Foot Demands of Tennis and Racquet Sports

Tennis, pickleball, racquetball, and squash are dynamic court sports requiring explosive lateral movement, rapid direction changes, split-step reactions, and forceful push-offs. The stop-start nature of court sports—combined with the hard playing surfaces used for most recreational and competitive play—creates substantial cumulative stress on the feet and ankles. With pickleball now the fastest-growing sport in the United States, podiatrists are seeing increasing numbers of recreational players presenting with foot and ankle injuries from these activities.

Ankle Sprains: The Most Acute Threat

Lateral ankle sprains are among the most common acute injuries in racquet sports. They occur when a player changes direction, reaches for a wide shot, or lands from a jump and the ankle rolls inward. The anterior talofibular ligament (ATFL) is most commonly torn. Severity ranges from mild Grade I sprains (ligament stretch) to severe Grade III complete tears with significant instability. Proper rehabilitation—including progressive balance and proprioception training—following any significant ankle sprain is essential to prevent the chronic ankle instability that develops in up to 40% of incompletely rehabilitated sprains.

Plantar Fasciitis in Court Athletes

The repetitive heel-to-toe movement patterns of tennis—combined with hard court surfaces that provide minimal shock absorption—make plantar fasciitis highly prevalent among frequent court sport players. Middle-aged recreational players who increase court time without adequate conditioning are particularly susceptible. Tennis-specific shoes with enhanced heel cushioning and medial arch support, combined with regular calf stretching and custom orthotics, provide effective prevention and treatment.

Blisters and Skin Friction Problems

The lateral sliding movements of court sports create high friction forces between the foot and sock, and between the sock and shoe. Blisters most commonly form on the posterior heel, ball of the foot, and toes. Prevention strategies include moisture-wicking double-layer or blister-specific socks, properly fitted court shoes (replacing them every 40–60 hours of play), and Moleskin or blister-prevention products applied prophylactically to known hotspots. Established blisters should be protected and not drained unless tense and painful; infected blisters require professional evaluation.

Achilles Tendinopathy in Racquet Sports

The explosive calf loading during serve motions, net approach sprints, and overhead smashes places significant eccentric stress on the Achilles tendon. Midportion Achilles tendinopathy develops gradually in players who increase training volume without adequate recovery. The eccentric heel drop protocol—3 sets of 15 slow, single-leg heel drops performed daily—is the gold-standard conservative treatment and is highly effective when performed consistently over 8–12 weeks.

Footwear for Court Sports

Court-specific shoes are engineered for the lateral stability demands of racquet sports and should never be substituted with running shoes. Court shoes feature reinforced lateral uppers to resist ankle rolling, toe drag reinforcement (important for tennis players who drag the dominant foot toe during serve follow-through), herringbone or modified herringbone outsoles for optimal court grip, and a lower heel-to-toe drop than running shoes for better court feel and stability. Replacing court shoes at recommended intervals (typically every 40–60 hours of play) maintains shock absorption and structural support critical for injury prevention.

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Dr. Tom Biernacki, DPM

Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.