The Risk of a Tennis serve for a woman

When you think about tennis you might imagine the hubbub of the Australian open. But this exploration uncovers the truth of what you perceive as a show. But why? This article discusses the dangers of the most used shot in tennis: The serve. The serve is an infallible component of any tennis match, it is required to start a point, and the speed, accuracy and definition of the serve often decides the winner of the point.

There are 6 stages of the tennis serve. Starting from the ball release to the loading phase, cocking, acceleration, contact and deceleration, each with their own risks involved. Although men are women are similarly impacted by serving, the amalgamation of the serve coupled with the fatigue of the following point disproportionately increases the risk of injury for women as will be discussed later.

Figure 1: Tennis serve stages

A study conducted by tennis Australia featured injuries present in both males and females across each of the major grand slams in the world.

Figure 2: Investigation into injuries at ¾ of the grand slams

As demonstrated in this infographic, after 10,000 games, the injury incidence for females was at 68.9 compared to just 41.2 in men specifically targeting shoulder injuries. ‘75% of the modern tennis game is either serves, or forehand strokes, this requires a lot of power from the internal rotators of the shoulder’.  [Ruddock, 2018]

Mechanics

The mechanics of a serve inside the human body is complex, yet there are 3 basic concepts that are required to complete a fluid chain of events that reduces the chances of injury. Firstly, an effective kinetic chain must be established, this is continuous transfer of energy from the legs during the cocking phase to the acceleration phase. Should there by a lack of rotation in the mid back there is a loss of moments increasing the reliance on the shoulder to generate force potentially leading to impingement problems [Ruddock, 2018]. These problems stem from when the rotor cuff tendons getting pinched by nearby bones due to the acceleration and contact phase. The highest risk for these injuries would be at the end of the match, when the body fatigues and consistently breaks the kinetic chain. The injury is not career ending, it simply causes irritation, swelling and inflammation in the shoulder, which requires physical therapy, treatment and a break from tournaments for a while.

This is manageable for a male body; however, research shows that the effectiveness of physical therapy interventions for males is 62% compared to a meagre 48% for women. Furthermore, the average treatment duration was 8 weeks for males compared to 10 in females. Now imagine if you and your doubles partner both got injured 8 weeks before the Australian open, he recovers and enters the singles tournament, whereas you have to wait 2 more agonizing weeks for your injury to  heal and to start training for the next tournament. [MAK HILL, 2025]

This is the reality of the game, however there are ways in which to minimize the impact of these highly taxing shots. From the directive of a researcher at tennis Australia ‘serves should be periodised and progressed to match tournament loads in order for players to be physically resilient of the required loads and subsequently limit their injury risk’ [Gescheit, n.d.]. Furthermore, advice from professional, whether that be a medical professional or a professional tennis coach is invalulable to the diminution of injuries for women in tennis.

As mentioned before, the effect of injury in women is heightened with the expected longer rallies and heavy shots. For men, rallies are shorter and balls fly faster warranting quicker movements on the court endangering lower body structures. Yet, for women the game is wildly different. Because the balls move slower, the power thrown into shots are far greater, this, coupled with the extremities of the serve exacerbate the risks of a shoulder injury, which as discussed before, could be detrimental to the career of a female athlete.  

The serve will remain the single most important shot in the game. Let’s protect out shoulders and serve big.

Bibliography:

Agarwal, N. (2025). Gender Differences in Response to Physical Therapy for Shoulder Impingement Syndrome. Research Journal Medical Sciences; Mak Hill. chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.makhillpublications.co/files/published-files/mak-rjms/2025/1-37-41.pdf

Ruddock, J. (2018, October 28). Align Body Clinic. Align Body Clinic. https://alignbodyclinic.co.uk/ankle-sprain-how-bad-is-it-and-what-should-i-do/

Gescheit, D. Tennis Australia. (n.d.). Injuries throughout the elite tennis pathway. Tennis Australia. //efaidnbmnnnibpcajpcglclefindmkaj/https://www.tennis.com.au/wp-content/uploads/2019/02/Injuries_through_elite_pathway_HPEDM_FINAL.pdf