How to play ping pong safely

People might not think of ping pong, or table tennis, as an injury-inducing sport, but what might be a pastime to some can be an intense match for others. A Baylor College of Medicine orthopedic surgeon details common ping pong injuries and how to avoid them with proper warm up and form. 

You usually think about working the hand and wrist in ping pong because you hold a paddle, but there is a difference in movement between high-level players and amateurs. More advanced players also jump, lunge, sprint, stand far back and do lateral movement using the muscles in their legs and core. 

“The level of play dictates a lot. More amateur players will be using hands, wrists and shoulders more, whereas high-level players are hitting harder and faster and standing further back so they have a lot more movement, kind of like an actual small tennis match,” said Dr. Adil Ahmed, assistant professor in the Joseph Barnhart Department of Orthopedic Surgery. 

Regardless of whether you are high-level or amateur, everyone should warm up before a ping pong match with basic stretching for legs, hamstrings, glutes and quads. While some might not think of it as an explosive or highly athletic activity, you lunge, make quick movements and take quick steps to hit the ball, especially if your opponent hits a good angle. 

“If you don’t warm up, those sudden, explosive movements are common modes of injury regardless of the sport,” Ahmed said. “Even in something like pickup basketball, you can tear your Achilles with a sudden drop step. You step similarly when playing ping pong, you’re just not covering the same distance.”  

He suggests dynamic stretching to gradually work those same muscles with motion. Dynamic stretches include light jogging, skipping or shuttles (lateral movement back and forth). Active stretching for the first 20 to 30 minutes of the workout is recommended. 

“It does fatigue you and you should be sweating. Stretching and warming up should not be a very relaxed activity. It needs to up your heart rate a little, and that’s how you’re going to get warm,” Ahmed said.

While ping pong is not a contact sport, injuries are common. Overdoing it or forcefully flicking the wrist (wrist extension) might lead to injury. If you have preexisting arthritis in the wrist, thumb-based joint or fingers, you might experience injury from gripping the paddle hard, making sudden, rapid movements and moving at different angles and rotations. Almost all muscles and tendons that go into the fingers originate in the forearms, so stretching the wrists, fingers and forearms is crucial for ping pong. 

The injuries between ping pong and tennis differ. Amateur tennis players are prone to overuse injuries and stress fractures that turn into shin splints, patellar pain, patella femoral pain and shoulder injuries from serving with incorrect form.

“It’s a very fast, aggressive movement, so if your form is not good, you can have bicep tendon injuries, rotator cuff injuries and labral injuries because you’re using those big muscles and hitting hard to get that serve speed up, whereas in ping pong, you’re not doing huge swings and huge motion,” Ahmed said.

An injury to the shoulder girdle is less likely in ping pong, but more often people will tweak the elbow if they torque it hard because spin is important. To put top spin on the ball, you work your elbow and wrist to generate the spin on the ball rather than a forceful swing through like tennis.  

Whether you play a friendly or competitive ping pong match, remember to stretch and warm up to prevent injuries as you would for any other sport.