Preventing Spinal Injuries in Tennis

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Written by Renuka Pinto, former WTA physio / trainer

The spine has to handle a lot of load in the sport of tennis. Moving laterally whilst striking rotationally in order to move the ball forward means the spine has to cope with significant torque and shearing forces. Add to this the very high number of reps and frequent flexion / extension of all 3 spinal curves, and it’s no wonder that the incidence of injury to tennis player’s backs is high.

In my experience working as a physical therapist with both elite and recreational tennis players in the New York area and around the world, including 3 seasons on the WTA, I’ve seen and treated a host of different spinal injuries. Below I’ve detailed some of the most common breakdowns along with my approach to fixing them and more importantly, preventing repeat injury.

A key component of my process is using a science based training system called GravityFit. The exercises and equipment is the product of revolutionary space research conducted by GravityFit with NASA, amongst others. It’s a very different approach to injury prevention that really addresses the cause and not the symptom of the breakdown. To my knowledge I’m the only practitioner in the world using the system to specifically treat and prevent tennis related injuries, and it’s for that reason that I would like to give you an insight to how and why I use it.


Injury Area No.1 – Facet Joint

This is commonly aggravated by the extension component of serve (think arching the back). When there is a weak core, the bones on either side of the vertebrae crash into another and the joints get inflamed and sometimes fractured rendering the area almost completely dysfunctional.

Equipment – GravityFit Core Awareness Belt and Gravity Cap

Technique – Teaching posture, walking under load, training correct hinging and extending movement patterns. Building up endurance in core and deep postural muscles.


Applying gentle yet effective load to the spine through the elastic tubing on the Gravity Cap. Core awareness belt giving audio feedback on whether the core is working effectively


Injury Area No.2 – Intervertebral Disc

The uncontrolled flexion and extension patterns I mentioned aboe, especially when combined with poor hip flexibility and clumsy, heavy-footed movement makes discs susceptible to annular tears and bulges.

Equipment – GravityFit Core Awareness Belt and Gravity Cap

Technique – Teaching posture, training core control and building endurance, training correct hinging and extending movement patterns. Training improved movement through better footwork. Training the deep postural muscles in the spine that support the discs to absorb compression from the Gravity Cap is especially important.


Challenging the ability to hold great posture and spinal ability with lunge and hinge variatons. Always being kept accountable by the Core Awareness Belt


Injury Area No.3 – Muscle tears

Sudden changes of direction at high speed from hitting make the abdominals and intercostals (rib muscles) susceptible to tears. This is an unavoidable part of the game and the better you become, the harder you will hit. So it’s really important to strengthen these muscles and the associated joints.

Equipment – GravityFit TPro

Technique – Building stability and strength in mid/upper spine. Strengthening the muscles in the shoulder girdle. Improving upper back and shoulder posture. Moving in to multidirectional training under compressive load.


Receiving feedback on spine and shoulder posture under gentle load from the elastic tubing on the TPro.


Expecting to go from sedentary lifestyles to charging around the court injury and pain free, with nothing to help us prepare for the spinal load is fanciful at best. I think that it’s more important than ever that we train and treat the spine through gradual and consistent strengthening exercises. Since using the GravityFit tools and exercise techniques, I have been able to correct and prevent injury to tennis playing spines in a much faster and more effective way.


Renuka Pinto is an internationally trained and traveled physical therapist with over a decade of experience in sports medicine and manual therapy, working at the highest levels of tennis and cricket.