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From Breakpoint To Advantage: A Practical Guide to Optimal Tennis Health and Performance
Table of Contents
By Babette Pluim and Marc Safran
Contents vii
Foreword xiii
Preface xv
Acknowledgements xvi
PART 1: PRINCIPLES OF INJURY PREVENTION AND REHABILITATION
1 The Biomechanics of Tennis 3
How to Hit the Ball with Power 3
Explanation of Terms 4
Movement Analysis 7
The Serve 6
Injury Risk during Serving 7
The Forehand 9
Injury Risk during the Forehand 10
The Backhand 12
Injury Risk during the Backhand 12
Summary 15
2 Physiological Demands of the Game 17
ATP and Energy 17
The Immediate Energy System 18
The Short-term Energy System 18
The Long-term Energy System 19
Measurement of Energy Capacities 20
Testing the Immediate Energy System 20
Testing the Short-term Energy System 20
Testing the Long-term Energy System 21
Summary 23
3 Racquets, Strings, and Balls 25
Material and Composition of the Racquet 25
Size of the Racquet Head 26
Stiffness 27
Length 27
Weight 27
Balance 28
Grip Size 28
Grip Material 29
Stringing Material 29
String Thickness 29
String Tension 29
Vibration Stoppers (string implant devices) 30
Pressurized and Nonpressurized Tennis Balls 30
The Size and Deformation of the Tennis Ball 31
Choosing Arm Friendly Equipment 31
Summary 31
4 Tennis Shoes and Playing Surfaces 33
Playing Surface 33
The Tennis Shoe 34
Cushioning 35
Stability 35
Stiffness 35
Outsole 35
Summary 37
5 Injury Prevention 39
Epidemiology of Injuries 40
Before Play 41
The Pre-participation Physical Examination 41
Warm-up 41
Flexibility and Stretching 42
Types of Stretching 42
Stretching Exercises 44
Strengthening Exercises 48
During Play 49
Racquets, Strings and Balls 49
Shoes and Surfaces 49
Protective Devices 49
Taping and Bracing 49
Protective Eyewear 50
After Play 51
Cooling-down 51
Massage 51
Whirlpool and Jacuzzi 51
Sleep 51
Muscle Relaxation Techniques 52
Breathing Exercises 53
Yoga 53
Pilates 53
Nutrition 54
Facility Checklist 54
Summary 56
6 General Rehabilitation Principles 57
Phases of Tissue Healing 57
Healing Time of Specific Tissues 58
Accute Phase 58
RICE 58
Therapeutic Modalities 59
Medications 59
Intermediate Phase 60
Early Mobilization 60
Range of Motion and Flexibility 60
Muscular Strength and Endurance 61
Alternative Training Methods 61
Proprioceptive Training 62
Therapeutic Modalities 62
Medications 63
Advanced Phase 63
Strengthening and Agility Exercises 63
Return to Play 63
Therapeutic Exercise Training for the Knee 64
Therapeutic Exercise Training for the Shoulder 67
Therapeutic Exercise Training for the Lower Back 71
Summary 74
PART 2: A COMPLETE INVENTORY
OF TENNIS INJURIES
7 Injuries of the Upper Body 77
Bump on the Hand or Wrist (ganglion cyst) 77
Snapping Wrist (subluxating extensor carpi ulnaris) 78
Clicking, Painful Wrist (triangular fibrocartilage tears) 80
Wrist Sprain 81
Wrist Pain in Young Players (wrist epiphysitis) 82
Tendinopathy (tendinitis) around the Wrist 83
Pain Moving Thumb (De Quervain's tenosynovitis) 85
Squeaker's Wrist (intersection syndrome) 86
Hamate (hook) Fractures 86
Tennis Elbow (lateral epicondylitis) 87
Golfer's Elbow (medial epicondylitis) 90
Elbow Pain in Young Children (Panner's Disease) 92
Osteochondrits Dissecans of the Elbow 92
Medial Epicondylar Apophysitis 93
Posterior Impingement Syndrome of the Elbow 94
Sprain of the Ulnar Collateral Ligament 96
Cubital Tunnel Syndrome (Ulnar Neuritis) 97
Ulnar and Humeral Stress Fracture 98
Traction Apophysitis of the Shoulder 98
Little Leaguer's Shoulder (stress fracture of the proximal humeral epiphysis) 99
Shoulder Instability 99
Dislocation of the Shoulder 101
Pinching Rotator Cuff Tendons (Impingement Syndrome) 103
Rotator Cuff Tear 106
SLAP Lesions 108
Snapping Scapula 111
Separated Shoulder (acromioclavicular joint separation) 112
Clavicular Osteolysis 113
AC Arthritis 113
Biceps Tendinopathy (Tendinitis) 114
Biceps Tendon Rupture at the Shoulder 116
Biceps Tendon Subluxation 117
Shoulder Muscle Wasting (suprascapular neuropathy) 117
Scapular Winging (serratus anterior palsy, long thoracic nerve injury) 119
Thoracic Outlet Syndrome 120
Summary 122
8 Injuries of the Lower Body 123
Muscle Strains 123
Tennis Leg (calf muscle strain) 124
Strain of the Anterior Thigh (quadriceps muscles) 126
Strain of the Posterior Thigh (hamstring muscles) 127
Strain of the Inner Thigh (adductor muscles) 128
Stress Fractures 130
Stress Fracture of the Forefoot (Metatarsals) 131
Stress Fracture of the Lower Leg (Tibia & Fibula) 131
Bump on the foot (Bunion) 132
Turf Toe 133
Stiff Big Toe (hallux rigidus) 134
Morton's Neuroma (interdigital neuritis) 135
Tarsal Tunnel Syndrome 136
Heel Pain Syndrome (plantar fasciitis) 137
Heel Pain in Young Players (calcaneal apophysitis,
Sever's disease) 139
Tendinopathy of the Achilles Tendon 140
Achilles Tendon Rupture 142
Ankle Sprain 143
Chronic Ankle Instability 145
Anterior Ankle Impingement 146
Posterior Ankle Impingement 148
Tendinopathy and Rupture of the Posterior Tibial Tendon 148
Tendinopathy and Rupture of the Peroneal Tendons 149
Peroneal Tendon Subluxation 150
Chronic Exertional Compartment Syndrome 152
Shin Splints (medial tibial stress syndrome) 153
Meniscus Tear 154
Meniscal Cyst 156
Medial Collateral Ligament Sprain 157
Anterior Cruciate Ligament Injury 159
Anterior Knee Pain (Pain in the Front of the Knee 161
Patellofemoral Pain Syndrome 161
Jumper's Knee (Patellar Tendonitis) 164
Osgood Schlatter's Disease 166
Sinding-Larsen-Johansson Syndrome 168
Hoffa's Disease (infrapatellar fat pad syndrome) 168
Pes Anserinus Syndrome 169
Iliotibial Band Syndrome 170
Popliteus Tendinopathy (Popliteus Tendinitis) 172
Osteitis Pubis 173
Bursitis of the Hip 175
Tendinopathy of the Outer Hip Muscles 175
Piriformis Syndrome 176
Hip Labral Tears 178
Summary 179
9 Injuries of the Trunk and Spine 181
Low Back Pain (nonspecific) 181
Facet Syndrome 183
Herniated Disc (ruptured or slipped disc) 185
Spondylolysis and Spondylolisthesis
(vertebrae fracture and slippage) 186
Rib Stress Fractures 188
Abdominal Muscle Strains 189
Whiplash (Cervical Strain and Sprain) 191
Summary 192
PART 3: MEDICAL ISSUES
10 Brain and Nervous System 195
Tension Headache 195
Migraine 195
Exercise Induced Headache 196
Cervicogenic Headache 197
Ringing in the Ear (tinnitus) 198
Summary 198
11 The Eye 199
Injuries of the Eyelid 199
Eye Scratches (corneal erosion) 200
Red Eye (conjunctivitis) 200
Blood in the Eye (hyphema) 201
Eyelid Inflammation (blepharitis) 201
The Common Stye 201
Bump on the Eyelid: Inflammation of
Oil Gland (chalazion) 202
Dry Eyes 202
Thickenings on the White of the Eye
(pinguecula and pterygium) 202
Cataracts 203
Retinal Detachment 204
Fracture of the Eye-Socket 204
Vision Disorders 205
Visual Training 206
Summary 206
12 Skin Disorders 209
Blisters 209
Callus 210
Corns (clavi) 211
Tennis toe (black toe) 211
Ingrown Toenail 212
Excessive Sweating 212
Insect Stings 212
Tick Bites and Lyme disease 213
MassageRash (folliculitis) 214
Athlete's foot (tinea pedis) 215
Cold Sores (fever blisters) 215
Warts (verrucae) 216
Sun Related Disorders 217
Sunburn 217
Skin cancer 217
Summary 219
13 The Heart and Blood Vessels 221
Athlete's Heart 221
Premature Heartbeat 222
Racing Heartbeat (tachycardia) 222
Fainting Spells (syncope) 223
Inflammation of the Heart Muscle (myocarditis) 223
Atherosclerosis (hardening and narrowing of arteries) 224
High Blood Pressure 225
Heart Attack 225
Sudden Exercise Related Cardiac Death 226
Upper Extremity Vascular Injuries 227
Cold Finger (digital ischemia) 227
Blood Clot in the Arm (effort thrombosis
of the upper extremity) 228
Axillary-Subclavian Artery Compression 228
Summary 229
14 The Respiratory System 231
Hay Fever (allergic rhinitis) 231
Sinusitis 232
Viral Upper Respiratory Tract Infection 233
Exercise Induced Asthma 233
Respect the Anti-doping Program 235
Summary 235
15 The Digestive System 237
Stomach flu (viral gastroenteritis) 237
Food Poisoning 238
Traveler's Diarrhea 239
Heartburn 240
Stitch 241
Irritable Bowel Syndrome 241
Summary 242
16 Other Medical Conditions 243
Diabetes Mellitus 243
Glandular Fever 245
Anemia 245
Summary 246
PART 4: SPECIAL ISSUES
17 Heat Stress 249
Heat Production 249
Fluid Loss 250
Salt Loss 251
The Risks of Playing in the Heat 251
Sports Drinks 253
Drinking during a Match 254
Drinking after a Match 254
Summary 256
18 Nutrition and Supplements 257
Carbohydrates 257
Protein 258
Fat 259
Vitamins 261
Minerals 261
Antioxidants 262
Creatine 262
Miscellaneous products 262
Summary 263
19 Doping and Drug Testing 265
What Is Doping? 265
The List of Prohibited Substances and Methods 266
What Is the WADA? 266
Who Can Be Tested? 266
When Can a Test Occur? 266
Who Administers the Testing? 266
The Therapeutic Use Exemption 266
Player Notification of Testing 267
The Testing Procedure 267
Test Results and Reporting 267
Penalties 267
Announcement of Suspensions 268
Nutritional Supplements 268
Summary 268
20 Overtraining and Burnout 271
Overtraining 271
Burnout 272
Summary 275
21 The Travelling Player 277
Jet lag 277
Vaccinations 279
Malaria 279
Sexually Transmitted Diseases 280
The Travel Kit 281
Summary 282
PART 5: SPECIAL TENNIS GROUPS
22 Junior Players 285
Growth and Maturation 285
Physical Capacities 286
Aerobic Power 286
Anaerobic Performance 286 Strength 287
Co-ordination 288
Flexibility 288
Heat Stress 289
Epidemiology of Injuries 290
Summary 290
23 Veteran Players 291
Use It or Lose It! 291
Aerobic Capacity 292
Strength Training 292
Co-ordination 293
Flexibility 293
Cardiovascular Risks 293
Heat Stress 294
Osteoporosis 294
Epidemiology of Injuries 295
Total Joint Replacement 295
Summary 296
24 Women's Issues 297
Body size 297
Injury patterns 297
The Female Athlete Triad 298
Eating Disorders 298
Menstrual Dysfunction 300
Osteoporosis 301
Pregnancy 301
Stress Urinary Incontinence 303
Summary 303
25 Wheelchair Tennis Players 305
Why Play Wheelchair Tennis? 305
Who Can Play Wheelchair Tennis? 305
Equipment 306
Wheelchair 306
Strapping 307
Clothing 307
Racquet 307
Conditioning 307
Injuries 308
Wrist Pain 308
Elbow Pain 309
Shoulder Pain 310
Trunk 310
Ailments 311
Bladder Infection 311
Seizures 312
Heat Stress 312
Autonomic Dysreflexia 313
Wheel Burns 313
Pressure Areas 313
Summary 314
PART 6: MANAGING AND DELIVERING
TENNIS MEDICINE PROGRAMS
26 The Sports Physician 317
The Tournament Physician 317
The Role of the Tournament Physician 317
Medical Rules 318
The Team Physician/Federation Doctor 319
The Role of the Team Physician 319
Pre-participation Physical Examination 319
Education and Counseling 320
Preparing for Travel 320
The Medical Bag 320
Medications 321
Respect the Tennis Anti-Doping Program 322
Sports Medicine Center Physician 322
Summary 323
27 The Athletic Trainer and Physiotherapist 325
Why A Certified Athletic Trainer or Sports
Physiotherapist Is Necessary 325
Education of the Certified Athletic Trainer 326
Education of Sports Physiotherapists 326
The Role of the Trainer or Physiotherapist 327
The Trainers and Physiotherapists on
the Professional Tours 327
Trainers and Physiotherapists at Local Tournaments 329
Trainers and Physiotherapistsr Responsibilities -- Pre-tournament 328
Trainers and Physiotherapists Responsibilities -- During the Tournament 328
Trainers and Physiotherapistsr Responsibilities -- Post-tournament 329
Summary 330
28 Strength Training for Tennis 331
Intensity, Duration, and Frequency 331
Velocity 332
Equipment 332
Basic Exercise Program 332
Shoulders 332
Arms 337
Elbow, Wrist and Hand 338
Upper Back 340
Addominals 341
Back and Trunk 343
Hips and Groin 347
Thigh and Knee 349
Lower Leg, Ankle, and Feet 350
References 353
Index 365
About the Authors 373