From tennis elbow to Alcaraz: the injuries of champions and fans

In the beginning was 'tennis elbow'. For decades, epicondylitis was the universal symbol of the suffering of those who wield the racket, a trademark of pain linked to repeated gestures and period equipment. Today, as the Foro Italico turns the spotlight back on the Internazionali d'Italia, the scenario has radically changed. Rome welcomes Jannik Sinner in an atmosphere of euphoria, but has to reckon with the heavy absence of Carlos Alcaraz, his main, at times only, opponent. The Spaniard's forfeit is not only a sports news story, but a biomechanical case study that raises questions about the sustainability of modern tennis, where the athlete is a complex machine constantly pushed to the limit of the overhead.

If in the professional world the wear injury dominates, in the amateur world the pain map is more varied and often moves from the arm to the legs. Although epicondylitis remains a classic due to imperfect technique, the real risk for the amateur lies in the lower limbs: ankle sprains and knee pain are the order of the day for the 'Sunday player' who takes on sharp sprints without adequate preparation. To reduce these risks, experts give advice and warning signs that should not be underestimated. It starts with prevention, which should become an integral part of the routine with the warm-up: ten minutes of joint mobility reduces the risk of acute injuries by 30 per cent.

Equally crucial is attention to equipment, particularly footwear: the improper use of running shoes on clay, lacking the necessary lateral support, is the leading cause of sprain injury. Finally, it is essential to learn to listen to the body's messages, considering any persistent discomfort in the wrist or elbow that exceeds twenty-four hours not as simple fatigue, but as an alert signal for an ongoing overload. As Professor Rodolfo Lisi, kinesiologist, specialist in motor activity science and techniques and one of the leading experts on tennis injuries, points out: 'Susceptibility to injury is the result of a complex interaction between intrinsic and extrinsic factors, and cannot be reduced to a single episode. For the amateur, this interaction is often unbalanced by poor off-court 'maintenance' of the physique.

Carlos Alcaraz's recent injury has turned the spotlight on a specific area: his right wrist and forearm. Specifically, it was a muscular oedema to the round pronator muscle, a condition that generates acute pain during forearm rotation and ball impact, making it impossible to manage the exaggerated topspin that characterises the Spaniard's game.

'Alcaraz's injury should be read with great caution,' explains Lisi, author of the award-winning book 'Four Injuries for Four Champions' about the ailments of Nadal, Djokovic, Murray and Del Potro. "In elite tennis, each athlete represents a separate system. In this specific case, the player was coming from an extraordinary sequence of results on cement - Australian Open, Doha, Indian Wells and Miami - a surface known to be more impactful for the musculoskeletal system'. Alcaraz's wrist paid the bill for an unmet technical transition, where the strength needed to generate power on clay clashed with tissues already stressed by the previous months spent on 'hard' ground.