Impact of Playing Surfaces in Grand Slam Tennis Tournaments on Injury Incidence, Location and Type: A Systematic Review

Abstract

Objective: Tennis is a sport played worldwide by athletes of all ages. The main outcome of this systematic review is to assess the impact of Grand Slam tennis surfaces on injury incidence in tennis players. The secondary outcomes are to evaluate the impact of these surfaces on the location and type of injuries. Design: Systematic review Data sources: A systematic search was conducted in PubMed, SCOPUS and Web of Science from 1968 to October 2024 with no language restrictions. Eligibility criteria for selecting studies: Observational studies from Grand Slam tournaments reporting incidence, location, or type of injuries in tennis players with reference to the playing surface. Study quality was assessed using an adapted version of the Newcastle-Ottawa Quality Assessment Scale. Results: Four articles met the eligibility criteria: one from Roland Garros - clay, one from Wimbledon - grass, and one each from the Australian Open and the US Open - hard courts. The highest number of injuries per year occurred on hard courts, while clay courts had the lowest. Injury location varied significantly by surface, with Roland Garros and the US Open showing the most contrasting patterns and Wimbledon having a more specific profile. Shoulder and knee were among the most common injury locations across all surfaces. Muscle injuries were the most frequent injury type. Conclusion: Tennis injuries are frequent and surface dependent, emphasizing the need for targeted prevention strategies. Proper conditioning, muscle strengthening, and appropriate footwear may help prevent injuries.