Summer in New Zealand means cricket at the park, tennis at the club, touch rugby at the beach, and weekend golf rounds. As Aucklanders embrace the sunshine and outdoor sports, physiotherapy clinics see a predictable surge in sports-related injuries. At Auckland Physiotherapy, we treat countless summer athletes each year - from weekend warriors to competitive club players - with injuries that are often preventable with the right knowledge and preparation.

Let's explore the most common summer sports injuries, understand why they happen, and outline evidence-based strategies to prevent and rehabilitate them effectively.

Tennis Elbow (Lateral Epicondylalgia)

Despite its name, tennis elbow affects far more than tennis players. It's one of the most common overuse injuries we treat during summer months.

What is Tennis Elbow?

Tennis elbow is a painful condition affecting the tendons on the outside of the elbow, specifically where the wrist extensor muscles attach to the lateral epicondyle (bony prominence on the outer elbow). The condition involves degenerative changes in the tendon rather than acute inflammation, which is why the modern term is "lateral epicondylalgia" or "tendinopathy" rather than "epicondylitis."

Why Does It Happen?

Overload and Overuse: The extensor tendons, particularly the extensor carpi radialis brevis, become overloaded when repetitive wrist extension occurs—such as during backhand strokes in tennis, gripping actions, or repetitive lifting.

Poor Technique: In tennis, improper backhand technique with excessive wrist movement rather than shoulder and trunk rotation increases elbow strain. Leading with the elbow instead of the shoulder compounds the problem.

Equipment Issues: Racquets that are too heavy, have incorrect grip size, or are strung too tightly increase vibration and force transmitted to the elbow.

Sudden Increases in Activity: Going from minimal tennis to playing multiple times weekly without gradual progression overloads tissues that aren't adapted to the demand.

Muscle Imbalances: Weak rotator cuff or scapular muscles force the elbow and wrist to compensate, increasing strain.

Symptoms

• Pain on the outer elbow, sometimes radiating down the forearm
• Weak grip strength
• Pain when lifting objects, shaking hands, or turning doorknobs
• Stiffness, especially in the morning
• Pain with wrist extension against resistance

Evidence-Based Prevention

Gradual Progression: Follow the 10% rule—increase playing time or intensity by no more than 10% weekly. If you haven't played tennis all winter, start with 20-30 minutes and gradually build up.

Proper Technique: Work with a qualified coach to ensure correct stroke mechanics, particularly for the backhand. Focus on using the whole body, not just the arm.

Equipment Check:

• Use appropriate racquet weight (lighter for beginners)
• Ensure correct grip size (when holding the racquet, there should be a finger-width gap between fingers and palm)
• String tension around 50-55 pounds (lower tension reduces vibration)
• Consider vibration dampeners

Strengthening:

• Wrist extensor exercises: Hold a light weight, rest forearm on a table with hand hanging off, slowly raise and lower hand
• Eccentric strengthening: Proven most effective for tendinopathy
• Grip strengthening using a therapy ball or gripper
• Shoulder and scapular strengthening to reduce compensatory strain

Warm-Up: Always warm up before playing with gentle arm movements, wrist circles, and light practice shots.

Rehabilitation Approach

Early Stage (Pain Management):

• Relative rest (modify but don't completely stop activity)
• Ice for pain relief (15-20 minutes, 3-4x daily)
• Consider wearing a counterforce brace during activity
• Gentle range of motion exercises

Progressive Loading: Research strongly supports eccentric exercise as the most effective treatment for tendinopathy. This involves slowly lengthening the muscle under load.

Return to Sport: Gradual return following a structured progression. Don't return to full play immediately after pain resolves - the tendon needs time to rebuild capacity.

Timeframe: Tennis elbow typically takes 6-12 weeks to improve with appropriate treatment, though chronic cases may take longer.

Cricket Shoulder Injuries

Cricket places unique demands on the shoulder, particularly for bowlers but also affecting batsmen and fielders. Shoulder injuries are among the most common cricket-related problems we see.

Types of Cricket Shoulder Injuries

Rotator Cuff Tendinopathy: Overuse of the rotator cuff muscles (particularly infraspinatus and supraspinatus) from repetitive bowling action.

Shoulder Impingement: Pinching of tendons or bursa in the shoulder during the overhead bowling action, causing pain and reduced range of motion.

Labral Tears: More common in fast bowlers, these involve tears to the cartilage rim of the shoulder socket from repetitive high-speed movements.

Biceps Tendinopathy: Pain at the front of the shoulder from overuse of the long head of biceps tendon.

Why Do Cricket Shoulders Get Injured?

Bowling Workload: Fast bowlers can bowl 100+ deliveries in a match, each placing enormous force through the shoulder. Without adequate conditioning and recovery, tissues become overloaded.

Poor Bowling Technique: Inefficient mechanics increase shoulder stress. Common issues include:

• Dropping the bowling arm ("bowling around the wicket arm")
• Excessive shoulder rotation
• Poor trunk and hip rotation forcing the shoulder to compensate
• Inappropriate bowling length and run-up

Muscle Imbalances: Dominant strengthening of internal rotators and neglect of external rotators creates imbalance and increased injury risk.

Inadequate Warm-Up: Bowling at full speed without proper warm-up places excessive stress on cold tissues.

Sudden Increases in Bowling Load: Going from off-season to full match bowling without gradual build-up is a recipe for injury.

Evidence-Based Prevention

Bowl Monitoring: Track bowling loads (number of deliveries) and follow progressive increases. Research suggests:

• Increase weekly bowling volume by no more than 10-20%
• Avoid bowling on consecutive days when possible
• Fast bowlers should limit overs per spell (4-6 overs maximum)
• Young cricketers have specific bowling guidelines by age

Technique Assessment: Work with qualified coaches to optimize bowling action, reducing unnecessary shoulder stress while maintaining effectiveness.

Strengthening Programme: Focus on:

• External rotators: Band exercises, side-lying external rotation
• Scapular stabilizers: Rows, scapular push-ups, wall slides
• Rotator cuff balance: Equal attention to all rotator cuff muscles
• Core and hip strength: Proper power generation starts from the ground up
• Throwing-specific exercises: Progressive return to throwing drills

Research shows that programmes emphasizing external rotation strength and scapular stability reduce shoulder injury rates in overhead athletes by 30-50%.

Warm-Up Protocol:

• 5-10 minutes general cardiovascular activity
• Dynamic shoulder mobility exercises
• Progressive throwing: Start at short distance with easy throws, gradually increase distance and intensity
• Practice deliveries at 50%, 75%, then 90% before full speed

Recovery Strategies:

• Ice shoulder for 15-20 minutes post-bowling
• Rest days between bowling sessions
• Maintain year-round shoulder conditioning, not just during season

Rehabilitation Approach

Initial Management:

• Reduce bowling volume or complete rest depending on severity
• Address pain and inflammation
• Maintain range of motion with gentle exercises

Strengthening Phase: Progressive strengthening emphasizing:

• Rotator cuff endurance and strength
• Scapular control
• Kinetic chain efficiency (power from legs and trunk, not just shoulder)

Return to Bowling: Structured progression through:

1. Pain-free daily activities and gym work
2. Stationary throwing drills
3. Short-distance throwing
4. Progressive distance throwing
5. Bowling with reduced run-up
6. Full run-up bowling at reduced speed
7. Match-pace bowling
8. Return to competitive play

Timeframe: Mild rotator cuff tendinopathy may resolve in 4-6 weeks with appropriate management. More severe injuries or labral issues may require 3-6 months or longer.

Other Common Summer Sports Injuries

Ankle Sprains (Touch Rugby, Beach Volleyball, Ultimate Frisbee)

What Happens: Ligaments on the outside of the ankle stretch or tear when the foot rolls inward.

Prevention:

• Ankle strengthening exercises (calf raises, balance work)
• Proprioception training (single-leg balance on unstable surfaces)
• Proper footwear with ankle support
• Taping or bracing for those with previous sprains

Rehabilitation: Progressive weight-bearing, range of motion exercises, strengthening, balance training, and sport-specific drills before return to play.

Rotator Cuff Injuries (Swimming, Surfing)

What Happens: Overuse of shoulder muscles from repetitive overhead movements in water sports.

Prevention:

• Progressive training volume increases
• Stroke technique assessment
• Dryland strengthening focusing on scapular stabilizers and external rotators
• Adequate recovery between sessions

Rehabilitation: Similar principles to cricket shoulders - progressive loading of rotator cuff, addressing muscle imbalances, gradual return to swimming volume.

Lower Back Pain (Golf, Rowing)

What Happens: Repetitive rotation and flexion movements, combined with poor core stability, strain lower back structures.

Prevention:

• Core strengthening programme
• Hip mobility work
• Technique coaching (particularly golf swing mechanics)
• Proper warm-up including rotation mobility
• Gradual increases in playing time or training volume

Rehabilitation: Address core stability deficits, improve hip and thoracic spine mobility, progressive return to sport following pain resolution and strength gains.

Achilles Tendinopathy (Running, Touch Rugby)

What Happens: Overload of the Achilles tendon from excessive running or jumping, especially when increasing volume too quickly.

Prevention:

• Gradual progression in running volume and intensity
• Calf strengthening (particularly eccentric calf raises)
• Appropriate footwear
• Adequate recovery between high-intensity sessions

Rehabilitation: Eccentric loading programme (proven most effective), progressive return to running, addressing contributing factors like ankle stiffness or calf weakness.

Runner's Knee (Running, Cycling)

What Happens: Pain around or behind the kneecap from tracking issues, often related to hip weakness or poor biomechanics.

Prevention:

• Hip strengthening (particularly gluteus medius)
• Gradual training progression
• Appropriate footwear
• Running technique assessment

Rehabilitation: Hip and quadriceps strengthening, addressing foot biomechanics if needed, gradual return to running with modified volume/intensity.

Universal Injury Prevention Principles

Regardless of your chosen summer sport, these principles reduce injury risk:

Progressive Overload

The single most important principle: increase demands gradually. The "too much, too soon" pattern is the leading cause of overuse injuries.

Apply the 10% Rule: Increase training volume, intensity, or frequency by no more than 10% per week.

Plan Periodization: Alternate harder and easier weeks. Every 3-4 weeks, reduce volume by 20-30% for recovery.

Proper Warm-Up and Cool-Down

Effective Warm-Up (10-15 minutes):

• General cardiovascular activity to increase body temperature
• Dynamic stretching and mobility work
• Sport-specific movements at gradually increasing intensity

Cool-Down (5-10 minutes):

• Light aerobic activity to gradually reduce heart rate
• Gentle static stretching of worked muscles
• Rehydration and nutrition

Strength and Conditioning

Sport-specific training isn't enough. Include:

• General strength training 2-3x weekly
• Core stability work
• Balance and proprioception exercises
• Flexibility and mobility training

Equipment and Environment

• Ensure equipment is appropriate and properly fitted
• Maintain equipment regularly (re-string racquets, replace worn shoes)
• Consider playing surfaces (hard courts vs grass creates different demands)
• Adapt to conditions (heat, wind, court conditions)

Listen to Your Body

Pain is a Signal: Don't ignore persistent pain or discomfort. Early intervention prevents minor issues from becoming major problems.

Distinguish Between Discomfort and Pain:

• Training discomfort (muscle fatigue, breathlessness) is normal
• Sharp pain, pain that worsens during activity, or pain that persists after should be investigated

Rest When Needed: Taking 2-3 days off is better than ignoring warning signs and needing 2-3 months off later.

When to Seek Physiotherapy

Consult Auckland Physiotherapy if you experience:

• Pain persisting more than 3-5 days despite rest
• Pain that worsens with activity
• Swelling, bruising, or deformity
• Significantly reduced range of motion
• Inability to perform normal activities
• Previous injury to the same area recurring
• Uncertainty about whether you should continue playing

What to Expect from Physiotherapy

Comprehensive Assessment:

• Detailed injury history
• Physical examination including strength, flexibility, and movement quality testing
• Sport-specific assessment (we may ask about technique, training volume, equipment)
• Identification of contributing factors

Individualized Treatment Plan:

• Pain management strategies
• Manual therapy techniques (massage, joint mobilization, dry needling)
• Progressive exercise prescription
• Load management advice
• Technique modification recommendations
• Return-to-sport planning

Education and Prevention:

• Understanding your injury and what caused it
• Self-management strategies
• Prevention of recurrence
• Long-term training recommendations

Creating Your Injury Prevention Plan

Pre-Season (November-December):

• Sport-specific conditioning programme
• Address any lingering niggles from previous season
• Equipment check and replacement if needed
• Technique assessment with coaches

In-Season (December-March):

• Monitor training loads and competition schedule
• Maintain strength and conditioning alongside sport
• Regular recovery practices (sleep, nutrition, rest days)
• Address minor issues promptly before they worsen

Post-Season (March-April):

• Active recovery with reduced training volume
• Address any injuries sustained during season
• Maintain base fitness level
• Plan improvements for next season

Conclusion

Summer sports injuries are frustrating but often preventable. The key lies in respecting your body's capacity, progressively building tolerance to sport demands, maintaining strength and mobility, and addressing warning signs early.

Whether you're returning to tennis after a winter break, bowling your first overs of the cricket season, or trying beach volleyball for the first time, remember that sustainable participation requires smart training, adequate recovery, and appropriate technique.

At Auckland Physiotherapy, we're passionate about keeping Auckland athletes active and injury-free throughout summer and beyond. We understand the demands of summer sports and provide evidence-based assessment, treatment, and prevention strategies tailored to your specific sport and goals.

Dealing with a summer sports injury or want to prevent one? Visit www.aucklandphysiotherapy.co.nz or contact Auckland Physiotherapy today to book your assessment and get back in the game. Housed in the beautiful Foundation Precinct, sandwiched in-between Newmarket, Parnell & Remuera

This blog provides general information and is not a substitute for individual assessment. Sports injuries vary in severity and appropriate management. Always consult with a qualified physiotherapist for personalised advice regarding your specific injury or condition.