Tennis is nowadays one of the most popular and widespread sports in the world. Some authors recommend it as a game which is ideal for everyone. Others on the other hand disagree with them, saying that it is not suitable for people with developmental disorders of the spine (scoliosis, ankylosing spondylitis, Scheuermann disease and other), spinal disc herniation or people who suffer with angina pectoris.
The main problem of this sport is the constant pressure on the dominant side of the body. Perfect symmetry of the body cannot be taken as a norm. Every single one of us suffers from certain muscle disbalances, which are caused by whether we are right-handed or left-handed. But we should not cross the borders of asymmetry to a point where the organism does not have physiological option to adapt, which means that it leads to damage of the body based on the imbalance caused by the different muscle tension. If we cross this border, it will leads to overload of certain structures, which results with injury.
TYPES OF TENNIS SHOTS AND POSSIBLE HEALTH RISKS
The elbow should be protected during the shot with a slight bend in range of 10-15 degrees. When the ball hits the strings of the racquet, there is a sudden tension in the wrist flexors, which restrict the opposite movement in the wrist. If these muscles do not fulfill their function (stabilization, so it wouldn’t lead to a bending in the wrist) sufficiently enough or the elbow is in a constant stretch, it would lead to overload in the attachments on the inner side of the elbow, which can result in pain in the attachments (enthesopathy - in this case it is specifically “javelin thrower elbow”).
The elbow is stretched during the backhand stroke, especially the extensor muscles of the forearm are being burdened. Mistakes in the technique or constant overload (incorrect execution of the movement, disproportion between overload and regeneration) of this muscle group can then result in a tennis elbow, in the area of attachment of these muscles on the inner side of the elbow.
Topspin hits (shots with a upper rotation)
Rotation movement in the elbow joint and wrist is essential, at the same time the elbow is nearly fully stretched. The whole arm is therefore exposed to a high demand in the joint area.
Servings and smashes
These hits cause an enormous pressure on the elbow, wrist and shoulder girdle. During a smash, these parts of the body are stretched to their utmost possible movement range. The smash is performed in a high speed with a substantial force. Most common injuries here are then impingement syndrome and rotator cuff syndrome, concerning the shoulder joint.
When we prepare to shoot from the forehand, and we wind up the racquet back, the whole trunk rotates to the side, which can have in numbers of played shots negative effect on the spine. With backhand we wind up the racquet in front of the body, so the trunk rotation is significantly smaller.
Based on the characteristics of single strokes and control of the arm (the dominant arm) we can define the problematic areas. The dominant side of the body has usually shortened muscles such as m. quadratus lumborum (posterior abdominal muscle), paravertebral muscles - muscles located along the spine, trapezius muscles, sternocleidomastoid muscles (moving the head and neck), and on the other side of the body it is usually m. levator scapulae (lifting the scapula) - when playing two-handed backhand. Paravertebral muscles are also extremely burdened during a service. Default position of the tennis player for every shot is then causing shortening of the iliopsoas muscle (lumbar-hip muscles), the hamstring muscles and the triceps surae muscles. Concerning the service, we can observe a shortening of the chest muscles (pectoralis major). Regular stretching of all the mentioned muscles is very important, in order to secure their correct function.
TYPICAL HEALTH ISSUES PRESENT BY TENNIS PLAYERS:
- Tennis elbow
- Javelin thrower elbow
- Patellar tendinitis - chondromalacia patellae, abnormalities of the quadriceps muscle
- Tennis leg (microfractures in the middle part of the calf muscle)
- Inflammation or ruptured Achilles tendon
- Microfractures in the quadriceps muscle and the adductor longus muscles (more in articles: pulled, ruptured, torn muscle and painful groin)
- Sprained ankle
- Stress fractures (especially in the metatarsal bones and the calf bone)
- Partial dislocation of the shoulder joint (subluxation)
- Rotator cuff syndrome
- Wrist pain
- Back pain
- Ruptured abdominal muscles
PREVENTION AND REMOVAL OF THE MOVEMENT DISORDERS
The principle of each training should be about the care for the musculoskeletal system. Compensating or balancing exercises should become a norm for everyone, even if you play tennis as an amateur.
WHAT IS RECOMMENDED?
- For relieving the stiff joints, stretching the contracted muscle
- Training a correct performance of the basic movements and the single movement stereotypes (more in articles: dynamic neuromuscular stabilization (DNS), sensomotoric stimulation (SMS), therapy for scoliosis with use of the Dr. Brügger concept)
- Strengthening the weakened muscles
- Corrected body posture
Author: FYZIOklinika physiotherapy Ltd., Prague, Czech Republic