“This is energy that springs from the legs, up through the spine, down the arm to the forearm and across the wrist to the racket. At some point, either through genetics or the playing style, the structural integrity of any of those structures is exceeded. For any given individual, the force is greater than the structures are capable of withstanding. That’s where the injury comes from.”

Most sports wrist injuries that involve swinging, Berger said, occur on the less firmly anchored ulnar side of the joint, below the little finger. And tennis players can be more susceptible to the injuries than baseball players or golfers because the impact of their swings is mostly absorbed by one arm.

“In tennis, even if somebody is using a two-handed backhand, there is still a dominance of one hand during the swing,” Berger said, adding, “That one-handedness during the swing is probably a point of vulnerability in the tennis player, much more so than in the other sports, where you’ve got both hands working equally on whatever it is that you’re swinging.”

And the level of physicality in the sport continues to be pushed higher, especially in lengthy rallies.

“This is no slam on the players of 20 years ago — they were incredibly fit,” Berger said. “But I think that with the technology available for training, the regimens that these players go through in their daily routines for fitness, you’re getting close to a superhuman capacity. Again, the ligaments aren’t really able to keep up with that because they don’t change.

“You’ve got this overwhelming strength and speed in the players, that competitive drive that once they’re out there playing, they’re going to be playing as hard as they can against their opponents, and they can get into this vicious cycle of ‘Well, I can outhit you.’ But these structures are just so vulnerable.”