Central European Journal of Sport Sciences and Medicine


ISSN: 2300-9705    eISSN: 2353-2807    OAI    DOI: 10.18276/cej.2025.2-05
CC BY-SA   Open Access   DOAJ  DOAJ  DOAJ

Issue archive / Vol. 50, No. 2/2025
A Systematic Review Comparing Epidemiology of Injuries in Padel, Tennis and Squash Players.

Authors: Caeleigh King ORCID
Department of Sport and Movement Studies, University of Johannesburg, South Africa

Lynn Smith ORCID
Department of Sport and Movement Studies, University of Johannesburg, South Africa

Heather Morris-Eyton ORCID
Department of Sport and Movement Studies, University of Johannesburg, South Africa
Keywords: padel tennis squash musculoskeletal injury
Whole issue publication date:2025
Page range:16 (53-68)
Klasyfikacja JEL: I19
Cited-by (Crossref) ?:

Abstract

Background: Padel, tennis and squash are racket sports involving repetitive manoeuvres, asymmetrical movements and multiple sprints over short distances. These sports include multiple changes of direction and elements of speed, agility and power. All these factors increase the injury risk in these sports. Objective: The aim of this systematic review was to investigate the epidemiology of injuries across padel, tennis and squash athletes. Study Design: This was a systematic review which included EBSCO, CINAHL, MEDLINE, SPORTDiscus, PubMed, and Scopus as the data sources. After risk of bias and quality assessment 11 articles were included for final review. Results: High prevalence of injuries in padel (85.4%), tennis (39%–46%) and squash (58%) athletes. Injury incidence rate of 3.5–56.6/1000 hours play in tennis and 7.28–14.75/1000 hours of squash exposure. Padel had (44%–49%) tendon and (27%–34%) muscle injuries with most injuries to the elbow (30%–74%). Tennis athletes had (33%–62%) muscle and (11%–38%) ligament injuries with the ankle the most injured (4%–24%). For squash players, muscle (5%–38%) and tendon (23%) injuries were common with most to the ankle (6%–27%). Risk factors across all sports included age, physical demands of the sport and overuse. Conclusion: Injury epidemiology between the sports was similar with muscular and tendon injuries the most common.
Download file

Article file

Bibliography

1.Abadi, M. R., Widyahening, I. S., Sudarsono, N. C., & Tobing, A. J. (2021). Incidence Rate of Musculoskeletal Injuries among Professional Tennis Players during 2019 International Tournaments in Indonesia. Journal of sports science & medicine, 20(2), 268–274. https://doi.org/10.52082/jssm.2021.268
2.Acquaye, G., Quartey, J., & Kwakye, S. (2020). Pattern of injuries amongst tennis players in Accra, Ghana. The South African journal of physiotherapy, 76(1), 1429. https://doi.org/10.4102/sajp.v76i1.1429
3.Bahr, R., & Holme, I. (2003). Risk factors for sports injuries - a methodological approach. British Journal of Sports Medicine, 37(5), 384. https://doi.org/10.1136/bjsm.37.5.384
4.Balazs, G.C., Brelin, A., Wolfe, J.A., Keblish, D.J. & Rue, J-P. (2015). Variation in injury incidence rate reporting: The case for standardization between American and non-American researchers. Current Orthopaedic Practice. 26. 395-402. 10.1097/BCO.0000000000000246.
5.Castillo-Lozano, R., & Casuso-Holgado, M. J. (2015). A comparison musculoskeletal injuries among junior and senior paddle-tennis players. Science & Sports, 30(5), 268–274.
6.Castillo-Lozano, R., & Casuso-Holgado, M. J. (2017). Incidence of musculoskeletal sport injuries in a sample of male and female recreational paddle-tennis players. The Journal of sports medicine and physical fitness, 57(6), 816–821. https://doi.org/10.23736/S0022-4707.16.06240-X
7.Castillo-Lozano, R. (2017). Epidemiology and prevention strategies for the musculoskeletal injuries in the paddle-tennis senior players. Revista Andaluza De Medicina Del Deporte, 8(4), 188. https://doi.org/10.1016/j.ramd.2015.08.010
8.Covidence systematic review software, Veritas Health Innovation, Melbourne, Australia. Available at www.covidence.org.
9.Dahmen, J., Emanuel, K. S., Fontanellas-Fes, A., Verhagen, E., Kerkhoffs, G. M. M. J., & Pluim, B. M. (2023). Incidence, prevalence and nature of injuries in padel: a systematic review. BMJ open sport & exercise medicine, 9(2), e001607. https://doi.org/10.1136/bmjsem-2023-001607
10.Dakic, J. G., Smith, B., Gosling, C. M., & Perraton, L. G. (2018). Musculoskeletal injury profiles in professional Women's Tennis Association players. British journal of sports medicine, 52(11), 723–729. https://doi.org/10.1136/bjsports-2017-097865
11.Demeco, A., de Sire, A., Marotta, N., Spanò, R., Lippi, L., Palumbo, A., Iona, T., Gramigna, V., Palermi, S., Leigheb, M., Invernizzi, M., & Ammendolia, A. (2022). Match Analysis, Physical Training, Risk of Injury and Rehabilitation in Padel: Overview of the Literature. International journal of environmental research and public health, 19(7):4153. https://doi.org/10.3390/ijerph19074153
12.Downes, M. J., Brennan, M. L., Williams, H. C., & Dean, R. S. (2016). Development of a critical appraisal tool to assess the quality of cross-sectional studies (AXIS). BMJ open, 6(12), e011458. https://doi.org/10.1136/bmjopen-2016-011458
13.Eriksen, M. B., & Frandsen, T. F. (2018). The impact of patient, intervention, comparison, outcome (PICO) as a search strategy tool on literature search quality: a systematic review. Journal of the Medical Library Association: JMLA, 106(4), 420–431. https://doi.org/10.5195/jmla.2018.345
14.Finch, C., & Eime, R. (2001). The epidemiology of squash injuries. International SportMed Journal. 2. 1-11.
15.Fu, M. C., Ellenbecker, T. S., Renstrom, P. A., Windler, G. S., & Dines, D. M. (2018). Epidemiology of injuries in tennis players. Current Reviews in Musculoskeletal Medicine, 11(1), 1-5. https://doi.org/10.1007/s12178-018-9452-9
16.García–Fernández, P., Guodemar–Pérez, J., Ruiz-López, M., Rodríguez-López, E., García-Heras, A., & Hervás–Pérez, J. (2019). Epidemiology of injuries in professional and amateur spanish paddle players. Revista Internacional De Medicina Y Ciencias De La Actividad Física Y Del Deporte, 19(76):641–654. https://doi.org/10.15366/rimcafd2019.76.006
17.Horobeanu, C., Johnson, A., & Pullinger, S.A. (2019). The Prevalence of Musculoskeletal Injuries in Junior Elite Squash Players. Asian Journal of Sports Medicine, 10(1):e84495. https://doi:10.5812/asjsm.84495.
18.Horsley, I. G., Dr, O'Donnell, V., & Leeder, J. (2020). The epidemiology of injuries in English professional squash; A retrospective analysis between 2004 and 2015. Physical therapy in sport: official journal of the Association of Chartered Physiotherapists in Sports Medicine, 46:1–6. https://doi.org/10.1016/j.ptsp.2020.07.009
19.Jones, T., Williams, B. K., Kilgallen, C., Horobeanu, C., Shillabeer, B. C., Murray, A., & Cardinale, M. (2018). A review of the performance requirements of squash. International Journal of Sports Science & Coaching, 13(6):1223-1232. https://doi.org/10.1177/1747954118792492
20.Kaiser, P., Stock, K., Benedikt, S., Ellenbecker, T., Kastenberger, T., Schmidle, G., & Arora, R. (2021). Acute Tennis Injuries in the Recreational Tennis Player. Orthopaedic journal of sports medicine, 9(1):2325967120973672. https://doi.org/10.1177/2325967120973672
21.Kekelekis, A., Nikolaidis, P. T., Moore, I. S., Rosemann, T., & Knechtle, B. (2020). Risk Factors for Upper Limb Injury in Tennis Players: A Systematic Review. International journal of environmental research and public health, 17(8), 2744. https://doi.org/10.3390/ijerph17082744
22.Kamalden, T. F. T., Gasibat, Q., Samsudin, S., & Joseph, J. A. (2021). Occurrence of Muscle Imbalance and Risk of Injuries in Athletes using Overhead Movements: A Systematic Review. Sport Mont, 19(3):115-122. https://doi:10.26773/smj.211012
23.Krueckel, J., Szymski, D., Lenz, J., Fluegel, J., Weber, J., Achenbach, L., Meffert, R., Alt, V., & Fehske, K. (2024). Tennis Injuries Among German League Players: Investigating Patterns and Epidemiology of Acute and Chronic Injuries. Open access journal of sports medicine, 15, 67–75. https://doi.org/10.2147/OAJSM.S460907
24.Lynall, R. C., Kerr, Z. Y., Djoko, A., Pluim, B. M., Hainline, B., & Dompier, T. P. (2016). Epidemiology of National Collegiate Athletic Association men's and women's tennis injuries, 2009/2010-2014/2015. British journal of sports medicine, 50(19), 1211–1216. https://doi.org/10.1136/bjsports-2015-095360
25.Migliavaca, C. B., Stein, C., Colpani, V., Munn, Z., Falavigna, M., & Prevalence Estimates Reviews – Systematic Review Methodology Group (PERSyst) (2020). Quality assessment of prevalence studies: a systematic review. Journal of clinical epidemiology, 127, 59–68.
26.Minghelli, B., & Cadete, J. (2019). Epidemiology of musculoskeletal injuries in tennis players: risk factors. The Journal of sports medicine and physical fitness, 59(12), 2045–2052. https://doi.org/10.23736/S0022-4707.19.09842-6
27.Moreno-Pérez, V., López-Samanes, Á., Domínguez, R., Fernández-Elías, V. E., González-Frutos, P., Fernández-Ruiz, V., Pérez-López, A., & Fernández-Fernández, J. (2019). Acute effects of a single tennis match on passive shoulder rotation range of motion, isometric strength and serve speed in professional tennis players. PloS one, 14(4):e0215015. https://doi.org/10.1371/journal.pone.0215015
28.Nhan, D. T., Klyce, W., & Lee, R. J. (2018). Epidemiological Patterns of Alternative Racquet-Sport Injuries in the United States, 1997-2016. Orthopaedic journal of sports medicine, 6(7): 2325967118786237. https://doi.org/10.1177/2325967118786237
29.Munn, Z., Moola, S., Lisy, K., Riitano, D., & Tufanaru, C. Chapter 5: Systematic reviews of prevalence and incidence. In: Aromataris E, Munn Z (Editors). JBI Manual for Evidence Synthesis. JBI, 2020
30.Muñoz, D., Coronado, M., Robles-Gil, M. C., Martín, M., & Escudero-Tena, A. (2022). Incidence of Upper Body Injuries in Amateur Padel Players. International journal of environmental research and public health, 19(24):16858. https://doi.org/10.3390/ijerph192416858
31.Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., McGuinness, L. A.,... Moher, D. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ (Clinical research ed.), 372, n71. https://doi.org/10.1136/bmj.n71
32.Pérez, F., Rubia, A., Cañadas, E., Lorenzo-Calvo, J., Marquina, M., & García-Sánchez, C. (2023). Musculoskeletal injury prevalence in professional padel players. A retrospective study of the 2021 season. Physical therapy in sport: official journal of the Association of Chartered Physiotherapists in Sports Medicine, 63, 9–16. https://doi.org/10.1016/j.ptsp.2023.06.003
33.Rice, R. P., Roach, K., Kirk-Sanchez, N., Waltz, B., Ellenbecker, T. S., Jayanthi, N., & Raya, M. (2022). Age and Gender Differences in Injuries and Risk Factors in Elite Junior and Professional Tennis Players. Sports health, 14(4), 466–477. https://doi.org/10.1177/19417381211062834
34.Sánchez-Alcaraz, B. J., & Courel-Ibáñez, J. (2022). The Role of Padel in Improving Physical Fitness and Health Promotion: Progress, Limitations, and Future Perspectives-A Narrative Review. International journal of environmental research and public health, 19(11):6582. https://doi.org/10.3390/ijerph19116582
35.Sánchez-Alcaraz, B. J., Martínez-Gallego, R., Llana, S., Vučković, G., Muñoz, D., Courel-Ibáñez, J., Sánchez-Pay, A., & Ramón-Llin, J. (2021). Ball Impact Position in Recreational Male Padel Players: Implications for Training and Injury Management. International journal of environmental research and public health, 18(2):435. https://doi.org/10.3390/ijerph18020435
36.Sankaravel, M., Lee, A. C., Mondam, S., & Low, J. (2017). Prevalence of musculoskeletal injuries among young squash players in Malaysia. Journal of Fundamental and Applied Sciences. 2017. 9-1132. 10.4314/jfas.v9i6s.83.
37.Tenny, S., & Boktor, S.W. Incidence. [Updated 2023 Apr 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430746/
38.Toney-Butler, T.J., & Varacallo, M. Motor Vehicle Collisions. [Updated 2023 Aug 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441955/
39.Vasenina, E., Hammert, W. B., Kataoka, R., Dankel, S. J., & Buckner, S. L. (2022). Injuries and Strength Training Practices in Collegiate Tennis. Sports (Basel, Switzerland), 10(10):149. https://doi.org/10.3390/sports10100149
40.Williams, K., & Hebron, C. (2018). The immediate effects of serving on shoulder rotational range of motion in tennis players. Physical therapy in sport: official journal of the Association of Chartered Physiotherapists in Sports Medicine, 34:14–20. https://doi.org/10.1016/j.ptsp.2018.08.007