves, groundstrokes, and longer matches.
Key Pointers
- Being pain-free at rest does not necessarily mean your shoulder or elbow is ready for tennis.
- Avoid returning immediately to the same frequency and intensity you played at before your break.
- Serving places considerable demands on the shoulder and elbow, so build serving volume gradually.
- Shoulder, upper back, and forearm strength are important when returning to racket sports.
- Recovery days matter, particularly during the first few weeks back.
- Recurring pain, weakness, stiffness, or loss of movement should be assessed rather than repeatedly played through.
Why Can Shoulder or Elbow Pain Return When You Start Playing Tennis Again?
When you take several weeks or months away from tennis, that period might give irritated tissues that take extra time to settle. But during that same period, your strength, endurance, coordination, and tolerance for repeated loading can also decrease.
That creates a common situation: your shoulder or elbow feels perfectly fine in everyday life, but the pain returns once you start playing.
Tennis asks much more of the upper body than normal daily activities. A single session may involve hundreds of repeated strokes, with serving in particular requiring coordinated movement through the shoulder, elbow, forearm, wrist, trunk, and legs.
If you return to your previous level too quickly, your body may be exposed to more load than it is currently prepared to handle.
How Quickly Should I Return to Tennis After a Long Break?
There is no single return-to-tennis schedule that works for everyone. Your previous injury, length of time away, fitness level, age, and current symptoms all matter.
What is generally more useful is a gradual increase in workload.
Instead of making your first week back three full matches, you might begin with shorter hitting sessions at a comfortable intensity. From there, duration, frequency, and intensity can be increased progressively if your shoulder and elbow are tolerating the activity.
Pay attention to how you feel not only during the session, but later that day and the following morning.
Pain that repeatedly worsens after each session can be a sign that you are progressing faster than your body can tolerate.
Should I Start Serving at Full Intensity Straight Away?
Probably not if you have been away from tennis for a significant period or are returning after a shoulder or elbow injury.
The serve is one of the more demanding movements in tennis. It requires repeated overhead motion and generates substantial forces through the shoulder and elbow.
Rather than immediately returning to powerful first serves, consider progressively rebuilding your serving workload. This may mean beginning with fewer serves at a lower intensity before gradually adding speed and volume.
Your return should also account for the rest of your session. Serving for 20 minutes after a long rally session is different from practising serves when your arm is fresh.
Fatigue can affect technique and the way forces are distributed through the arm.
Which Shoulder Injuries Can Affect Tennis Players?
Repeated overhead movements can contribute to several shoulder problems.
These may include:
Rotator Cuff Injuries
The rotator cuff is a group of muscles and tendons that helps stabilise and move the shoulder. Repeated overhead activity may irritate or injure these structures.
Symptoms can include pain when raising the arm, weakness, or discomfort when serving.
Shoulder Impingement
Some players experience pain when lifting the arm overhead, particularly during serving or smashing movements.
Shoulder Instability
A previous shoulder dislocation or ligament injury may leave some players feeling that the shoulder is loose, unstable, or unreliable during overhead movements.
Persistent symptoms should be assessed to determine the underlying cause rather than assuming that all tennis-related shoulder pain is simply overuse.
Which Elbow Injuries Are Common in Tennis?
One of the most familiar is tennis elbow, although you certainly do not have to play tennis to develop it.
Tennis elbow affects the tendons on the outside of the elbow. Players may notice pain when gripping the racket, hitting a backhand, carrying objects, or performing other wrist and forearm movements.
Other elbow problems can involve the inner elbow, ligaments, joint, or nerves.
Technique, racket setup, grip size, sudden increases in playing volume, and inadequate strength may all influence how much stress is placed on the arm.
What Strength Should I Rebuild Before Returning to Tennis?
Tennis is not powered by the arm alone.
A well-coordinated stroke transfers force from the legs and trunk through the shoulder and arm to the racket. When one part of this chain is not working efficiently, another area may take on additional load.
A return-to-tennis programme may therefore include exercises targeting:
- Shoulder and rotator cuff strength
- Shoulder blade control
- Upper back strength
- Forearm and grip strength
- Trunk or core strength
- Lower-body strength and balance
The appropriate exercises will depend on your previous injury and current physical condition. If you are returning after an injury, your physiotherapist or doctor can advise on an appropriate progression.
How Important Are Rest Days When Returning to Tennis?
It can be easy to get carried away once you start playing again, particularly if you feel good after your first session.
But feeling good immediately afterwards does not always tell you how your shoulder or elbow will respond to repeated sessions.
During the first few weeks back, allow your body enough time to recover between tennis sessions. Avoid suddenly combining several matches, gym sessions, and serve practices after a long period of reduced activity.
Training load includes more than tennis. Strength training, other sports, physically demanding work, and even additional racket sports all contribute to the overall demands placed on your body.
Is Some Shoulder or Elbow Soreness Normal After Tennis?
Some muscle soreness can occur when returning to an activity you have not performed for a while.
What deserves more attention is pain that:
- Returns in the same location as your previous injury
- Becomes worse with each tennis session
- Persists beyond the expected period of post-exercise soreness
- Causes weakness
- Limits shoulder or elbow movement
- Affects your serve or stroke mechanics
- Interferes with sleep or everyday activities
Repeatedly adjusting your technique to avoid pain can also be a sign that something needs to be assessed.
When Should I See an Orthopaedic Doctor Before Returning to Tennis?
You do not necessarily need an orthopaedic assessment simply because you have taken time away from tennis.
However, consider seeking medical advice if you have an existing shoulder or elbow injury and are unsure whether you are ready to return, or if pain keeps returning whenever you try to play.
An assessment may help determine whether the issue relates to a tendon, ligament, joint, or another structure and whether further treatment or rehabilitation is appropriate.
This can be particularly useful if you have already tried resting several times, only for the same problem to return once you pick up your racket again.
Frequently Asked Questions
1. How long should I wait before returning to tennis after a shoulder or elbow injury?
There is no fixed timeframe. Return to sport depends on the type and severity of the injury, your recovery, strength, range of motion, and ability to tolerate tennis-specific movements.
2. Can I play tennis if my shoulder only hurts when I serve?
Pain during serving should not automatically be ignored because everyday movements are comfortable. Serving places different demands on the shoulder, and recurring pain may warrant assessment.
3. Why did my injury come back even though I rested for several months?
Rest can allow symptoms to settle, but it does not necessarily rebuild the strength and load tolerance required for tennis. A gradual rehabilitation and return-to-sport programme may be needed.
4. Can changing my tennis racket or grip help with elbow pain?
Racket weight, string tension, grip size, and technique can influence the forces transmitted through the arm. However, equipment changes should not be used as a substitute for assessing persistent elbow pain.
5. Should I stop playing completely if my shoulder or elbow starts hurting again?
This depends on the cause and severity of your symptoms. If pain is persistent, worsening, affecting your movement, or repeatedly returning with tennis, consider having it assessed before continuing to increase your playing load.
Ready to Pick Up Your Racket Again? Talk to an Orthopaedic Doctor
Returning to tennis should be about more than waiting for the pain to disappear. After a long break or previous injury, gradually rebuilding strength, movement, and tolerance for tennis-specific demands can help reduce the risk of the same problem returning.
If shoulder or elbow pain keeps coming back when you play, it may be worth finding out why rather than repeatedly resting and restarting.
Dr Eileen Tay, Senior Consultant Orthopaedic Surgeon at The Orthopaedic Practice and Surgery (TOPS), has a special interest in shoulder and elbow conditions, including sports-related injuries. She can assess your symptoms and discuss treatment and return-to-sport considerations based on your condition and activity goals.
