Preventing Wrist Injuries

Scott Riewald, PhD

The extreme range of motion in the wrist may be contributing to the rise of injuries.

Wrist injuries appear to be on the rise in tennis. The Venus Williams animation shows one potential reason why this may be so. Watch the extreme position and downward bending (ulnar deviation) of the right wrist as she prepares to accelerate the racquet forward to ball contact.


Although different players use this position to different degrees on different balls, it ahs become a widespread component of the two-handed backhand technique. Why? It allows the players to drop the racquet head much further below the path of incoming ball to produce greater topspin. As the players begin the forward swing, the wrist, arm, and racket rotate upward with great force.


When players move backwards through the hit, as is also common in high level tennis, this limits the linear momentum and places an even greater demand on the upper body segments.


When players move backward there is more potential for stress in upper body segments.


Implications for Injury

The repetitive use of the wrist in this fashion, and the force generated through this extended range of the motion, place greater stress on the tendons that cross this joint. The players are obviously hitting the ball harder and with more spin. The game is being played primarily from the baseline, not only on clay and hard courts, but also on grass. Despite the pace, the points are also becoming longer. 5 or 10 stroke exchanges, or longer, have become routine.

Wrist injuries occur most frequently when the joint approaches the extreme ends of its range of motion. Injuries to the wrist can occur on either the thumb (radial) side or the little finger (ulnar) side of the wrist.




Two stretches for wrist flexibility and range of motion.

The cartilage on the ulnar side of the wrist (technically, the triangular fibro-cartilage complex) is loaded when the wrist is put into a position of extreme ulnar deviation and or extension.

When put in this position repeatedly, this cartilage can actually tear away from the end of the ulna bone. When this happens players may experience a clicking feeling in the wrist and/or pain. This type of injury often requires surgery to correct.

In previous articles, we've talked about the importance of basic flexibility and strengthening to help prevent injuries. We believe that all players need to achieve a minimum baseline in both areas to reduce their risk factors. This is irrespective of additional strength and conditioning they may undertake to improve performance.

For the wrist it is critical to maintain or increase wrist flexibility and stability. The exercises below are designed to help you do this. You can find additional exercises on our USTA High Performance website. (Click Here.)

Wrist Flexibility

These two stretches are designed to increase wrist flexibility and maintain range of motion.

To stretch the extensors, gently push the wrist into a flexed position with the opposite hand. To stretch the flexors, go the opposite way, gently pushing the wrist to an extended position. With any stretch, perform at the end of practice 2-3 times, holding each stretch for 20-30 seconds.

Two exercises to strength wrist flexion and extension.

Wrist Flexion and Extension

Strengthening the muscles that flex and extend the wrist will provide greater stability to the joint. Wrist flexion and extension exercises can both be performed using barbells, or by using rubber tubing for resistance.

Wrist flexion should be performed in a seated position with the forearms resting on your thighs, palms facing upward. Grasping the weights or the tubing in both hands, contract the forearm muscles to draw the palms toward the forearms. Perform 1-3 sets of this exercise, completing 15-20 repetitions in each set.

Wrist extension is performed in a similar way, but starting with the palms facing the floor. From this position, raise the backs of the hands towards the forearms. Again do 1-3 sets with 15-20 repetitions in each set.



Two additional wrist exercises for radial and ulnar deviation.

Radial and Ulnar Deviation

These are two more exercises to strength the forearm muscles that control the wrist. These exercises simulate the actual wrist action that can occur on the two-hander. You can do them with small barbells as shown, but also with rubber tubing.

For ulnar deviation, let your arm fall to the side and hold the barbell from the top end. Start with the wrist flexed upward. Now lower the barbell head using only the wrist, until you hit the bottom of the range of motion. Perform 1-3 sets of 15 to 20 repetitions.

For radial deviation, reverse the motion. Hold the barbell by the bottom end. Flex the wrist downward, tilting the barbell until it points downward at about a 45 degree angle. Now tilt the tip of the barbell upward through the full range of motion of the wrist. Again do 1-3 sets of 15-20 repetitions.

Scott Riewald, PhD is the Administrator of Sports Science for the USTA Player Development program, based in Key Biscayne, Florida. Working with the USTA sports science and coaching education staffs, Scott helps provide cutting edge research and training information to top American players and coaches.

Before joining the USTA in 2003, Scott was the biomechanics director for USA Swimming and participated as part of an international biomechanical research team during the Sydney Olympic Games. He has also worked as the coordinator of educational programs for the National Strength and Conditioning Association.

An elite competitive swimmer at Boston University, Scott earned his degree there in biomedical engineering in 1992. He received his PhD in the same field from Northwestern University in 2002.

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