Tennis
Injury Prevention -
Functional training for a stronger athlete
Some
sports injury prevention measures are simpler than others. Helmets minimize
head injuries. Mouthguards can prevent concussions.
Protective padding greatly lowers the risk of contusions, lacerations
and fractures. Unfortunately for tennis players, however, even the use
of head to toe body armor would be of no help in preventing those injuries
most commonly experienced on the court.
Considering the demands of court play, tennis players are
at risk of developing two distinctly different categories of injuries.
Whereas the high speed starting and stopping nature of tennis subjects
the player to acute/traumatic lower extremity injuries, repetitive motions,
overhead play and the strain of frequent acceleration and deceleration
heightens vulnerability to chronic/overuse type injuries.
A
two part article series on Preventing Tennis Injuries was previously published
in the USA Tennis New England e-newsletter.For a more
detailed discussion of acute/traumatic and chronic/overuse tennis injuries,
visit www.NCCsportsmed.com.
Review
Acute/traumatic injuries are those marked by an instantaneous
onset of pain and disability, and include conditions such as muscular
strains and ligament sprains or tears. Chronic/overuse injuries more
typically evolve over time, with the athlete experiencing progressive
pain and stiffness that may ultimately lead to physical limitations.
More commonly seen in the adult player, chronic/overuse injuries represent
more than two thirds of all tennis injuries and include ailments such
as tennis elbow, rotator cuff syndrome, achillestendinosis, degenerative arthritis, chronic joint sprains,
and stress fractures. Left untreated, chronic injuries and their resultant
physical impairments can increase an athlete’s likelihood of sustaining
a more disabling acute/traumatic injury.
Injury
Management
Regardless of whether an injury is acute or chronic in nature,
inadequate injury management can impede healing, prolong symptoms, and
may result in additional complications and functional impairment.
Inadequate management could include playing through pain,
delayed or sub-optimal injury evaluation, mis-directed
or ineffective therapeutic care, and the failure to take appropriate
preventative and/or supportive measures.
Consultation with a sports physician experienced in the management
of such injuries can provide for proper injury diagnosis, assuring timely
and appropriate care. In many cases,
this early intervention keeps the tennis
player on the court. However, when injury severity necessitates a period
of downtime, the goal of care is to facilitate a safe but speedy return
to play.
Without
question, timely and effective treatment of developing and/or existing
injuries serves as the foundation for preventing additional future injury.
Although it is difficult or impossible to predict exactly
who will get injured, and what type of injury they may sustain, perhaps
the most informative and practical way to identify an individual’s predilection
to injury is through a functional evaluation. This type of evaluation
goes beyond traditional symptom-based assessments in that it considers
the athlete’s genetic pre-disposition and structural vulnerability to
injury, and attempts to identify tennis-specific weaknesses prior to
the development of an injury.
For practical
purposes, functional evaluations are most often carried out in a group
or team setting; co-administered by a sports physician and a strength
and conditioning coach
Communication
between the sports physician, strength coach and the athlete’s tennis
coach can then assure that each individual player’s identified deficiencies
are appropriately addressed through prescriptive therapeutic and/or
conditioning based exercises.
Therapeutic
and conditioning exercises often begin with basic muscular coordination
movements; progressing to full speed, tennis specific skill development.
Coincident to this deficiency-based training, the strength coach can
implement an overall training routineto prevent injury and serve as the foundation of the
player’s tennis conditioning. An effective tennis injury prevention
program is multi-faceted in design and is not achieved
without considerable attention and effort. In order to be
truly comprehensive, the design of this type of program must respect
the intrinsic physical demands and risk factors of tennis, and must
be customized on an individual basis, as each athlete brings with them
their own personal injury history, athletic strengths and weaknesses.
With
considerationto the player’s seasonal tennis schedule, the strength
coach can implement training cycles into the overall conditioning routine,
a concept of training referred to as periodization.
By design, a periodized schedule times phases
of peak conditioning to coincide with the athlete’s competitive seasons
and lessens the cumulative stress and strain of repetitive, non-varied
training. In this way, both acute/traumatic and chronic/overuse injuries
can be minimized, performance can be maximized, and athlete burnout
prevented.
According
to Michael Wood, who is certified as a Strength and Conditioning Specialist
by the National Strength and Conditioning Association, this concept
of periodization is essential in training the competitive tennis
player.
“It
should be mandatory that all tennis coaches have their athletes involved
in a year long periodized strength and conditioning program that will ensure
their peaking for competition at the right time in addition to reducing
the risk of injury.”
Athletic
components such as agility, speed, reaction time, aerobic recovery, muscular
strength and power production can be developed in a tennis-specific manner.
As
Director of Business at Velocity Sports Performance in Mansfield,MA,
Michael witnesses first hand the multitude of benefits achieved through
the sport-specific training of all types of athletes, including the tennis
player.
“To
receive added benefit in speed and agility development, it is important
to train the body using the correct Work:Rest
ratio that you would see in a match situation.” He also notes that “The
average point in a tennis match lasts only 5 to 10 seconds, typically
followed by a rest period of 18 to 25 seconds.”
Five
to ten second intervals of anaerobic speed and agility work, followed
by a 10-25 second rest period simulates match
play.
Considering this type of physiological demand, the design of an effective
tennis conditioning program should include a Work:Rest
interval of approximately 1:2, and should implement short duration,
multi-directional movement patterns, similar to that of match play.
As
with dedicated athletes in any sport, it can be difficult to convince
the tennis player that time spent off-court can elevate their game.
However, attention given to tennis-specific fitness development will
improve many aspects of the athlete’s game and can minimize on-court
injuries.
Dr. Tim Morgan is a partner of
USA Tennis New England and maintains a sports medicine practice in Medfield,
MA.
For information regarding sports medicine, chiropractic and functional
training programs, contact him at TMorgan@NCCsportsmed.com or at 508.359.5200.
Michael
Wood, C.S.C.S., is Director of Business at Velocity Sports Performance
in Mansfield, MA, contact him at mwood@velocitysp.com
or 978.443.5727. Michael is a former assistant strength and conditioning
coach at the University
of Connecticut and was recently named as one
of the top 100 trainers in the country by Men’s Journal.
