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Tennis-Related Injuries Treated in United States Emergency Departments, 1990 to 2011

Gaw, Christopher E. BS*,†; Chounthirath, Thiphalak MS*; Smith, Gary A. MD, DrPH*,‡,§

Clinical Journal of Sport Medicine: May 2014 - Volume 24 - Issue 3 - p 226–232
doi: 10.1097/JSM.0000000000000029
Original Research

Objective: To analyze the patterns and causes of tennis-related injuries using, for the first time, a nationally representative data set.

Design: A retrospective cohort analysis was performed using the National Electronic Injury Surveillance System database.

Setting: All tennis-related injuries treated in US emergency departments (EDs) from 1990 to 2011 were analyzed.

Patients: During the study period, an estimated 492 002 (95% confidence interval, 364 668-619 336) individuals, aged 5 to 94 years, presented to US EDs for tennis-related injuries.

Assessment of Risk Factors: Independent variables included patient age and gender, mechanism of injury, and location of injury event.

Main Outcome Measures: Outcome variables included injury diagnosis, body region injured, disposition from ED, and involvement of the net.

Results: Most injuries were sustained by a nonspecific mechanism during play (37.9%) and occurred at a sport or recreation facility (83.4%). Children aged 5 to 18 years had a higher mean injury rate than adults older than 19 years. The most commonly injured body regions were the lower extremities (42.2%) and upper extremities (26.7%). Sprains or strains (44.1%) were the most common type of injury. The number of tennis-related injuries decreased by 41.4% during the years 1990 to 2011, and the tennis-related injury rates decreased by more than 45% during the study period. Among the 3.4% of patients who were admitted to the hospital, two-thirds (65.6%) involved patients 56 years of age or older.

Conclusions: Despite the decrease in tennis-related injuries, the growing popularity of this sport warrants increased efforts to prevent injuries, especially among child and older adult participants.

*Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio;

Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania;

The Ohio State University, College of Medicine, Columbus, Ohio; and

§Child Injury Prevention Alliance, Columbus, Ohio.

Corresponding Author: Gary A. Smith, MD, DrPH, Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, 700 Children's Dr, Columbus, OH 43205-2696 (

The Ohio State University's Mayers Scholarship in Natural and Mathematical Sciences, a research fund for undergraduate students, provided a financial stipend for author C.E.G. while he worked on this study. The opinions expressed in this article do not necessarily reflect those of the funding organization.

The authors report no conflicts of interest.

Received December 31, 2012

Accepted September 10, 2013

© 2014 by Lippincott Williams & Wilkins