Cervical or neck injuries occur in the game of tennis because of the tremendous forces occurring during play including rapid turning of the head, looking up to follow the ball, and incorporating the neck muscles and bone structures when exerting the tremendous forces to hit the ball. Between the shoulder blades injurious pain is local and referred from the neck.
Shoulder injuries occur mostly when hitting the ball overhead and when serving. A fall on the shoulder or hand is another cause of shoulder injuries. Rotator cuff injuries are rarely seen. There are other structures in that area that will cause pain. The diagnosis is done by examination.
Elbow pain is caused by one or a combination of structural injuries, including lateral and medial muscles, and the capsule of the joint, which has a lateral and medial compartment. The treatment is quickly accomplished after the proper location of the injury is found, and the reason for that injury is ascertained. It is rarely the racket.
The hip joint is subject to rapid changes in direction when chasing the ball to hit it back. The forces on the hip joints is not usually the injured structure, but the connecting ligament structure. There is a specific method of diagnosis of the proper area of pain production, that is the injured area, then it can be treated successfully.
Knee pain is quite common in tennis players because of the same forces that affect the hip. In addition, the knee can only operate where the hip places it to bear weight. The knee pain is always located on the outer edge of the bone structures that is, the knee capsule where all of the pain fibers of the knee are located. Internal injuries to the knee joint are rare. Proper diagnosis of the location of the injury and the mechanism of that injury and its relation to the hip is most important for succesful treatment. Internal injuries always result in heat and free fluid is evident.
The lumbar spine and muscles is apparently not a major problem.
Surgery is always a failure of treatment.