Injury Profile in Female Tennis Players: a Systematic Review

Abstract

Background Tennis is a demanding sport requiring endurance, speed, and precision. Despite its popularity, the research on injury epidemiology in female players remains limited. Understanding their injury profile is crucial for targeted prevention strategies. Objectives This systematic review analyses injury incidence, severity and anatomical distribution among female tennis players across different competition levels. It also explores the influence of match and training loads on injury outcomes. Data sources A systematic search was conducted in PubMed, EBSCO, Scopus, Web of Science and Cochrane databases up to December 2024, with additional manual searches. Study Eligibility Criteria, Participants and Interventions Eligible studies reported injury incidence, severity, location, or type in female tennis players using observational or cohort designs. Only peer-reviewed English-language studies with quantitative injury data were included. Study Appraisal and Synthesis Methods Risk of bias was assessed using the Newcastle-Ottawa Scale, and reporting quality was evaluated with the STROBE-SIIS statement. Injury incidence rates were standardized to per 1,000 exposure hours for comparability. Results Thirteen studies met inclusion criteria. The mean injury incidence was highest at the professional level (36,36 injuries per 1000 hours, IC95% 34,5-43,9), and it was particularly higher during matches. Lower limb injuries were most common (33-63.6%), followed by the upper limb (9.1-37.5%) and trunk (11.6-27%). Muscle and tendon injuries were predominant, overall with acute injuries affecting the lower limbs and overuse injuries impacting the upper limbs. Time-loss injuries were more frequent in junior players. Limitations Variability in injury definitions, data collection, and reporting methods limits comparability across the studies. Some studies didn't focus exclusively on female players, meaning some conclusions were inevitably drawn from mixed-gender data. Conclusions and Implications of Key Findings Female tennis players face a high injury burden, particularly in matches. Standardized injury reporting, prevention programs, and workload management strategies are needed. Future research should examine the sex-specific risk factors and long-term injury effects.