From Breakpoint To Advantage: A Practical Guide to Optimal Tennis Health and Performance

By Babette Pluim, M.D., Ph.D., and Marc Safran, M.D.


A book like this does not just "happen" from one day to the next. Many steps need to be taken before the final product can be found on the bookstore shelves. And we never realized how many steps actually need to be taken, until we started writing this book ourselves.

Babette started working as a sports physician for the Royal Netherlands Lawn Tennis Association in 1990. One of the aspects of the job she very much enjoyed was writing short articles. The first article she wrote was called "Ten Ways to Prevent Tennis Elbow," which included ten practical tips for tennis players. The article was well received, so she decided to use that same concept with other topics as well. Later, she started extending the articles somewhat by including first aid and treatment, in addition to prevention. These articles became so popular that the Royal Netherlands Lawn Tennis Association decided to make "Injury Cards" of them. Each A4-sized laminated card discusses one tennis-related medical topic as it relates to coaches and players. The popularity of the cards showed us that practical medical information on tennis-related issues was very much needed and desired!

Marc worked in private practice and with an HMO before joining the full time faculty at the University of California, San Francisco as the director of sports medicine in the department of Orthopaedic Surgery in 2001. He studied junior tennis injury rates, patterns, and gender differences as he noticed the game of tennis was changing for boys, girls, men and women. He served as the medical director for the WTA tournament in La Costa (San Diego, California) and as the neutral site physician for several Davis Cup ties. As such, he had much experience dealing with the recreational, competitive and professional tennis player and had always tried to educate players, coaches and others in tennis injury treatment, prevention and return to play guidelines. He noted a lack of scientific data to help guide these recommendations, but noted that many of those with experience in treating players recommended similar procedures. By the time he was approached by Babette about writing this book, he was nearly finished writing a general sports medicine book for patients with sports medicine problems. But that book was not specific for tennis.

In 1991, the Society of Tennis Medicine and Science (STMS) was founded, with Ben Kibler and then Per Renström as the first presidents. Babette was thrilled to attend the first congress at Yale, in August 1991. What a great opportunity to be able to interact with an international group of sports medicine experts, working in close co-operation with the ITF, ATP and WTA Tour, dedicated to generating and disseminating knowledge of tennis medicine and science.

Marc joined the society in 1995, seeing the same wonderful things about the society that so enthralled Babette. This is where we found that many clinicians (surgeons, medical doctors, therapists and trainers) had similar practice ideas and results with regard to treating tennis players, but this was mostly based on their experience. Since then, we have both attended many meetings, sharing our knowledge with others and learning a lot in the process as well.

Marc organized a very successful STMS congress in Indian Wells, in March 1999. We got on very well, and started working together on projects within the STMS. And slowly the idea of writing a book emerged, with Babette initiating and driving the idea. We had noticed there are many books on the market on general sports medicine, but relatively few on tennis medicine, and fewer still written for non-physicians. And even though the knowledge in this field had steadily increased, the information was still not very accessible to the coach and player. So … why not write a book to fill the gap? But since writing a book is definitely more difficult and much more work than writing an article, it took us two years of thinking and playing with the idea before anything happened. If we were going to write this book, we really had to be sure we were writing a practical book for players, coaches, trainers and so forth.

The final impetus came at a conference in London where Babette discussed the idea of the book with a sport science colleague, Paul Roetert. Paul had written a great tennis book on strengthening and conditioning and was in the process of finishing another book. "How did you do that," Babette asked. "I just sat down and started writing," he told Babette. That did it! We could do that! And so the project began.

When we started writing this book, we had three goals in mind. First, we wanted to provide the reader with state-of-the-art information on tennis injuries and illnesses, and include both prevention and treatment approaches, as well as how to return to play. We knew from our experience that this information was lacking to the people who most need it. Secondly, we wanted to present this information in a very practical way, so the book would not remain lying on a shelf. We wanted the reader (coach, player, therapist, athletic trainer) to take the book on court with them. And thirdly, we wanted the reader to really understand their injuries and be able to perform the exercises without having to read a sentence three times and without the need of a medical translator. Since a picture says more than a thousand words, we decided to include many drawings and photographs.

We organized in such a way that it allows for selective reading. The book starts with the basics of the game: the physiological and biomechanical aspects of tennis, equipment variables, shoes and surfaces, and the basic principles of injury prevention and rehabilitation.

The core of the book is formed by a complete inventory of tennis injuries. All injuries are discussed by first describing the nature of the injury, followed by the symptoms, the treatment principles and then finally by practical tips for the tennis player — making this a very unique book. The next sections are devoted to medical issues in tennis players, selected issues (e.g., heat stress, doping, jet lag, and nutrition), special tennis groups (women, junior, veteran, and wheelchair tennis players), and managing and delivering tennis medicine programs (by the certified athletic trainer, sports physiotherapist, and sports physician). The final chapter presents a strength training program for tennis players.

We hope that reading this book will help you to enjoy tennis more, longer, and with as few injuries as possible. We have both learned by experience that you really DO need to prepare for tennis if you want to remain injury free. It has been said that you should get into shape to play tennis, but do not use tennis to get into shape — this is how players can get injured. This book will give you plenty of useful tips. So go out there, and enjoy!

Babette M. Pluim
Marc R. Safran

Book Specifications
Chapters 28
Sections 6
Pages 400
Illustrations 500
Index Yes
References Yes
Cover Paperback
Size 8.5 × 11
ISBN 0-9722759-1-6