Functional Movement screens are an outstanding way to evaluate athletes for injury and for injury risk. Here is a recent presentation for tennis professionals on basic functional movement injury screens.

1. Injury Screening and Prevention
for the Tennis Professional
Brittany Laxton DPT
Patrick Weaver DPT
Stephan Esser MD, USPTA

2. Florida Institute of Tennis www.tennismedicine.com

3. Tennis Injury
• Abrams et al BJSM 2012
– Lower extremity > Upper Extremity
– Back

4. Facts
• Tennis athletes get hurt
• Injury = participation
• Decreased participation =
– Decreased club engagement
– Decreased ability to share the sport we love
– Decreased personal and club income

5. PLAN
• Identify the Need
• Know your Resources
• Develop relationships and a plan
• Discuss with your staff, GM etc
• Consider a run through for emergency issues
• Re-visit: Adjust and Adapt

6. Identify the Need
• Extrinsic
• Intrinsic

7. Preventing Injury
• Extrinsic: Walk the Grounds 3 times per year
– Court: Algae, potholes, cracks, lines, net cranks, fencing
(sharp edges, loose fence bottoms etc)
– Seating Areas: steep steps, slick surfaces, broken
furnishings, exposed sharp edges
– Walkways: Uneven stones, slick surfaces, unmarked stairs,
poorly lit walkways, guardrails, signage
– Parking/Entry: Markings, stop signs, uneven surfaces, blind
spots
– Ambient Weather: Heat, Cold, Sun, Rain, Lightening, Snow
etc
– Lessons: Carts, Balls, Other players

8. Preventing Injury
• Intrinsic:
– Personal Disease: Previous surgeries, Major Heart,
Lung issues, Joint or Muscle/Tendon Problems,
Seizures
• Consider a notebook for serious stuff with Emergency
Contact numbers
• Consider “PAR-Q for you”
– Conditioning: Strength, Cardiovascular Fitness,
Flexibility, Balance
– On Court Technique
– Hydration/Nutrition

9. • Individual Injury Risk
– Functional Movement Screens

10. Evaluating Injury Risk
• Goals: Identify changes in your athletes which
place them at risk of injury
• Method: Assess simple movements and
determine if they are
– A: Functional and Non-Painful
– B: Functional and Painful
– C: Dysfunctional and Non-Painful
– D: Dysfunctional and Painful

11. Managing Injury Risk
Plan:
• A: Any “Painful” findings should be referred
for evaluation and treatment by medical
provider: PT/MD/DO/DC etc
• B: Dysfunctional and Non-Painful can be
treated by you or a personal trainer
• C: Functional and Non-Painful: Continue their
successful program

12. Low Back Flexion
• Start with Knees straight,
feet together
• -Athlete should be able to
touch toes
• -Athlete should have a
uniform spinal curve
• -Movement completed
without stress or force

13. Low Back Extension
• -Start with knees straight and feet together and hands over
head
• -Athlete should have uniform spinal curve
• -Arms should be able to reach fully
extended overhead
• -Athlete’s scapula should pass the heels

14. Trunk Rotation
• -Start with feet together and hands by the sides palms facing forwad
• -Athlete rotates entire body as far as possible to one side
• -The hip and shoulders should rotate > 50 degrees
• -There should be no tipping to the side
• -You should be able to see the back shoulder when standing in front of
the athlete

15. Shoulder Reach
• #1:-Athlete reaches up back as high as
possible (repeat opposite side)
-Athlete should be able to touch bottom of
scapula
-Athlete should have equal reach on both
sides
-Athlete should have no pain and should
not
• #2: -Athlete reaches over head toward
opposite shoulder (repeat opposite side)
-Athlete should be able to touch top of
scapula
-Athlete should have equal reach on both
sides
-Athlete should have no pain and should not
“force” the motion

16. Neck Motion
• -Flexion: Athlete brings chin to chest
• -Normal: Can touch chin to chest without major effort or pain
• -Extension: Athlete looks up as high as possible
• -Normal: Can get head up to within 10 degrees of parallel
• -Rotation: Athlete looks over shoulder as far as possible
• -Normal: Can get nose even with clavicle
• -Side-Bend:
• -Athlete should have no pain and should not “force” the motion

17. Single Leg Balance
• -Start with feet side by side
on ground. Lift one leg up till
hip is bent at 90 degrees
• -Athlete stands in this
position for 10 seconds
(repeat other side)
• -Then have athlete stand in
same posture for 10 seconds
with eyes closed (repeat
other leg)
• -Normal is able to remain
stable with both legs, eyes
open or closed for 10 seconds
and the hip does not drop as
time progresses

18. • Break out

19. PLAN
• Identify the Need
• Know your Resources
• Develop relationships and a plan
• Discuss with your staff, GM etc
• Consider a run through for emergency issues
• Re-visit: Adjust and Adapt

20. Know Your Resources
• Learn about your
– Players/Members: Healthcare Providers?
• Consider a referral list for the front desk
– Docs’, therapists etc (added value)
– Neighbors
• Which healthcare providers are nearby
• Can call or give player contact for quick access

21. Develop Relationships
• You are a resource
– Players
– Healthcare Providers
• Reach out, develop relationships
– Mixers
– Health Committee
– Healthy on the Court Newsletter

22. PLAN
• Identify the Need
• Know your Resources
• Develop relationships and a plan
• Discuss with your staff, GM etc
• Consider a run through for emergency issues
• Re-visit: Adjust and Adapt

23. • Volunteer

24. Basic Movement Screen

25. Take Homes
–A: Functional and Non-Painful
• Affirmation
–B: Functional and Painful
• PT/MD/DC/DO
–C: Dysfunctional and Non-Painful
• HEP/CPT
–D: Dysfunctional and Painful
• PT/MD/DC/DO

26. Take-Aways
• Risk of Injury is real
• Intrinsic and Extrinsic Factors affect risk
• Pro-active approaches can help prevent injury
• Use a Functional Movement Screen to
identify injured players and those at risk
• Collaborate
• Continue to advance your knowledge

28. Thank you!
www.tennismedicine.com

29. Framework
INJURYINJURYNON-
EMERGENT
NON-
EMERGENT
TRANSFER
CARE
TRANSFER
CARE
EMERGENTEMERGENTNew
Unknown
New
Unknown
Old
Chronic
Old
Chronic
Follow upFollow up
Mild
discomfort,
Clear cause,
no Abnormal
symptoms
Mild
discomfort,
Clear cause,
no Abnormal
symptoms
Return to the
CourtSevere
Pain/Numb
ness/Tinglin
g/Swelling/I
nability to
walk etc
Severe
Pain/Numb
ness/Tinglin
g/Swelling/I
nability to
walk etc
Encourage
MD/PT visit
Encourage
MD/PT visit
Follow upFollow up
PRICE
3-7 days of rest
Home Exercise
Technique Modifications
PRICE
3-7 days of rest
Home Exercise
Technique Modifications
Symptoms Resolved
SymptomsResolved
Resolved
Sym
ptom
s
Cleared for Sport
ClearedforSport