Epidemiology of Tennis-Related Injuries Among Competitive Youth Players in Tunisia: Frequency, Characteristics, and Management Patterns.

Background and Objectives: Tennis involves repetitive high-velocity movements, rapid directional changes, and challenging environmental conditions, exposing players to injury risk. However, injury surveillance data for North African youth players are lacking. This study aimed to determine the frequency, characteristics, and management of tennis-related injuries among competitive Tunisian youth players. Materials and Methods: A cross-sectional study was conducted among players aged 5-18 years from tennis clubs (October 2023-November 2024). Data were collected using researcher-administered questionnaires, incorporating the Oslo Sports Trauma Research Center Overuse Injury Questionnaire and a sport-specialization assessment, following International Olympic Committee guidelines. Results: Among 256 players, 53.5% (n = 137) reported 366 injuries. Lower limbs were most affected (58.5%), followed by upper limbs (32.8%); knees (23.2%), ankles (17.5%), and wrists (10.1%). Muscle/tendon (36.9%), superficial tissue (28.1%), and ligament/joint capsule injuries (27.6%) predominated. Most injuries occurred during practice (74.9%) and hot weather (93.4%). Severe injuries represented 24%, while 29.5% were minor without time loss. Subsequent injuries occurred in 54.6% of injured players, with significantly higher rates in those with incomplete rehabilitation (p < 0.001). Conclusions: The high frequency of recurrent injuries and limited rehabilitation highlight critical gaps in injury management, emphasizing the need for targeted neuromuscular training, accessible rehabilitation, and standardized return-to-play protocols.