Tennis Injuries can keep athletes off the court and unable to achieve their personal on court goals. Learn how to reduce the risk of these injuries and to enhance function.

1. Injury Prevention on Your Court
2017
Stephan Esser MD, USPTA
www.tennismedicine.com

2. Goals
• Review 3 major concepts related to injury
• Explore opportunities for prevention
• Practice some on site assessment
• Have Fun

3. Concepts related to Injury
• Time
• Technique
• Training/Conditioning

4. Time
• Frequency
• Duration
• Volume
• The Too’s
– Too Far, Too Fast, Too Soon
• Inadequate Recovery Time

5. Time
• Frequency:
– < 5 times per week
• Duration:
– < 2 hrs per time
• Volume: Total Time
– < 16 hrs per week
• Recovery:
– Consider Age, Conditioning, Total Health, On-
Court Goals etc

6. Technique
• Common technical errors which increase the
risk of injury

7. Upper extremity Injury
• Late Contact
– Forehand
• Medial Epicondylitis, wrist injuries, shoulder injuries
– Backhand
• Lateral Epicondylitis (tennis elbow), wrist injuries,
shoulder injuries

10. Contact
• General Recommendations
• Awareness, demonstrations, Videos of player
• Begin back swing sooner
• Split Step when opponent hits ball
• Shorten/Modify swing path
• Accelerate racket head speed
• Strengthen core, proximal legs
• Evaluate racket weight, length, head size
• Evaluate ball type for age, skill level

11. Open Stance Forehand
• Dominant Hip Loaded in Internal Rotation
– Loss of range of motion
– Increased rates of hip injury

12. Open Stance Forehand

14. Open Stance Forehand
• General Recommendations
– Vary Stance in practice and play
– Maintain Hip Flexibility
• Pre and Post sports participation stretching
– Dynamic pre and Static post
– Improve Hip Abductor Strength (outer buttocks)
• Demo

15. Abbreviated Service Motion
• Bringing the racket up when midway back
increases risk of “rotator cuff impingement”
• May encourage limited use of core and legs

17. Abbreviated Service Motion
• General Recommendations
– Avoid sudden and high volume changes
– Bring elbow past line of the shoulder prior to bringing
elbow up to shoulder height
• Avoid “impingement position”
– Maximize posterior shoulder strength and pec flex.
– Pre-match RTC exercises and shoulder motion
• Demo: ER at 0 and 90, scapular pinches, kick backs
– Post-match capsular stretching
• Demo: cross body, “ sleeper stretch” , Foam roller chest
stretch

18. Low Back Injury
• Key Technical Issues
– Avoid repetitive Spinal hyperextension < 15
• < 25% of total serve volume as topspin when < 15
• Consider waiting for extreme “topspin” serves till > 14
– Focus on core, hamstring and quad strength first
– Vary serve type, avoid sudden increase in volume

19. Forehand Grip Type
• Power
– Heel of the hand behind the “strings”
– Facilitates an “early contact point”
• Core, shoulder rotation, legs involved
– FH: Eastern = Semiwestern > Continental
• Control
– Face of raquet at contact
– Facilitates biomechanically “friendly” wrist motion

20. Volley Grip Type
• Continental
– Symmetric raquet face side to side
– Wrist in an “L conformation”/neutral position of
support and stability

21. Muscle Firing Patterns
• Excess Forearm Firing
– Late contact, wrist, elbow and shoulder injury
• Tips
– Cognitive: awareness, taglines “Don’t kill the
hummingbird”, breathe out, grunt, shadow stroke
with music etc
– Physical: Carry raquet in non-dominant hand,
evaluate for inadequate muscle strength or poor
technique, inadequate core, leg and shoulder
strength, “compensatory” forearm dominance

22. Training/Conditioning
• Consider body regions for
– Inadequacy vs Overdevelopment
– Overuse and Misuse

23. Training/Conditioning
• Shoulder
– Common patterns
• Tight pecs, Weak Posterior shoulder
– Answer
• Stretch pecs, Strengthen Posterior Shoulder

24. Training/Conditioning
• Handout/Breakout

25. Training/Conditioning
• Use movement screen to evaluate “at risk”
players
• Confirm players participating in age/goal/play
level appropriate cross training

26. Take Homes
• Time/Technique/Training (Conditioning)
• Plan Warm ups and cool downs
• Look for functional asymmetry
• Be aware of predisposing weak/tight regions
• Shoulder and hip key
• Avoid sudden changes in technique or volume
• Develop preventive strategies
• You can be an advocate for injury prevention

27. Thank You!
Stephan Esser MD, USPTA
www.tennismedicine.com