Tennis can be a demanding, injury-inducing sport. You throw your elbows and shoulders into serves and strokes. You stop and go constantly, and most recreational players pound their legs on hard surfaces instead of clay or grass. If you incur a tennis injury, you risk more than losing a few games. You could be sidelined from tennis and other sports for months. Luckily, recreational players who do not hit the ball as hard or as often as advanced and elite players have a lower risk of injury. But, some tennis players, no matter what their skill level, are prone to injury. So, whether you head out to the local courts occasionally or you are heading for the pro tour, here is what you need to know about the most common tennis injuries.

Tennis Elbow

Tennis elbow is the common term for the degeneration (not inflammation) of the wrist extensor tendons where they attach at the elbow, according to Robert Leach, MD, Editor Emeritus of the American Journal of Sports Medicine. Using correct mechanics when you hit the ball, especially on your backhand, is important for the prevention of tennis elbow.

"Make sure you hit the ball in front of you," Leach says. To nail down proper technique, take a lesson. It might even improve your game.

Shoulder Pain

Shoulder pain can be caused by a number of ailments, but the most common is rotator cuff dysfunction. Serving is largely responsible for shoulder pain; an easier service motion is less likely to cause shoulder problems. However, if you are determined to rip the ball at your opponent, make sure you warm up well and keep your rotator cuff muscles strong. Eddie Vargas, a certified APEX fitness professional and director of fitness for the Columbia Basin Racquet Club in Richland, Washington, recommends moving your rotator cuff muscles through their full range of motion using dumbbells or pull cords.

Back Pain

Tennis players most often experience low back pain. According to Dr. Leach, it is not usually serious. Though disc injuries are possible, muscle-related back injury is more common in tennis. Dr. Leach advises working on your back flexibility and building strong abdominal muscles. Vargas recommends using a seated cable row machine to strengthen lower back muscles.

Ankle Sprain

Ankle sprains occur when you turn your ankle in; they are fairly unpredictable and tough to prevent. If you do sprain your ankle, Dr. Leach says, get acute treatment. Ice and elevate the ankle immediately, and wrap it for support.

Hamstring Strain

Many athletes experience hamstring problems, and tennis players are no exception. Hamstring muscles need to be flexible. Vargas advises stretching hamstrings thoroughly before playing, but, he warns, "Don't stretch cold." Vargas says you can work to strengthen your hamstring muscles by doing hamstring curls or using a pronated leg curl machine. When doing hamstring strength work, he says, warm up first and stretch second—and "always stretch between sets."

Knee Cartilage Tear

The most common knee injury in tennis is a meniscal tear, Dr. Leach says. You can work on general strengthening of your hamstrings and quads, but there is not much you can do specifically to prevent this. Just be aware that it could occur, and if you injure your knee while playing tennis, see an orthopedic surgeon for an appropriate course of treatment.

Achilles' Tendon Injury

Playing tennis could lead to either a strain or tear of the Achilles tendon. Good flexibility is the best preventive measure you can take. Always warm up first before you start playing hard. Work on increasing flexibility in that area on off-court days, too.

General Injury Prevention

Perhaps the most important action you can take to prevent injury in tennis—as in many sports—is engaging in a good warm-up before playing. "Start gently and get your heart rate up," Dr. Leach advises. "The biggest problem is that many recreational players go out and hit two balls, and then feel like they're ready to go."

Dr. Leach advises at least a five-minute warm-up—either on the court or off. An on-court warm-up should involve gentle hitting in a controlled manner. You should not be scrambling all over the court to get balls back during your warm-up. If your level of play does not allow for such a controlled warm-up, get your heart rate up before you hit the court. Try biking, brisk walking, or jogging. Then when you hit the court, warm up your strokes as gently as possible.

Do not forget to warm-up your serve too. Dr. Leach, an accomplished tennis player, says, "Don't hit four serves and say 'okay, first serve in.' " Under normal circumstances, Dr. Leach figures he hits about 15 serves as part of his 10-12 minute warm-up routine.

A Healthy Routine

The following tennis warm-up was designed by Andy Shupe, a USPTA tennis professional and former head coach of men's and women's tennis at the University of Massachusetts, Lowell. This is appropriate for advanced, aggressive players preparing for match play. Recreational players may not need such an extensive warm-up, but can follow the steps outlined below.

• Begin with about 10 minutes of light hitting (or another light aerobic activity).
• Do five minutes of slow on-court running, including forward and backward running and side stepping.
• Move into another five minutes of what Shupe calls "dynamic flexibility movements" (eg, slow running with knees to the chest or feet to the butt).
• Stretch for 5-10 minutes, working on shoulders, triceps, forearms, wrists, chest, back, hamstrings, quadriceps, hip flexors, and ankles.
• Move back onto the court for about 15 minutes of hitting. Start at the net with easy volleys, move back to the service line for a short rally and make the natural progression back to the baseline, picking up pace on your shots as you back up.
• Warm up your shoulder with light overhead shots, first to the service line and then a few light overhead shots to the baseline.
• Take about five minutes to warm up your serve. Start slowly. "Warm up your second serve first," Shupe says. Work up to a harder serve. You may not be serving at full pace until a few games into the match.
• Do not forget to cool down after an intense tennis match, and stretch again when you are done.

The most important thing to remember is that you need to warm up all your shots and you need to do it gradually. "If I see my guys hitting hard right away, I get on them. They won't play well if they don't get their blood flowing and their footwork going. And not warming up is a good way to get hurt," Shupe says.