By CSSM Physio Hugh Feary

Sad news for tennis fans: reigning Olympic men’s tennis champion Andy Murray has been forced to withdraw from the singles competition in this year’s Olympics due to a quadricep strain. 

Interestingly, Andy is continuing with the double’s competition after consultation with his medical team. Based on the information available, it seems that Andy is experiencing a pre-strain that has forced this decision during such a major event. 

What is this injury, and why can he still play doubles but not singles? 

First, let’s look at injuries in tennis.  

Hitting the ball hard requires players to generate force throughout the whole body, starting at the feet and legs, eventually transferring force to the ball. Approximately 51% of the force during a serve is generated through the leg-hip-trunk complex, highlighting the muscular effort required from the lower body [1]. It is no surprise then that among tennis players, up to 67% of injuries affect the lower body, the most common of these being muscle strain [1].  

What is a muscle strain? 

A muscle is made up of multiple muscle fibers that work together to contract and produce force. If a muscle is overworked or overstretched beyond its maximum capacity, a muscle strain can occur. A common term for a more significant strain is a tear. 

In a muscle strain, some or all of the muscle fibers can get disrupted resulting in pain and weakness. Injury can be classified into various grades based on severity, ranging from focal neuromuscular soreness to complete rupture of the muscle [2].  

The mild end of muscle strain, grade 0, can also be described as a pre-strain. This is an area in the muscle that might be a hotspot, but disruption of the muscle fiber has not yet occurred. In this group, there may be some mild pain, tightness or aching, but strength and range of motion is typically mostly intact. This would mean that for the most part performance is minimally, if at all affected. 

If Andy can still perform, can’t he just push through given it’s the Olympics? 

Despite mild symptoms arising from this type of injury, it is very important that it is treated seriously. If left unchecked, this can develop into a more significant injury resulting in prolonged time away from sport. A recent study found that within 7 days of experiencing a muscular niggle or soreness, the risk of sustaining a significant injury was up to 6.9 times higher [3]. 

In the case of Andy Murray, it seems that the medical team have deemed this injury at the very least a pre-strain that needs some attention. Alongside the likely heavy behind-the-scenes medical and physiotherapy care, it seems his team have employed load management to reduce the load on his quadricep muscle. Participating in only one event rather than two allows him to give his quadricep relative rest. Additionally, playing doubles means that he does not have to cover as much of the court independently. 

While no doubt devastating for the team, taking a “stitch in time saves nine” approach will give him the best possible chance at winning a medal while preventing a blow out later in the tournament. 

What can you take out of this? 

• A muscle strain describes disruption of muscle fibers resulting in pain and weakness. This can vary in severity depending on the mechanism of injury. 

• Getting a niggle or area of mild muscle soreness is frustrating and seemingly innocuous, however it is important that it is not ignored entirely as it can significantly increase your risk for further, more significant injury.  
• Having a niggle does not necessarily mean you have to stop sport altogether, it may just mean you need to make some tweaks depending on the circumstances, such as with Andy Murray. 
• Get a proper assessment to ensure the best possible plan to protect your muscle and keep you playing as much as possible 

About the author

Hugh Feary has always been interested in how the body works, sport and strength training. Physio was the perfect fit. Hugh has previously worked in GP clinics as well as a variety of local sporting teams including the Fremantle Dockers in the AFLW. Spending a lot of time strength training in the gym, Hugh enjoys helping others who have any niggles or injuries to modify their program to keep them moving. 

References 

Dines JS, Bedi A, Williams PN, Dodson CC, Ellenbecker TS, Altchek DW, Windler G, Dines DM. Tennis injuries: epidemiology, pathophysiology, and treatment. J Am Acad Orthop Surg. 2015 Mar;23(3):181-9. doi: 10.5435/JAAOS-D-13-00148. Epub 2015 Feb 9. PMID: 25667400. 

Grassi, A., Quaglia, A., Canata, G. L., & Zaffagnini, S. (2016). An update on the grading of muscle injuries: a narrative review from clinical to comprehensive systems. Joints, 4(1), 39–46. https://doi.org/10.11138/jts/2016.4.1.039 

Whalan, M., Lovell, R., & Sampson, J. A. (2020). Do Niggles Matter?-Increased injury risk following physical complaints in football (soccer). Science and Medicine in Football, 4(3), 216-224.