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

by Pluim, Babette; Safran, Marc

• ISBN13: 9780972275910
• ISBN10: 0972275916
• Format: Paperback
• Copyright: 2004-09-01
• Publisher: Racquet Tech Publishing

Summary

Muscle imbalance, microtrauma, insufficient recovery, and biomechanical compensations are among the top health risks that tennis players encounter when they compete and practice too much, a common habit among professionals and avid players. This guide to playing healthy tennis offers descriptions and illustrations of the physical complexity of every tennis motion, demonstrating the astonishing array of potential injuries threatening the unprepared player. Optimal performance and low risk of injury are the top results for tennis players who adhere to the training program, proper nutrition, and equipment selection recommendations in this sports medicine manual. Consideration is given to the specific physical risks that juniors, veterans, female competitors, and wheelchair athletes may encounter.

Author Biography

Babette Pluim, M.D., Ph.D, is a sports physician and medical director of the Royal Netherlands
Lawn Tennis Association. She is the editor of the newsletter Medicine and Science in Tennis,
a coeditor of Tennis Medicine for Tennis Coaches, and a contributor to the IOC Handbook of
Sports Medicine and Science: Tennis. Marc Safran, M.D., is a board-certified orthopedic surgeon
specializing in sports medicine and biomechanics. He is the coauthor of Instructions for Sports
Medicine Patients and The Spiral Manual of Sports Medicine. He lives in San Francisco,
California.

Table of Contents

Contents	vii
Foreword	xiii
Preface	xv
Acknowledgements	xvi
PART 1: PRINCIPLES OF INJURY PREVENTION AND REHABILITATION
The Biomechanics of Tennis	3	(14)
How to Hit the Ball with Power	3	(1)
Explanation of Terms	4	(3)
Movement Analysis	7
The Serve	6	(1)
Injury Risk during Serving	7	(2)
The Forehand	9	(1)
Injury Risk during the Forehand	10	(2)
The Backhand	12	(1)
Injury Risk during the Backhand	12	(3)
Summary	15	(2)
Physiological Demands of the Game	17	(8)
ATP and Energy	17	(1)
The Immediate Energy System	18	(1)
The Short-term Energy System	18	(1)
The Long-term Energy System	19	(1)
Measurement of Energy Capacities	20	(1)
Testing the Immediate Energy System	20	(1)
Testing the Short-term Energy System	20	(1)
Testing the Long-term Energy System	21	(2)
Summary	23	(2)
Racquets, Strings, and Balls	25	(8)
Material and Composition of the Racquet	25	(1)
Size of the Racquet Head	26	(1)
Stiffness	27	(1)
Length	27	(1)
Weight	27	(1)
Balance	28	(1)
Grip Size	28	(1)
Grip Material	29	(1)
Stringing Material	29	(1)
String Thickness	29	(1)
String Tension	29	(1)
Vibration Stoppers (string implant devices)	30	(1)
Pressurized and Nonpressurized Tennis Balls	30	(1)
The Size and Deformation of the Tennis Ball	31	(1)
Choosing Arm Friendly Equipment	31	(1)
Summary	31	(2)
Tennis Shoes and Playing Surfaces	33	(6)
Playing Surface	33	(1)
The Tennis Shoe	34	(3)
Cushioning	35	(1)
Stability	35	(1)
Stiffness	35	(1)
Outsole	35	(2)
Summary	37	(2)
Injury Prevention	39	(18)
Epidemiology of Injuries	40	(1)
Before Play	41	(8)
The Pre-participation Physical Examination	41	(1)
Warm-up	41	(1)
Flexibility and Stretching	42	(1)
Types of Stretching	42	(2)
Stretching Exercises	44	(4)
Strengthening Exercises	48	(1)
During Play	49	(2)
Racquets, Strings and Balls	49	(1)
Shoes and Surfaces	49	(1)
Protective Devices	49	(1)
Taping and Bracing	49	(1)
Protective Eyewear	50	(1)
After Play	51	(6)
Cooling-down	51	(1)
Massage	51	(1)
Whirlpool and Jacuzzi	51	(1)
Sleep	51	(1)
Muscle Relaxation Techniques	52	(1)
Breathing Exercises	53	(1)
Yoga	53	(1)
Pilates	53	(1)
Nutrition	54	(1)
Facility Checklist	54	(2)
Summary	56	(1)
General Rehabilitation Principles	57	(20)
Phases of Tissue Healing	57	(1)
Healing Time of Specific Tissues	58	(1)
Accute Phase	58	(2)
RICE	58	(1)
Therapeutic Modalities	59	(1)
Medications	59	(1)
Intermediate Phase	60	(3)
Early Mobilization	60	(1)
Range of Motion and Flexibility	60	(1)
Muscular Strength and Endurance	61	(1)
Alternative Training Methods	61	(1)
Proprioceptive Training	62	(1)
Therapeutic Modalities	62	(1)
Medications	63	(1)
Advanced Phase	63	(1)
Strengthening and Agility Exercises	63	(1)
Return to Play	63	(1)
Therapeutic Exercise Training for the Knee	64	(3)
Therapeutic Exercise Training for the Shoulder	67	(4)
Therapeutic Exercise Training for the Lower Back	71	(3)
Summary	74	(3)
PART 2: A COMPLETE INVENTORY OF TENNIS INJURIES
Injuries of the Upper Body	77	(46)
Bump on the Hand or Wrist (ganglion cyst)	77	(1)
Snapping Wrist (subluxating extensor carpi ulnaris)	78	(2)
Clicking, Painful Wrist (triangular fibrocartilage tears)	80	(1)
Wrist Sprain	81	(1)
Wrist Pain in Young Players (wrist epiphysitis)	82	(1)
Tendinopathy (tendinitis) around the Wrist	83	(2)
Pain Moving Thumb (De Quervain's tenosynovitis)	85	(1)
Squeaker's Wrist (intersection syndrome)	86	(1)
Hamate (hook) Fractures	86	(1)
Tennis Elbow (lateral epicondylitis)	87	(3)
Golfer's Elbow (medial epicondylitis)	90	(2)
Elbow Pain in Young Children (Panner's Disease)	92	(1)
Osteochondrits Dissecans of the Elbow	92	(1)
Medial Epicondylar Apophysitis	93	(1)
Posterior Impingement Syndrome of the Elbow	94	(2)
Sprain of the Ulnar Collateral Ligament	96	(1)
Cubital Tunnel Syndrome (Ulnar Neuritis)	97	(1)
Ulnar and Humeral Stress Fracture	98	(1)
Traction Apophysitis of the Shoulder	98	(1)
Little Leaguer's Shoulder (stress fracture of the proximal humeral epiphysis)	99	(1)
Shoulder Instability	99	(2)
Dislocation of the Shoulder	101	(2)
Pinching Rotator Cuff Tendons (Impingement Syndrome)	103	(3)
Rotator Cuff Tear	106	(2)
SLAP Lesions	108	(3)
Snapping Scapula	111	(1)
Separated Shoulder (acromioclavicular joint separation)	112	(1)
Clavicular Osteolysis	113	(1)
AC Arthritis	113	(1)
Biceps Tendinopathy (Tendinitis)	114	(2)
Biceps Tendon Rupture at the Shoulder	116	(1)
Biceps Tendon Subluxation	117	(1)
Shoulder Muscle Wasting (suprascapular neuropathy)	117	(2)
Scapular Winging (serratus anterior palsy, long thoracic nerve injury)	119	(1)
Thoracic Outlet Syndrome	120	(2)
Summary	122	(1)
Injuries of the Lower Body	123	(58)
Muscle Strains	123	(7)
Tennis Leg (calf muscle strain)	124	(2)
Strain of the Anterior Thigh (quadriceps muscles)	126	(1)
Strain of the Posterior Thigh (hamstring muscles)	127	(1)
Strain of the Inner Thigh (adductor muscles)	128	(2)
Stress Fractures	130	(2)
Stress Fracture of the Forefoot (Metatarsals)	131	(1)
Stress Fracture of the Lower Leg (Tibia & Fibula)	131	(1)
Bump on the foot (Bunion)	132	(1)
Turf Toe	133	(1)
Stiff Big Toe (hallux rigidus)	134	(1)
Morton's Neuroma (interdigital neuritis)	135	(1)
Tarsal Tunnel Syndrome	136	(1)
Heel Pain Syndrome (plantar fasciitis)	137	(2)
Heel Pain in Young Players (calcaneal apophysitis, Sever's disease)	139	(1)
Tendinopathy of the Achilles Tendon	140	(2)
Achilles Tendon Rupture	142	(1)
Ankle Sprain	143	(2)
Chronic Ankle Instability	145	(1)
Anterior Ankle Impingement	146	(2)
Posterior Ankle Impingement	148	(1)
Tendinopathy and Rupture of the Posterior Tibial Tendon	148	(1)
Tendinopathy and Rupture of the Peroneal Tendons	149	(1)
Peroneal Tendon Subluxation	150	(2)
Chronic Exertional Compartment Syndrome	152	(1)
Shin Splints (medial tibial stress syndrome)	153	(1)
Meniscus Tear	154	(2)
Meniscal Cyst	156	(1)
Medial Collateral Ligament Sprain	157	(2)
Anterior Cruciate Ligament Injury	159	(2)
Anterior Knee Pain (Pain in the Front of the Knee	161	(12)
Patellofemoral Pain Syndrome	161	(3)
Jumper's Knee (Patellar Tendonitis)	164	(2)
Osgood Schlatter's Disease	166	(2)
Sinding-Larsen-Johansson Syndrome	168	(1)
Hoffa's Disease (infrapatellar fat pad syndrome)	168	(1)
Pes Anserinus Syndrome	169	(1)
Iliotibial Band Syndrome	170	(2)
Popliteus Tendinopathy (Popliteus Tendinitis)	172	(1)
Osteitis Pubis	173	(2)
Bursitis of the Hip	175	(1)
Tendinopathy of the Outer Hip Muscles	175	(1)
Piriformis Syndrome	176	(2)
Hip Labral Tears	178	(1)
Summary	179	(2)
Injuries of the Trunk and Spine	181	(14)
Low Back Pain (nonspecific)	181	(2)
Facet Syndrome	183	(2)
Herniated Disc (ruptured or slipped disc)	185	(1)
Spondylolysis and Spondylolisthesis (vertebrae fracture and slippage)	186	(2)
Rib Stress Fractures	188	(1)
Abdominal Muscle Strains	189	(2)
Whiplash (Cervical Strain and Sprain)	191	(1)
Summary	192	(3)
PART 3: MEDICAL ISSUES
Brain and Nervous System	195	(4)
Tension Headache	195	(1)
Migraine	195	(1)
Exercise Induced Headache	196	(1)
Cervicogenic Headache	197	(1)
Ringing in the Ear (tinnitus)	198	(1)
Summary	198	(1)
The Eye	199	(10)
Injuries of the Eyelid	199	(1)
Eye Scratches (corneal erosion)	200	(1)
Red Eye (conjunctivitis)	200	(1)
Blood in the Eye (hyphema)	201	(1)
Eyelid Inflammation (blepharitis)	201	(1)
The Common Stye	201	(1)
Bump on the Eyelid: Inflammation of Oil Gland (chalazion)	202	(1)
Dry Eyes	202	(1)
Thickenings on the White of the Eye (pinguecula and pterygium)	202	(1)
Cataracts	203	(1)
Retinal Detachment	204	(1)
Fracture of the Eye-Socket	204	(1)
Vision Disorders	205	(1)
Visual Training	206	(1)
Summary	206	(3)
Skin Disorders	209	(12)
Blisters	209	(1)
Callus	210	(1)
Corns (clavi)	211	(1)
Tennis toe (black toe)	211	(1)
Ingrown Toenail	212	(1)
Excessive Sweating	212	(1)
Insect Stings	212	(1)
Tick Bites and Lyme disease	213	(1)
MassageRash (folliculitis)	214	(1)
Athlete's foot (tinea pedis)	215	(1)
Cold Sores (fever blisters)	215	(1)
Warts (verrucae)	216	(1)
Sun Related Disorders	217	(1)
Sunburn	217	(1)
Skin cancer	217	(2)
Summary	219	(2)
The Heart and Blood Vessels	221	(10)
Athlete's Heart	221	(1)
Premature Heartbeat	222	(1)
Racing Heartbeat (tachycardia)	222	(1)
Fainting Spells (syncope)	223	(1)
Inflammation of the Heart Muscle (myocarditis)	223	(1)
Atherosclerosis (hardening and narrowing of arteries)	224	(1)
High Blood Pressure	225	(1)
Heart Attack	225	(1)
Sudden Exercise Related Cardiac Death	226	(1)
Upper Extremity Vascular Injuries	227	(2)
Cold Finger (digital ischemia)	227	(1)
Blood Clot in the Arm (effort thrombosis of the upper extremity)	228	(1)
Axillary-Subclavian Artery Compression	228	(1)
Summary	229	(2)
The Respiratory System	231	(6)
Hay Fever (allergic rhinitis)	231	(1)
Sinusitis	232	(1)
Viral Upper Respiratory Tract Infection	233	(1)
Exercise Induced Asthma	233	(2)
Respect the Anti-doping Program	235	(1)
Summary	235	(2)
The Digestive System	237	(6)
Stomach flu (viral gastroenteritis)	237	(1)
Food Poisoning	238	(1)
Traveler's Diarrhea	239	(1)
Heartburn	240	(1)
Stitch	241	(1)
Irritable Bowel Syndrome	241	(1)
Summary	242	(1)
Other Medical Conditions	243	(6)
Diabetes Mellitus	243	(2)
Glandular Fever	245	(1)
Anemia	245	(1)
Summary	246	(3)
PART 4: SPECIAL ISSUES
Heat Stress	249	(8)
Heat Production	249	(1)
Fluid Loss	250	(1)
Salt Loss	251	(1)
The Risks of Playing in the Heat	251	(2)
Sports Drinks	253	(1)
Drinking during a Match	254	(1)
Drinking after a Match	254	(2)
Summary	256	(1)
Nutrition and Supplements	257	(8)
Carbohydrates	257	(1)
Protein	258	(1)
Fat	259	(2)
Vitamins	261	(1)
Minerals	261	(1)
Antioxidants	262	(1)
Creatine	262	(1)
Miscellaneous products	262	(1)
Summary	263	(2)
Doping and Drug Testing	265	(6)
What Is Doping?	265	(1)
The List of Prohibited Substances and Methods	266	(1)
What Is the WADA?	266	(1)
Who Can Be Tested?	266	(1)
When Can a Test Occur?	266	(1)
Who Administers the Testing?	266	(1)
The Therapeutic Use Exemption	266	(1)
Player Notification of Testing	267	(1)
The Testing Procedure	267	(1)
Test Results and Reporting	267	(1)
Penalties	267	(1)
Announcement of Suspensions	268	(1)
Nutritional Supplements	268	(1)
Summary	268	(3)
Overtraining and Burnout	271	(6)
Overtraining	271	(1)
Burnout	272	(3)
Summary	275	(2)
The Travelling Player	277	(8)
Jet lag	277	(2)
Vaccinations	279	(1)
Malaria	279	(1)
Sexually Transmitted Diseases	280	(1)
The Travel Kit	281	(1)
Summary	282	(3)
PART 5: SPECIAL TENNIS GROUPS
Junior Players	285	(6)
Growth and Maturation	285	(1)
Physical Capacities	286	(3)
Aerobic Power	286	(1)
Anaerobic Performance	286	(1)
Strength	287	(1)
Co-ordination	288	(1)
Flexibility	288	(1)
Heat Stress	289	(1)
Epidemiology of Injuries	290	(1)
Summary	290	(1)
Veteran Players	291	(6)
Use It or Lose It!	291	(1)
Aerobic Capacity	292	(1)
Strength Training	292	(1)
Co-ordination	293	(1)
Flexibility	293	(1)
Cardiovascular Risks	293	(1)
Heat Stress	294	(1)
Osteoporosis	294	(1)
Epidemiology of Injuries	295	(1)
Total Joint Replacement	295	(1)
Summary	296	(1)
Women's Issues	297	(8)
Body size	297	(1)
Injury patterns	297	(1)
The Female Athlete Triad	298	(3)
Eating Disorders	298	(2)
Menstrual Dysfunction	300	(1)
Osteoporosis	301	(1)
Pregnancy	301	(2)
Stress Urinary Incontinence	303	(1)
Summary	303	(2)
Wheelchair Tennis Players	305	(12)
Why Play Wheelchair Tennis?	305	(1)
Who Can Play Wheelchair Tennis?	305	(1)
Equipment	306	(1)
Wheelchair	306	(1)
Strapping	307	(1)
Clothing	307	(1)
Racquet	307	(1)
Conditioning	307	(1)
Injuries	308	(3)
Wrist Pain	308	(1)
Elbow Pain	309	(1)
Shoulder Pain	310	(1)
Trunk	310	(1)
Ailments	311	(1)
Bladder Infection	311	(1)
Seizures	312	(1)
Heat Stress	312	(1)
Autonomic Dysreflexia	313	(1)
Wheel Burns	313	(1)
Pressure Areas	313	(1)
Summary	314	(3)
PART 6: MANAGING AND DELIVERING TENNIS MEDICINE PROGRAMS
The Sports Physician	317	(8)
The Tournament Physician	317	(2)
The Role of the Tournament Physician	317	(1)
Medical Rules	318	(1)
The Team Physician/Federation Doctor	319	(3)
The Role of the Team Physician	319	(1)
Pre-participation Physical Examination	319	(1)
Education and Counseling	320	(1)
Preparing for Travel	320	(1)
The Medical Bag	320	(1)
Medications	321	(1)
Respect the Tennis Anti-Doping Program	322	(1)
Sports Medicine Center Physician	322	(1)
Summary	323	(2)
The Athletic Trainer and Physiotherapist	325	(6)
Why A Certified Athletic Trainer or Sports Physiotherapist Is Necessary	325	(1)
Education of the Certified Athletic Trainer	326	(1)
Education of Sports Physiotherapists	327	(1)
The Role of the Trainer or Physiotherapist	327	(1)
The Trainers and Physiotherapists on the Professional Tours	327	(2)
Trainers and Physiotherapists at Local Tournaments	329
Trainers and Physiotherapists Responsibilities ---Pre-tournament	328	(1)
Trainers and Physiotherapists Responsibilities ---During the Tournament	328	(1)
Trainers and Physiotherapistsr Responsibilities ---Post-tournament	329	(1)
Summary	330	(1)
Strength Training for Tennis	331	(22)
Intensity, Duration, and Frequency	331	(1)
Velocity	332	(1)
Equipment	332	(1)
Basic Exercise Program	332	(21)
Shoulders	332	(5)
Arms	337	(1)
Elbow, Wrist and Hand	338	(2)
Upper Back	340	(1)
Addominals	341	(2)
Back and Trunk	343	(4)
Hips and Groin	347	(2)
Thigh and Knee	349	(1)
Lower Leg, Ankle, and Feet	350	(3)
References	353	(12)
Index	365	(8)
About the Authors	373