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Tóm tắt nội dung (trích từ tài liệu gốc): Handbook of Sports Medicine and Science Tennis IOC Medical Commission Sub-Commission on Publications in the Sport Sciences Howard G. KnuttgenPhD (Co-ordinator) Boston, Massachusetts, USA Francesco Conconi MD Ferrara, Italy Harm Kuipers MD, PhD Maastricht, The Netherlands Per A.F.H. RenstromMD, PhD Stockholm, Sweden Handbook of Sports Medicine and Science Tennis EDITED BY Per A.F.H. Renstrom MD, P M Section of Sports Medicine Department of Surgical Sciences Karolinska Institutet Stockholm Sweden BlackweII Science 0 2002 by Blackwell Science Ltd a Blackwell Publishing Company Editorial Offices:
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Handbook of
Sports Medicine
and Science
Tennis
IOC Medical Commission
Sub-Commission on Publications in
the Sport Sciences
Howard G. KnuttgenPhD (Co-ordinator)
Boston, Massachusetts, USA
Francesco Conconi MD
Ferrara, Italy
Harm Kuipers MD, PhD
Maastricht, The Netherlands
Per A.F.H. RenstromMD, PhD
Stockholm, Sweden
Handbook of
Sports Medicine
and Science
Tennis
EDITED BY
Per A.F.H. Renstrom
MD, P M
Section of Sports Medicine
Department of Surgical Sciences
Karolinska Institutet
Stockholm
Sweden
BlackweII
Science
0 2002 by Blackwell Science Ltd
a Blackwell Publishing Company
Editorial Offices:
Osney Mead, Oxford OX2 OEL, UK
"el: +44 (0)1865206206
Blackwell Science, Inc., 350 Main Street, Malden, MA 02148-5018, USA
Tel: +1 781 388 8250
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Tel: +6l (0)39347 0300
Blackwell Wissenschafts Verlag, Kurfiirstendarnrn 57. 10707 Berlin, Germany
Tel: +49 (0)30 32 79 060
The right of the Author to be identified as the Author of this Work has been asserted in accordance with the
Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in
any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by
the IJK Copyright, Designs and Patents Act 1988,without the prior permission of the publisher.
First published 2002
Library of Congress Cataloging-in-Publication Data
Tennis: handbook of sports medicine and science / edited by Per A.F.H. Renstrom.
p. ;cm -[Handbook of sports medicine and science)
Includes bibliographical references and index.
ISBN 0-fi32-05034-9
1. Tennis injuries-Handbooks, manuals, etc. 2. Tennis-Physiological
aspects-Handbooks, manuals, etc. I. Renstrom, Per. 11. Series.
(DNLM: 1.Tennis. 2. Athletic Injuries. 3. Sports Medicine. QT 260.5.T3 T311 20021
KC1220. T4 T46 2002
617.1'027'08879634-dc21
2001052783
ISBN 0-ti32-05034-9
A catalogue record for this title is available from the British Library
Set in Melior by Graphicraft Limited, Hong Kong
Printed and bound in Great Britain at the Alden Press Ltd, Oxford and Northampton
For further information of Blackwell Science,visit our website:
www.blackwell-science.com
Contents 11 Specific problems for the young tennis player, 139
W.Ben Kibler
List of contributors,vi
Forewords by the IOC, viii 12 Pathophysiology of tennis injuries-
Forewords by the ITF, ATP, WTA and STMS, ix an overview, 147
Preface, xi W .Ben Kibler
1 Biomechanics of tennis, 1
Bruce C. Elliott 13 Foot problems in tennis, 155
2 The tennis racket, 29 Scott A . Lynch and Per A.F.H. Renstrom
Howard Brody
3 Shoes and surfaces in tennis: injury and 14 Ankle problems in tennis, 165
performance aspects, 39 Scott A. Lynch and PerA.F.H. Renstrom
Karin G.M. Gerritsen, Benno M.Nigg and 15 Lower leg and Achilles tendon problems
in tennis, 176
Ian C. Wright Scott A . Lynch and Per A.F.H. Renstrom
4 The physiological demands of tennis, 46
16 Knee injuries in tennis, 186
Michael F. Bergeron and Joseph Keul PerA.F.H. Renstrom and Scott A. Lynch
5 Nutrition in tennis, 54
17 Spine injuries in tennis, 204
Michael F. Bergeron Hartmut Krahl, Carsten B. Radas, Hans-Gerd
6 Playing tennis in the heat: fluid and Pieper and Ulf Michaelis
electrolyte balance, 65 18 Hand and wrist injuries in tennis, 223
Michael F. Bergeron Arthur C.Rettig
7 Medical care of tennis players, 75
Babette Pluim 19 Elbow injuries in tennis, 233
8 Travel and jet lag, 96 Per A.F.H. Renstrom
Moira O'Brien
9 Strength training, flexibility training and 20 Shoulder injuries in tennis, 248
physical conditioning, 103 David W .Altchek
E. Paul Roetert and Todd S. Ellenbecker
10 Pre-participation profiling for tennis, 124 21 Rehabilitation principles of injuries in tennis, 262
E. Paul Roetert and Todd S. Ellenbecker W.Ben Kibler
22 The psychology of tennis: gaining the mental
advantage, 278
Robert S. Weinberg
23 ITF involvement in tennis medicine and
science, 291
Miguel Crespo and Machar Reid
24 Medical services in men's and women's
professional tennis, 296
Per Bastholt, JurgenDess, Sue Fleshman, Bill
Norris, Doug Spreen, Alex Stober, Kathleen A .
Stroia, Paul Settles and Gary Windler
Index, 303
V
List of contributors Joseph KeulMD, PhD (Deceased)Medizinische
Universitatsklinik, Rehabilitative/Praventive
SportMedizin, Hugstetter Strasse 55,0-79106
Freiburg, Germany
w. Ben KiblerMD, FACSM Medical Director,
Lexington Sports Medicine Center, 1221 S. Broadway,
Lexington, KY 40504, USA
David W. Altchek MD Hospital for Special Surgery, Hartmut KrahlMD Professor, Wiirthstrasse21,81667
535 East 70th Street, New York, N Y 10021, U S A Munich, Germany
Per BastholtRPT F-06140 Vence,France Scott A. LynchMD Sports Medicine Section,
Michael F. BergeronPhD, FACSM Assistant Department of Orthopedics,Penn State University,
HersheyMedical Center,PO Box 850, Hershey, PA
Professor of Pediatrics, Medical College of Georgia, 17033-0850, U S A
Georgia Prevention Institute, HS-1640, Augusta,
GA 30912-3710, USA Ulf MichaelisMD Department of Orthopaedic
Howard BrodyPhD Professor, physics Department, Surgery and Sports Medicine, Alfried Krupp
Hospital, Alfried-Krupp-Strasse 21,D-45117 Essen,
Universityof Pennsylvania, 209 S. 33rd Street, Germany
Philadelphia, PA 19104-6396, USA
Benno M.NiggDr sc. nat. Director, Human
Miguel CreSpOPhD International Tennis Federation,
Performance Laboratory, Faculty of Kinesiology,
TennisDevelopment Department, Bank Lane, The University of Calgary, Calgary, Alberta, Canada
Roehampton, London SW15 5XZ, UK
Bill NorrisATC Boca Raton, FL 33498, USA
Jurgen DessRPT 92318 Neumarkt, Germany
Moira O'BrienMD Professor and Head, Anatomy
Todd S . EllenbeckerMs, PT, scs,cscs
Department, Trinity College, University of Dublin,
Physiotherapy Associates, Scottsdale Sports Dublin 2, Ireland
Clinic, 9449 N . 90th Street, Suite ZOO, Scottsdale,
AZ 85258, USA Hans-GerdPieperMD Department of Orthopaedic
c. Bruce ElliottPhD Professor and Head, The Surgery and Sports Medicine, Alfried Krupp Hospital,
Alfried-Krupp-Strasse 21,0-45117 Essen, Germany
Department of Human Movement and Exercise
Science, The University of Western Australia, Babette PlUimMD, PhD Koninklijke Nederlandse
Stirling Highway, Crawley 6009, Australia
Lawn TennisBond, Sport Medisch Centrum Papendal,
Papendallaan 60,6816 VDArnhem, The Netherlands
Sue FleshmanPT, ATC Sport Sciences and Medicine Carsten 6. RadasMD Department of Out-patient
Department, Sanex W T A Tour, 133 First Street NE, Surgery, Orthopaedic Centre, St Josef-Stifi,Westtor 7,
St Petersburg, FL 33701, U S A 0-48324 Sendenhorst, Germany
Karin G.M. GerritsenMSC,PhD Assistant Professor Machar ReidBSc ITFAssistant Research Officer,
in Biomechanics, Department of Exercise Science and International Tennis Federation, TennisDevelopment
Physical Education, Arizona State University,Box Department, Bank Lane, Roehampton, London SW15
870404, Tempe,AZ 85287-0404, USA 5XZ, UK
vi
LIST O F CONTRIBUTORS vii
Per A.F.H. Renstrom MD,PhD Professor, Section Alex Stober RPT 90459 Nuremberg, Germany
of Sports Medicine, Department of Surgical Sciences, Kathleen A. Stroia MS, PT, ATC Associate Vice
Karolinska lnstitutet, SE-171 76,Stockholm, Sweden
President, Sport Sciences and Medicine Department,
c. Arthur RettigM D Orthopedic Surgeon, Methodist Sanex W T A Tour, 133 First Steet NE, St Petersburg, FL
33701, U S A
Sports Medicine Center, ThomasA. Brady Clinic,
Department of Education and Research, 1815 N. Robert s. WeinbergPhD Professor and Chair,
Capitol Avenue, Suite 560, Indianapolis, IN 46202,
USA Department of Physical Education, Health and Sport
Studies, 109 Phillips Hall, Miami University, Oxford,
E. Paul RoetertPhDDirector of Administration, USA OH 45056-1675, USA
Tennis High Performance Program, 7310 Crandon Gary Windler M D Sports Medicine Services, 321
Boulevard, Key Biscayne, FL 33149, U S A
Middleton Boulevard, Summerville, SG 29485-8027,
Paul SettlesDirector of Player Services, ATP Tennis USA
International Headquarters, 201 ATP Tour Boulevard, c . Ian Wright MSc Human Peqformance Laboratory,
Ponte Vedra Beach, FL 32082, USA
Faculty of Kinesiology, The Universityof Galgary,
Doug S p e l l ATC Terrace Park, OH 451 74, USA Calgary,Alberta, Canada
Forewords by the IOC Tracing its beginnings from games played some
hundreds of years ago, the sport of tennis underwent
The sport of tennis was one of the nine sports major changes during the latter part of the 19th
included for men participating in the Games of the I century. During the 20th century, the sport spread
Olympiad as held in Athens in 1896. Men'stennis internationally and it is currently practised in
appeared in each of the following Olympic Games virtually every country of the world.
until the year 1924. Women's tennis competition in
the Olympic Games was introduced in 1900 in Paris Success in tennis requires a tremendous amount of
and continued until 1924,with the exception of 1904 physiological variables. These variables are further
in St Louis. Because of controversies related to the supplemented by the needs for proper nutrition,
participation of amateur versus professional athletes, hydration, strategy, and being psychologically
tennis disappeared from the Olympic programme for prepared. Developments in both sports medicine and
over 60 years until its reintroduction in 1988 in Seoul sports science during the last 50 years have resulted in
with a completely open competition. stronger, faster, better skilled tennis players who are
utilizing the most efficient and effective equipment
Despite the extended hiatus, tennis must be that the engineers and biomechanists can design. With
recognized as having an important history within the enhanced challenges and stresses to the human
the Olympic programme. It is, therefore, entirely body, injury prevention and injury rehabilitation
appropriate that this Handbook on the sport of have become important issues for sports medicine
tennis takes its rightful place among the other sports physicians, health personnel, and coaches.
that have already appeared in the IOC Medical
Commission series of Handbooks of SportsMedicine Our thanks go to Professor Per Renstrom and the
and Science. contributing authors for this Handbook on Tennis
who have collaborated to produce an up-to-date
My sincere appreciation goes to the Chairman of and complete coverage for all of the biomechanical,
the IOC Medical Commission, Prince Alexandre de biological and clinical aspects of tennis play. This
Merode, and to the IOC Medical Commission's Sub- publication will prove to be an invaluable reference
commission on Publications in the Sport Sciences. for everyone involved with the game of tennis.
Prince Alexandre de Merode
Chairman. IOC Medical Commission
Dr Jacques Rogge
IOCPresident
viii
Forewords by the ITF, ATP, six continents in over 50 countries on a variety of
playing surfaces-from carpet to hard courts to grass
WTA and STMS and clay. Until one considers that the average match
lasts 1 112 to 2 hours and may last as long as four; that
Foreword by the InternationalTennis players may have to compete as many as 5 days in a
Federation row, sometimes with two matches a day, before get-
Tennis is a sport for all ages and requires speed, ting a day off. Take a look at the teeming activity that
dexterity and endurance,especially at the professional is the training room on day one of an ATP tournament
level. Tennis is also an intellectual sport that requires and you will have a sense for how physically demand-
court sense and strategic thinking. At the highest ing professional tennis can be.
level, the professional tennis player competes nearly
every week of the year, requiring fitness levels that are Those of us on the ATP Medical Services Com-
very high and an ability to play with consistency on a mittee are increasingly aware of the physical demands
variety of surfaces at locations around the world. placed on professional tennis players and the import-
ance of providing the highest standards of medical
The International Tennis Federation (ITF)takes care for them on a tournament-by-tournamentbasis.
pride in its leadership of the Joint Tennis Anti-Doping Whether you are a player, coach, athletic trainer,
Programme in conjunction with the ATP and the WTA physiotherapist, or physician, we hope that this
Tour. The ITF's Sports Medical Commission is pro- handbook will provide some insight into the most
active in studying all areas that pertain to the overall common tennis medical problems of professional
health of tennis players. These areas include physiology, tennis players, as well as the preferred treatment
nutrition, bio-mechanics, the effect of the evolution of protocols recommended by ATP Medical Services
equipment on players,mental preparation and other personnel.
specificissues such as jet lag, altitude, heat and humidity
and the effects of playing tennis at a very young age. Paul Settles
Director of Player Services
The ITF, the world governing body of tennis,
welcomes the Handbook on Tennis. This book, with Foreword by the Women'sTennis Association
contributions from internationalscientists and experts,
will prove to be a very useful tool, a comprehensive Tennis presents unique challenges with one-on-
guide to sports medicine as it pertains to tennis. one competition, typified by its demand for total
athleticism, and necessitating the mental and
Francesco Ricci Bitti physical strength to sustain an eleven month
President, ITF season that spans the globe.
Foreword by the Associationof Tennis In order to remain in the game and at a high level of
Professionals competition, professional tennis players must utilize
One doesn't immediately think of professional tennis and incorporate the latest trends in sports medicine.
when consideringthe most physically demanding The IOC Handbook on Tennis identifies and outlines
sports. Until, that is, one considers that the professional the steps every elite tennis player must take in order
tennis season spans eleven months and is played on to excel, a daunting but invaluable undertaking. A
resource has been created that allows the tennis
community (coaches,players, physiotherapists,
physicians, certified athletic trainers, etc.) to access
and apply the principles of tennis medicine in
the creation and advancement of a successful
professional tennis player.
On behalf of the Sanex WTA Tour and its group of
sports sciences and medicine experts, it is my honor
to be able to share our pleasure associated with the
ix
x FOREWORDS
publication of this book and we look forward to the newsletter with the ITF, ATP and Sanex WTA. The
positive repercussions it will have in the game of STMS also organizes courses regularly every year in
tennis; truly a sport for a lifetime. the field of medicine and science in tennis, including
management of injuries and medical problems in
Kathleen A. Stroia tennis.
Director of Sports Sciences and Medicine, WTA
There is a great demand in tennis for this kind
Foreword by the Society for Tennis Medicine of handbook. Because of increasing pressures and
and Science intensity, there is a heightened risk of injury and other
medical problems. Therefore, the STMS feels that this
The STMSwas founded in 1990 to promote, educate handbook is essential reading and congratulatesthe
and disseminate information about medicine and IOC for its initiative in producing this publication.
science in tennis. The STMS has initiated a newsletter
which is now distributed worldwide as a joint Per A.F.H. Renstrom
President, STMS
Preface A major concern for the sport is the extended
length of the season for top-level tennis players.
Tennis is a truly international sport enjoyed by Tournaments are offered during 10 months of the
millions of people of all ages around the world. The year and this allows little time for recovery and basic
players experience tennis as an exhilarating game training. Few other sports have such a lengthy
resulting not only in stimulating competition but season. Another risk factor may be the conduct of
also in conditioning, general health benefits and tournaments on different surfaces,including hard
camaraderie. For spectators,tennis is one of the most court, clay and grass. The shift from one surface to
exciting and popular sports, not the least because of another may very well be the cause of a number of
its ingenious scoring system. Because of this, a tennis injury problems, especially when changing from
match can be very dramatic and ever changing like a a clay surfaceto a hard court with high friction,
theatrical production by Shakespeare. A player can at
some point seem to have lost a match but, in the end, The increasing intensity of the game and the
emerge as the winner after three to five intensive sets. associated physical demands also involve an
increased risk of injury and other medical problems.
At the top competitive levels, tennis can be a very The ATP, Sanex WTA and ITF provide excellent
demanding sport,both physically and mentally. medical services by assigning well-educated and
Regular participation in the sport provides excellent specialized physiotherapists andlor athletic trainers
cardiovascular exercise, improves the body's general to all major tournaments around the world. Well-
functional capacity, and promotes both coordination qualified medical doctors are also available at all the
and balance. This is of special importance for older tournaments for top players. The medical services
tennis players. Tennis is definitely a sport for all ages, provided in tennis on a worldwide basis are probably
from 3 to 103 years old. the best any international sport can offer. The ITF
has founded a medical and science committeethat
The sport of tennis provides an all-round game reviews and coordinates the medical and scientific
with quick starts and stops, repetitive overhead concerns in tennis. The Society for Tennis Medicine
motions,and involvement of all the muscles of the and Science (STMS)provides education and
body. During the last 10to 20 years, the game of tennis disseminates information through newsletters
has developed enormously as facilitated by the new and conferences in cooperation with the other
designs for rackets and other equipment and new international organizations. Top-level tennis players
playing techniques, with special reference to serving. are presently offered excellent medical services but,
Training methods have also improved. The players as always, further improvement is possible, especially
at the top level are now stronger and faster than for the players below top level and for recreational
ever before. The rackets are larger, wider and stiffer, players.
allowing for serve velocities of greater than 200
kilometres per hour (130miles per hour). The players This IOC Handbook on the medicine a n d science of
are playing much more from the back court with an tennis should constitute a valuable reference in the
open stance that permits the generation of greater effort to improve the information available to tennis
forces. The game is much more intense and players at all levels of competition. The aim of this
demanding as compared to 10 years ago. publication is to provide all tennis players, their
coaches and the associated health care personnel with
an authoritative reference in which basic information
is described in a clear format concerning common
injuries and medical problems that can be sustained
during tennis play. The available information in this
book can then aid them in considering what kind of
immediate, short-term or long-term treatment is
available, leading to the decision as to the necessity
of consulting a medical doctor.
xi
xii PREFACE
The contributorsto this book have been chosen David Altchek, who is ATP medical director and
from the outstanding experts in the field of tennis the US Davis Cup physician, has described current
medicine and science. They are all experienced in management of shoulder injuries which has become
participating i n the many sports medicine/sports an increasing problem in tennis. Hartmut Krahl, a
science conferences and meetings organized by the former medical director of the ATP and his coworkers
STMS, ATP, Sanex WTA and ITF. The Handbook from the ATP tournament in Essen, have discussed
leads off with a description of the biomechanics how to manage back problems. Arthur Rettig, the
in tennis and an evaluation of the different strokes in medical doctor for the Indianapolis ATP Tournament,
tennis as contributed by an internationallyrecognized has presented his views on the management of
expert in this area, Bruce Elliott from Australia. hand and wrist problems. The undersigned has,
Different aspects of the racket and the ball are then in cooperation with Scott Lynch, discussed knee,
discussed by Howard Brody, the ITF'srecognized lower leg, ankle and foot problems as well as elbow
expert in this field, who has completed extensive problems in tennis. Tennis is very much a sport where
research in this area. An evaluation of shoes and a strong mind is very important. The psychological
their relation to the playing surface is discussed by aspects of tennis competition have, therefore, been
Karin Gerritsen. discussed by Robert Weinberg.
Michael Bergeron discusses current research As mentioned above, the medical services offered
information regarding the physiological and to the top-level tennis players by the ATP, Sanex WTA
nutritional demands of tennis as well as the risks and ITF at every tournement are of the highest quality
involved with playing in the heat. Babette Pluim, and rather unique in international sports. In two
editor of the STMS Newsletter and a leading tennis chapters, these organizations describe their activities
physician, has written about the medical concerns in the field.
in tennis. Moira O'Brien presents her views on the
problems experienced during international travel. It is an honour to have been invited by the IOC to
coordinate this project. We are very grateful that so
Physical conditioning for tennis becomes more many of the leading experts in tennis medicine and
and more important each year. Paul Roetert and Todd science have been willing to share their expertise
Ellenbecker, who have worked for many years with and advice with us. I would also like to thank
the United States Tennis Association (USTA),present Sue Mattingley, Julie Elliott and Nick Morgan of
their views on strength and flexibility training, Blackwell Publishing for their administrative help,
conditioning and physiological preparation. Younger editorial assistanceand patience throughout the
players experience increasing injury problems and time-consuming work in the production of this book.
their specific problems are discussed by Ben Kibler, Many thanks also to Professor Howard G. Knuttgen for
who is former president of the STMS and current his strong support along the way.
member of USTA's medical committee. He includes
a discussion of the background (pathophysiology) It is our sincere hope that this book will be of value
for tennis injuries and the rehabilitation principles to all persons involved with the sport of tennis and,
after injuries have occurred with the aim of returning especially,to the players of all ages and at all levels
players to competitive play as quickly as possible of competition around the world.
following an injury.
Per A.F.H. Renstrom,MD, PhD
The various injury problems are described by Stockholm 2001
persons with extensive experience in the field.
Chapter 1 margin for error are an accepted example of modern
technique. Coaches must therefore decide when they
Biomechanics of tennis should teach the multisegment topspin forehand,
used by a majority of leading professionals. In the
Introduction multisegment forehand,the individual segments
of the upper limb move relative to each other in a
As the term suggests, biomechanics involves a study coordinated manner to produce a high racket speed.
of the structure and function of the human body The alternative to this stroke is the forehand where
using mechanics. Biomechanics of tennis therefore the whole arm swings forward predominantly as a
deals with the mechanical basis of tennis, with single unit.
particular emphasis on the techniques used in 4 The biomechanical basis of stroke production.
stroke production. The criterion measure in tennis, The time of contact between the ball and the strings,
that is successful performance in an injury-free a biomechanical consideration in strokeproduction,
environment,makes it imperative that coaches and varies minimally (5 ms) irrespective of string tension.
medical/paramedicalpersonnel have an understand- The movement of the racket and ball together with a
ing of biomechanics. vertical racket face at impact are therefore the key
mechanical determinants of a successful topspin
The primary objective of a coach should be to groundstroke.
develop `goodtechnique'.The coach who has an
understanding of biomechanics can integrate the This chapter will be divided into three sections.
personal characteristicsof the player with sound The first, reviews a number of general biomechanical
stroke mechanics to develop skills that suit the factors that influence stroke production, while the
individual. Sports science and sports medicine second section deals with research specific to each
personnel use these individual player characteristics of the strokes. The third section is on the analysis
to structure appropriate training and rehabilitation of technique, a key factor in the successful modifica-
programmes. tion of stroke production. Chapter 2 deals with bio-
mechanical considerations of equipment design and
The individualized mechanical model for per- tennis.
formance must be developed with consideration
of four broad areas. General mechanicalfactors
1 Past experiences of the coach. Years of coaching
or experiencesas a player may have led a coach for The following mechanical factors are common to all
example to the conclusion that a semi-western or tennis strokes and as such should be treated separately
western forehand grip should be adopted in prefer- to a discussion of individual stroke production.
ence to a continental grip when hitting a topspin
forehand drive. Time of ball contact
2 The individual characteristics of the player. The
physical characteristics (e.g. lack of strength) or flair The time of contact between the ball and the strings
of a player may dictate that a particular technique be varies minimally from 3 to 6 ms (Plagenhoef 1979;
considered when deciding what should be learned Brody 1987).No other fact has had more influence
(8.g. double-handed backhand). on the game, as it is not possible (withinthe laws of
3 The current techniques used by champion players. the game) to significantly alter this time. The racket
High-speed forehand drives that clear the net with a must therefore be in the desired position at impact,
so that the relative path and speed of both the racket
and ball determine the type and amount of spin
imparted, rather than any sudden movement that is
attempted while the ball is in contact with the strings.
[Speed is used interchangeablywith velocity for
ease of reading.)
1
2 CHAPTER 1
Grip firmness the closing speed of both ball and racket (addition of
speed of the ball and racket irrespective of direction)
Tennis coaches believe that grip firmness at impact rather than the influence of grip firmness. Significant
is generally critical to success in stroke production. increases in rebound coefficients for an increase in
Studies featuring central impacts, using a number grip pressure, particularly for off-centre impacts, were
of different experimental designs (propellingor reported for closing speeds more closely related to
dropping balls at freestanding or clamped stationary match conditions (30m.s-l, Elliott 1982;38 m.s-',
or swinging rackets) show that rebound ball speed is Plagenhoef 1979)whereas at a lower closing speed
not significantly affected by the level of grip pressure (10.6 me-', Grabiner et al. 1983)no significant
[Elliott 1982; Grabiner et al. 1983; Missavage et al. increase was reported.
1984;Knudson 1989).Theoretical support for this
result is provided by Liu [1983),whose model The generation of racket speed
predicted that the rebound coefficient (ball speed
postimpact/ball speed preimpact) is principally a Coaches are continually posed the question of how
function of the elastic nature of the impact between to enable their pupils to develop more power in their
the ball and strings,which is practically independent stroke production,that is hit the ball with a higher
of the condition of grip firmness. forward speed, while still maintaining an acceptable
level of control. Recent changes in stroke technique
A decrease in rebound coefficient was generally (e.g.service, Elliott et al. 1995; forehand, Elliott et al.
reported for off-centre impacts. Hatze (1976)reported 1989a)have further caused them to ponder iflwhen
that theoretically, an off-centre impact would be selected aspects of stroke production should be taught
accompanied by an increase in racket recoil, which to young players. This section provides a framework
decreased postimpact ball speed. Plagenhoef (1979) for coaches to assess changes in technique associ-
using photography and an instrumented racket ated with the development of high-speed stroke
reported that the further away an impact occurred production.
perpendicular to the long axis (from the centre),the
lower was the rebound coefficient (2.5 cm, 15% The use of elastic energy
reduction; 5.0 cm, 40% reduction). Postimpact ball
speeds were less affected by off-centre impacts along `Prepare early' is a phrase commonly used by coaches.
the long axis, where reductions of only 10% were The logic behind such a statement is that for the ball
reported for impacts near the end of the racket com- to be hit at the appropriate time and not `late'requires
pared to speeds for central impacts. These reductions this early preparation. The question then arises as
in rebound speed were accompaniedby increases in to whether performance is in fact hindered by this
the forces transmitted to the hand (Plagenhoef 1979; early preparation, as elastic energy stored during
Elliott 1982). the `stretch cycle' of the movement may not be of
benefit during the `shortencycle' of the activity.
Higher off-centre rebound coefficients were associ- This stretch-shorten cycle is observed in tennis as a
ated with an increase in grip pressure (Elliott 1982). counter-movement during the racket backswing or
An approximate 20% increase in rebound coeffici- movement preparation phase (i.e. bending of the legs
ent was reported (approx.0.47-0.57) for a change during the split step in a volley) that precedes the
from a `lightto tight' grip for off-centre impacts, actual forwardswingof the racket [external followed
whereas central impacts increased to a lesser degree by internal rotation of the upper arm) or movement
(0.64-0.69) (Elliott 1982). Grabiner et al. (1983)also to the ball (theshortening phase).
investigated the relationship between resistance to
rotation (about the long axis) and postimpact ball The theory underlying the use of elastic energy
speed following off-centre impacts. They reported no in stretch-shorten cycle activities is a relatively
significant differences between postimpact ball speed simple process. During the stretch phase (eccentric
for two extreme conditions of grip firmness (maximal contraction)the muscles, tendons and associated
pressure clamped and free standing).However, they tissue are actually stretched and store elastic energy.
suggested that this result may have been influencedby
BIOMECHANICS 3
l2OL for a groundstroke or as part of the split step in serve-
volley and approach shot-volley play. The rapid
0.00 0.50 1.00 1.50 2.00 2.50 3.00 3.50 4.00 flexion of the knees must obviously be controlled,
otherwise the body would drop into a full squat
Pause time (s) position. This stopping of the downward movement
Fig. 1.1 Loss of elastic energy with increase in pause time. has been shown to apply stretch to the muscles and
(Modifiedfrom Wilson et aJ. 1991.) other tissues of the lower limbs, which results in
the storage of energy. This stored energy may then
at least partially, if the movement of knee flexion is
quickly followed by knee extension, be used to assist
the lower limb drive in moving a player to the ball.
Knee extension and the acceleration of the body
upward increases the reaction force from the court
and therefore allows the players to drive in the
direction of the next stroke.
On movement reversal, during the shortening phase, The distance over which racket speed
the stretched muscles (which are in a better position can be developed
to produce force) and tendons recoil back to their
original shape and in so doing a portion of the stored One of the main reasons of having a backswing is to
energy is recovered and assists the movement. increase the distance over which racket speed can be
Research has shown that the use of elastic energy is developed during the forwardswingto the ball. In a
reduced if a delay occurs between the stretch and straight backswing (often taught to beginners),the
shorten cycles of an upper limb movement (Wilson racket is taken back in a relatively straight line, before
ef al. 1991) (see Fig. 1.1)I.n the upper limb, after a stopping in the backswing position, prior to swinging
period of approximately 1 s, 55% of the stored energy forward to the ball. This type of backswing, which is
is lost; after 2 s, 80% of the stored energy is lost; and easy to learn, is very good in developing ball control.
after a 4-s delay all stored energy is lost. It may even use some of the elastic energy stored
during the stretch cycle. However, the distance the
The recovery of this stored energy tends to occur racket moves forward to the ball is often not sufficient
relatively quickly and is thus of major benefit early to allow the development of a high racket speed at
in the forwardswing phase of the stroke or in the impact.
movement to the ball (Wilson et al. 1991).This is
of major benefit to young children, who need the The looped backswing was introduced in ground-
assistance of this energy source, to overcome the strokes (it has always been used in the serve)to
inertia (swingweight) of the racket during the early increase the distance over which racket speed could
section of the forwardswing of for instance the be developed during the forwardswingto the ball.
forehand or serve. In the service action, the racket is kept away from
the body when `looped'behind the back (Fig. 1.2),
Speed of movement around the court is also related which effectively increases the distance over which
to the ability to `use elastic energy'. Groppel(l984) the player can develop racket speed when swinging
wrote: `regardless of the position a skilled player up to the ball.
assumes while awaiting the opponent's shot, upon
or just prior to impact by the opponent, the player The looped backswing requires more coordination
will unweight'.As the player flexes at the knees than the straight backswing and therefore control may
(accelerates downward) the reaction force from the suffer initially. However, once correctly developed
court is lowered (unweighted).This unweighting this form of backswing allows for the production of
is an integral part of tennis movement, whether greater racket speed and therefore more power in
it be before a return of serve, moving to position stroke production as compared to the straight back-
swing. If a pause is required between backswing and
4 CHAPTER 1
Fig. 1.2 The backswing position in the service action. points during the forehand drive. The only joint
movement that has been shown to occur very late in
forwardswing phases of the groundstroke then the the forwardswing (and therefore not in proximal-to-
racket should stop near the top of the loop to increase distal sequencing)for the service (Elliott et al. 1995)
the distance over which racket speed can be generated and forehand strokes (Elliott et al. 1997)is internal
for impact. Research has shown that 2.7 m.s-l of extra rotation of the upper arm.
speed was generated with an increase of only 30 cm
of racket drop during a looped forwardswing. Recent developments in forehand and backhand
stroke production have created some concern among
The use of coordinafedmovemenfs coaches. The need for greater trunk rotation and
the use of individual segments of the upper limb
In tennis, where a high racket speed is generally (arm, forearm and hand) in an attempt to generate a
required, a number of body segments must be higher racket speed has created a need for changes in
coordinated if success is to occur. The motion of coaching methodologies. The extension at the elbow
segments in high-speed tennis strokes is generally joint during the forwardswingof a backhand drive
sequenced in a proximal-to-distal fashion. One of (note flexed elbow in Fig. 1.4) increases the racket
the most popular principles underlying the descrip- speed at impact. Rotation of the trunk and shoulders
tion of this sequencing is the `summationof speed' in the backhand not only increases the distance over
principle. This concept suggests that the speed of the which the racket can generate speed but also adds
distal end of a linked sequence (theracket) is built another segment to the total movement (the trunk)
up by summing the individual speeds of all segments that if coordinated with upper limb movements can
participating in this sequence, although the prin- assist in building racket speed.
ciple does not provide a mechanical explanation of
how this is achieved. It is generally believed that joint In the serve, a `legdrive' and `bodyrotation',just to
rotational speed data provide the clearest descrip- name two segments,are essential features of stroke
tion of proximal-to-distal sequencing.Furthermore, technique. Most coaching texts include a section that
these data enable coaches to visualize a movement, deals with the flow or summation effect in the service
as motion is generally characterized as a series of action (as shown below),which leads to optimal
coordinated segment rotations. Figure 1.3shows racket speed at impact.
how these joint rotations influence segment end
Leg drive + Trunk rotation + Upper arm elevation +
Forearm extension + Upper arm internal rotation,
forearm pronation and hand flexion
The role of muscle strength and endurance
The relationship between selected physical capacities
such as muscle strength and performance is relatively
easy to assess in sports such as weightlifting. How-
ever, such a relationship is very difficult to quantify in
tennis. Varied relationships have been found between
muscle strength and serving speed (Ellenbecker 1989),
although more recently Kleinoder (1990) showed
that a specifically designed exercise programme can
improve racket speed. A prospective study by Elliott
et al. (1990)was not able to predict with any certainty
those physiological (fitness) or kinanthropometric
(physical capacities)variables that would allow
superior tennis performance to be identified for
11-,13-and 15-years-olds. Players must obviously
External rotation BIOMECHANICS 5
Abduction/flexion A Upper arm rotation
rn Upper arm abduction/flexion
"Flo Forearm supination A Forearm flexionlextension
Forearm flexion 0 Forearm pronationlsupination
Palrnar flexion
Radial flexion o Hand palmarlflexion
0 Hand radiallulnar flexion
"I Internal rotation L
Forearm pronation
2 -151 Forearm extension
Palmar extension
Ulnar flexion
t-20
Fig. 1.3 Summation of segment -25 I I I I I I I
velocities (speed)in the tennis
-0.25 -0.2 -0.15 -0.1 -0.05 0 0.05
forehand. (From Takahashi et al. 1996.) Time (s)
Fig. 1.4 The backswing position in the backhand drive. develop sufficient muscle strength and endurance to
perform effectively in a long match. An increase in
muscle strength means that a lesser ptmentage of total
strength is needed for each movement, whirh may
assist in the ability to repeat the performance and
protect the body from injury. Strength development is
certainly needed for instanre i n the shoulder region,
not only to produre the high upper arm rotational
values for stroke production but also to protect the
region froni injury.
The role of equipment design
Redriers arr' referred to the chapter on the tennis racket
how changes in tiesign and string
stimpart ball 5pec.d.
Margin for error and rally speed
An understanding of the concept of 'margins of error'
is essential for any coach attempting to develop
6 CHAPTER 1
Table 1.1 Error margins for a groundstroke Table 1.2 Error margins for a service hit at
hit with different levels of spin and speed. varying heights and speeds. (Modified from
(Modified from Brody 1987.) Brody 1987.)
80 km.h-' 108 km.h-l 120 km.h-' Height 108 km.h-' 145 km.h-' 180 km.h-'
(50 mph) (67 mph) (75 mph) (67 mph) (90 mph) (112 mph)
- 9.0" - __ 2.00 _ __ . . ~ _
5.0' 0.0"
No spin 10.5' 3.4" 2.03 m (80 inches) 1.9 0.6 0.0
Backspin 4.0" 2.54 m (100 inches) 2.6
Topspin 1.20 3.05 m (120 inches) 3.5 1.4 0.8
5.8" 2.1 1.6
Approximate values for waist-height impacts. Approximate values for a flat service technique.
high-performance players. Brody (1987) provides Horizontal errors and bail speed in groundstrokes
a very comprehensive coverage of this and other
tennis topics. Although many coaches emphasize stance as a key
determinant in postimpact ball direction, the real
Spin and rally speed factors that must be considered are: the angle of the
racket face and direction of the racket speed. Stance
Many players who are capable of rallying at a given of course may affect both these factors. The poorer a
level often experience a loss of control when player's timing the larger the angular error. If a ball
attempting to hit the ball harder or when required to leaves the strings at an angle of 6.5"from its aimed
rally with a better player. The vertical error margin direction, it will end up approximately 2.75 m
(the difference in the angle the ball leaves the racket horizontally (at the baseline] away from the point at
for a shot that will just clear the net to the one that which it was aimed (Brody 1987).Table 1.3clearly
clears the net easily and lands on the baseline) is shows that the effect of horizontal angular error (error
reduced as ball speed increases (Table 1.1)(Brody in racket angle compared to aiming point) decreases
1987).Backspin also reduces this margin for error, as a function of racket speed. However, it is important
particularly if a player hits the ball with 'power', for coaches to also understand that the differences
while topspin increases the margin for error. The at high speeds are not as large as those in the lower
relative importance of topspin increases for an range. Therefore, if blocking a return of service (close
increase in ball speed. to 0 m+-l racket speed),aim more for the central
Success as afunction of height in the serve Table 1.3 Horizontal angular error as a &0
function of racket speed. (Modified from
It is evident from Table 1 . 2 that if a player wishes to Brody 1987.) !I:
develop a high-speed service, it is also necessary to
impact the ball as high as possible from the court, a-
A near fully extended body and a good 'leg drive'
such that the body is off the ground at impact will Racket speed (m+-') Angle of deviation (")
obviously enhance service technique. For instance a
ball hit 2.03 m from the court's surface has no chance ( O ft's-') -~
of success if hit at 180 km.h-l. Brody (1987) also 9 (30 ft.s-')
demonstrated through computer simulation that 18(60 f t d ) 20.0
success rate improved if the ball was hit with some 27 (90 ft.s-') 8.0
forward rotation (usuallya combination of topspin 5.8
and sidespin). 4.0
Approximate values for a preimpact ball angle of 20" to the
racket direction at a speed of 18 m s-l (40 mphl.
BIOMECHANICS 7
region of the court, and if attempting a passing shot falling 1.2 m. In this situation the player has to contact
always swing at the speed `grooved during practice'. a target moving at approximately 5 m.s-l.
A lower speed (often mistakenly adopted to improve
accuracy) will increase the effect of any error in the The swing to impact
angle the ball leaves the racket and often leads to the
ball landing out of court. Although coaching books provide guidance, weight
distribution, along with the initial positioning of the
Stroke production feet, tends to be modified by personal preference.
During the backswing the body weight initially moves
This section reviews the scientific literature with back, then forwards such that at contact the vertical
reference to the key mechanical factors in effective line from the centre of gravity (the hips) is approxim-
stroke production. The need to present general ately 25 cm and 40 cm forwards of the front toe in the
mechanical principles to beginners (in an appropriate flat and slice serves,respectively.
manner) and certainly to college-age students or
above, has been shown to be beneficial to learning. What movements then drive the hitting shoulder
For a comprehensive understanding of stroke tech- forwards and upwards for impact? Different serving
nique this section must be read in conjunction with techniques, with reference to movement of the feet,
the coaching literature. Specific conclusions will be produce different mechanical characteristics(Elliott
drawn from the literature where this is possible; &Wood 1983).
however, coaching theory based on subjective opinion
will not be included. The foot-up style: this technique produces greater
vertical forces over time, which results in a higher
The serve impact position and a better up-and-outracket
trajectory when compared to the foot-back style.
The service action is not only the most studied stroke
in tennis but is also the most strenuous, and as such a The foot-back style: this technique produces larger
sound biomechanical basis is critical to performance. horizontal forces during the drive phase than the
Coaches must pay specific attention to the physical foot-up style and may thereforebe more conducive
characteristics of the player, along with the key to rapid movement to the net, following the serve.
mechanical features needed to develop a rhythmic
action. Because of the complexity of the shot, the Players may choose either style and then con-
key mechanical factors in the service action will be centrate on eliminating weaknesses and enhancing
presented under separate headings. strengths of each technique. An efficient service action
was characterizedby negligible side-to-sideforces,
TPIe ball toss and small forward forces during the preparatory
phase (vanGheluwe & Hebbelinck 1986).Vertical
The height the ball should be `pushed'using the forces should be such that the body is `driven off the
`straight forwards and up' or the `rotary style' is the ground' for impact (Elliott & Wood 1983;van Gheluwe
first service skill to be mastered. An analysis of players & Hebbelinck 1986).This lower limb drive, together
at the Atlanta Olympics showed that the toss was with trunk rotation (Fig. 1.5a-d), then produce a
positioned such that it was in front and marginally to forward speed of the shoulder that represents
the left of the front foot at impact (Chow et d.1999). approximately 10-20% of the racket speed at impact
High-speed photography has been used to show that for high-performance players (Elliott et d.1986,1995;
many elite performers impact the ball after it has van Gheluwe & Hebbelinck 1986).As the lower limb
begun to drop (2.5-20.0 cm). It has been calculated action also drives the racket `downbehind the back'
that when impact occurs at the top of its flight, a this movement together with trunk rotation (to drive
player has eight times the amount of time to contact the racket away from the body) are key mechanical
the ball (stationaryball) than when the ball is hit after characteristicsof the service action.
Research has very recently supported a commonly
held view by coaches on the role of trunk rotation in
the serve (Bahamonde2000). Trunk rotations in the
three planes are observed i n the period prior to impact.
- \-I -
1-1
Fig. 1.5 The service forwardswing to impact.
---
[Cuối tài liệu]
I N D E X 313
sweetspot 32 modern testing techniques 35-6
testing 131-4 moment of inertia 32-3,35
practice node 29,30-1
with distractions present 287
fluid intake 70-1 power 32
under pressure 283 longitudinal distribution 33
prehabilitation 150,264 point of maximum 36
shoulder 274
young tennis players 142-5 role in tennis elbow 237-9
see also rehabilitation size, tennis elbow and 238
preparation, early 2 speed
pre-participation medical screening 297
pre-participation profiling 124-38,150 error margins and 6-7
fitness-testing protocol 125-37
goals 124-5 generation 2-5
for training programme design 137-8 strings see strings
young tennis players 142-3 swingweight 33
pre-patellar bursitis 201 weight 33
primary health care providers (PHCPs] 94, 296,297,298
facilities and equipment 95,298 tennis elbow and 238
injury evaluation 300-1 young tennis players 141
player confidentiality 301 radial deviation exercise 122
player treatment 298-300 radial nerve 233
support function 301 compression 242
prone horizontal abduction exercise 118 radiocarpal ligaments 223
proprioceptive feedback exercises 143,145 radiographs
proprioceptive neuromuscular facilitation (PNF) 273,275 ankle injuries 166,174
protein hand and wrist injuries 224-5
dietary intake 56,57 knee problems 195
as energy source 56 shoulder injuries 251,255
metabolism 48 Rafter, Patrick 278
use, effects of training 56-7 range of motion (ROM)exercises
pseudo-anaemia, dilutional 87-8 in knee rehabilitation 275, 276
pseudo-spondylolisthesis 213 in shoulder rehabilitation 272-3
psychological support 301 Reagan Shuck test 228,229
psychology 278-90 rebound coefficient 2
pump bump 155-6 records, medical 301
push-ups 135-6,142 rehabilitation 262-77
wall 144 acute phase 263-4
pyruvate 47,48 closed-chain see closed-chain rehabilitation
functional phase 264
Qangle 195,196 hip in leg injuries 266,267
quadriceps 104 kinetic chain integration 264-5
in knee injuries 275-7
isokinetic strength testing 137 making diagnosis 262-3
stork stretch exercise 104 phases 263-4
strength training 195,196 plyometric exercises 269-71,272
tendinopathy and tears 198-9 recovery phase 264
scapula in arm injuries 266
racket 29-38 setting goals 262
ball speed and see ball, speed in shoulder injuries 260,272-5
centre of mass (CM)(balance point] 30, 32,33 in tennis elbow 240
centre of percussion (COP) 29,30,237 see also prehabilitation
coefficient of restitution see coefficient of restitution relaxation 282
errors and 36-7 on-court tips 282-3
face angle 6,13 progressive 282
frame 29 response 282
stiffness 35 relocation test 255
vibrations 30-1,237-8,239-40 repetition maximum (RM) 121-3
head research 294-5
additional weight at 33 resistance stress test 235
impact locations 36-7 resistance training 116,117-18
size 32,240 in rehabilitation 270-1
materials 29 respiration, cellular 48
tennis elbow and 238 respiratory disorders 82-5
respiratory exchange ratio (RER) 49
respiratory tract infections, viral upper 83-4
restringing, racket 35
retinal detachment 78
314 I N D E X serotonin 63
serratus anterior muscle 122
retrocalcaneal bursitis 155-6 serve 7-10
return of serve 10-11
reverse medicine ball toss 132 backswing 3 , 4
rhinitis 82-3 ball toss 7,210-11
RICE principle 166 elbow hyperextension 244,245
right ventricular dysplasia 82 error margins 6
Rh4 see repetition maximum follow-through 10
roll moment of inertia 32-3 lower extremity problems and 156, 176
rooms, allocating 101 mechanical model 25
rotary torso machine exercise 1 1 1 , 1 1 2 racket trajectory prior/after impact 9-10
rotator cuff return of 10-11
routines 286-7
assessment 251,255 shoulder instability 254
exercises 117,118,252,268 speed, racket and 36
injuries (tendinitis) 250-3 spinal injury prevention 217
spinal strain 207,208,209-11
evaluation 151 summation of segment velocities 4
pathophysiology 248-9 swing to impact 7-9
in senior players 260 tennis elbow and 234,237
surgical treatment 252-3,257,258 valgus stress on elbow 9, 242,243
symptoms 250-1 wrist movement 9,223
tears 257, 258,259 sesamoid dysfunction 161-2
treatment 251-2 sex differences
surgical repair 253 electrolyte losses 66
routines, using 286-7 spine injuries 213
run, 1.5-mile(2.4-km) 127 sweating rates 66
runner's knee 201,202 tennis elbow 236
running see also female tennis players
biomechanics 41,42 Sexias, Vic 282
injury mechanisms 42 `shin splints' 177, 179
shirt, changing wet 71
sacroiliac joints 206 shoes 39-44
salt intake 60,68-9, 72-3 with flexible soles 176,177
hallux valgus and 162-3
during play 71 high-topped 44
postmatch 72 injury aspects 39-43, 176, 186
prematch 70 inserts 156-7
see nlso sodium modifications 43-4
Sampras, Pete 278,289 in nerve entrapments 161
Sanchez-Vicario, Arantxa 278 performance aspects 43
Sanex WTA Tour 294 poor fitting 155,164,176
medical services 94-5,296-7 posterior heel pain and 155,156
pre-participation medical screening 297 with stiff soles 159,163
saphenous nerve entrapment 160 shoulder
scapula arthrokinematics 273
exercises 117-20 arthroplasty, total 260
capsularlaxity 258-9
in rehabilitation 251-2, 266,268, 273 capsular tears 259-60
function 266 capsulolabral reconstruction 258, 259
position 117 extension exercise 118
in rotator cuff injuries 251 external rotators 116,118,119
scapular slide test, lateral 116 injuries 248-60
Scheuermann's disease 220
Schmorl'snodes 216 in adolescent players 249
scoliosis 216,220 in adult players 249-60
scuba diving 99 pathophysiology 248-9
seated row exercise 117, 219 postoperative management 260
seizures 76 rehabilitation 266,268-9, 272-5
selenium sulphide 91 in senior players 260
Seles, Monica 278,283 instability 254-60
self-monitoring 288 in adolescent players 249
self-talk 287-90 conservative treatment 255-6
effectiveness 28 7- 8 indications for surgery 256
methods of using 288 physical examination 255
negative and positive 289
techniques for improving 288-90
semimembranosis bursa problems 202
senior tennis players see older tennis players
I N D E X 315
postoperative management 260 spastic colon 86
surgical procedures 256-60 specialist physicians 297
type1 258 specificity principle 116
type 11 258-60 spectacles 78
internal impingement 254,257,258 spectators 297
internal rotation, limited 114,140, 251 speed
internal rotators 116
joint see glenohumeral joint ball see ball(s),speed
movements testing 127-34
approach shot 2 1 training 107-8,109
backhand 14,18 spider test 130-1
forehand 11,13 spin 6
serve 9 see also backspin; topspin
volley 19-20 spinal canal stenosis 213, 215
muscular imbalances 115-16,140 spinal twist stretch 114
press exercise 120 spine
range of motion, young tennis players 140,141 biomechanical strain 207-11
rotation congenital malformation 220,221
flexibility testing 126-7 flexors and extensors 204,205
isokinetic strength testing 137 functional anatomy 204-7
shrug exercise 119 functional unit 204
strength and endurance exercises 117-18, 144 injuries 204-21
stretch exercises 114-15
`tennis' 117 epidemiology 212-13
shoulder blade see scapula medical check-up 220-1
sidelying external rotation exercise 118 pathology 213-16
side-shuffle movement prevention 110-14,216-17
biomechanics 41,42,176 rehabilitation 216-17
injury mechanisms 42,43 treatment 217-20
sideways shuffle test 130 manipulation 217-19
sinusitis 83, 99 mobility 205-6, 207
sinus tarsi syndrome 1 7 2 , 1 7 4 tennis 213-16
sit and reach test 125-6 splinting
sit-ups 135 night 156
skill acquisition, young tennis players 141-2 wrist 232
skin spondylolisthesis 215-16
bloodflow 67 spondylolysis 215-16
cancer 90 spondylosis,lumbar 213-15
disorders 88-90 sport bars 58,60
fungal infections 91,98-9 sports anaemia 87-8
premature ageing 90 sports drinks
SLAP (superior labmm anterior-posterior) lesions 257,258 carbohydrate-electrolyte see carbohydrate-electrolyte
sleep 98,100,101
sleeping tablets 100,101 drinks
sleep-wake cycle 9 7 , ~ postmatch 60
sliding, surfaces permitting 43,44
slow down, between points 282 prematch 70
smash, overhead 24 sports medicine trainers (SMTs) 94, 297,298
smog 84
smoking 100 equipment and facilities 95,298
snacks injury evaluation 300-1
during play 60 player confidentiality 301
prematch 58, 70 player treatment 298-300
Society of Tennis Medicine and Science 294 support function 301
sodium (Na'] 63,66 sprains 40
deficit (hyponatraemia) 72-3 squats 106,143
foods containing 70 stance, one-legged 266, 267
heat cramps and 68 staphylococcal skin infections 91
intake see salt intake steroids see corticosteroids
losses in sweat 66 stitch in side 86
sodium bicarbonate 62 straight leg raise 275
strapping 299
sole heel pain (plantar fasciitis) 156-8 strength
soleus muscle strain 179-80 isokinetic, testing 136-7
somersault service action 9 muscle
in stroke production 4-5
tennis elbow and 237
testing 134-6
young tennis players 140,141-2
316 INDEX subtalar joint
chronic instability 172,173-4
strength (continued) fusion 175
training sinus tarsi syndrome 174
defined 104 sprains 173
in knee rehabilitation 276
lower back and trunk 110- 4.23 subungual haematomas (tennistoe) 89,164
218 sudden cardiac death 79,81,82
lower body 104-6 sugars 55
physiological effects 52
in rotator cuff injuries 252 metabolism 47
in shoulder rehabilitation 273, 274 see also glucose
in tennis elbow 240 sulcus sign 255
upper extremity 116-17 summation of segment velocities (speed) 4 , s
young tennis players 143 sun-related disorders 90,99
sunscreens/sunblocks 90,91,99
stress fractures 42 superficial peroneal nerve entrapment 160
female tennisplayers 93, 94, 159, 178 superman exercise 110
foot and ankle 159-60 suprachiasmatic nuclei 97
hand and wrist 226,231 suprascapularneuropathy 251,253-4
lowerleg 178 supraspinatus exercise 118
supraspinatus tendon 250
stretching 298, 300 tears 257
in Achilles tendinopathy 184 sural nerve entrapment 160
lower body 103-4,202 surfaces,playing 39-44,301
in plantar fasciitis 156 injury aspects 39-43, 176, 186
in tennis elbow 240 modifications 43-4
trunk and lower back 114 performance aspects 43
upper extremity 114-15,231-2 tennis elbow and 239
surgery, flying after 99
stretch-shorten cycle 2-3 sweating 65
strings 33-5 electrolyte losses 66
excessive 89
ball dwell (contact) time 34 rates 65-6, 71
elasticity 35 salt intake and 60
gut 34,35,239 sweet spot 29,237
plane stiffness (deformation) 34 power 32
replacement frequency 35 see olso centre of percussion
synthetic 34,35,239 swingweight 33
tennis elbow and 238,239 sympathetic activity 49
tension 34-5 syncope 80
synovial plica syndrome 191-2
tennis elbow and 238,239 synovitis 192
vibrations 31,35
stroke production 1-26 talus
analysis 24-6 fractures 168
osteochondritis dissecans 171-2
objective methods 26
predictive methods 26 taping 298
subjective methods 24-6 tarsal tunnel syndrome 160-1
approach shot 21-4 technology 294
backhand 14-19 television monitors 298
forehand 11-14 temperature, body
general mechanical factors 1-7
generation of racket speed 2-5 diurnal variation 96-7
grip firmness 2 regulation see thermoregulation
margin for error and rally speed tendinitis 183,235
tendinopathy 151,152,183,234-6
5-7 tendinosis 183
time of ball contact 1 angiofibroblastic 148
return of serve 10-11 tendon injuries
serve 7-10 lower leg 179-85
smash 24 mechanisms 42
volley 19-21 pathology 148-9
stroke technique terminology 183, 235
changing 301 wrist and hand 225-6
choosing 1 tennis elbow see lateral elbow tendinopathy and olso medial
faulty, causing tennis elbow 234
subacromial bursa 252-3,258 elbow tendinopathy
subacromial decompression 252-3, 258,259
subacromial impingement 253,258,259,262
subscapularis tendon 250,257
subscapular nerve 250
tennis leg 152,179-80 INDEX 317
tennis shoulder 117
tennis spine 213-16 young tennis players 143-5,293
tennis toe 89,164 see also prehabilitation; rehabilitation; specific exercises
tensile loading 264
tension headache 75 and types of training
teres minor tendon 116, 250 travel 96-101
testosterone, plasma 50 traveller's diarrhoea 85,98
thermoregulation 65 Travelling Sports Medicine Fellow 297, 300
treatment 298-300
age effects 67-8
heat acclimatization and 70 on-court 299
in hypohydration 67 postmatch 300
thirst 71 prematch 298-9
Thompson's squeeze test 181, 182 tables 298
thoracic spine 207 Trendelenburg posture 266,267
injuries 213 triangular fibrocartilage complex (TFCC)injuries
mobility 205,206
thought stopping 288-9 228
thrombosis, venous 99 triceps 233
thrower's elbow see medial elbow tendinopathy
tibia, stress fractures 178 curl exercise 120
tibial nerve entrapment 160-1 tendinosis 245
tibial tubercle transfer 195,196 triglycerides 55
tibiotalar joint, chronic instability 1 7 2 medium-chain (MCTs) 61-2
time zones triquetral hamate impingement 226
acclimatization to changes 97-8 triquetrolunate ligament tears 228-9
crossing 96-101 trunk
tinea pedis 91 flexion and extension 109-10
tinnitus 76 injury prevention 110-14
toe isokinetic strength testing 137
machine exercises 111,112
hammer 164 movements, approach shot 22
problems 161-4 muscles
tennis 89,164
toenails kinetic link 109
fungal infection 91 training 108-14
ingrown 89 pain, evaluation 152
toilet break rules 293 rotation 110
tooth care 99 backhand 14,17
topspin 6,36 forehand 11-12,13
approach shot 21-2,234 serve 7-9
backhand 14-15 young tennis players 140
forehand 11-12,13 tryptophan 63
tournament physicians 94,296,297-8 tuhcups 157
equipment and facilities 95, 298 20-yard (18-m)dash 1 2 8
injury evaluation 300-1 2.4-km (1.5-mile)run 127
ITF policy 292, 293
patient confidentiality 301 ulnar artery, repetitive injury 230-1
tournaments 296 ulnar carpal impingement 227-8
injury evaluation 300-1 ulnar deviation 223
ITF involvement 291-4
medical services 94-5, 297-8 exercise 122
player treatment 298-300 u h a r nerve 233
psychological support 301
traction apophysitis 139-40 compression at elbow 244-5
training 103-23 compression at wrist 230
effects on nutrient use 56-7 ulnar neuritis 244-5
frequency, young tennis players 140 ulnar shaft stress fractures 231
kit 298 ulnar styloid carpal impingement 227-8
lower body 103-8 u h a r variance, positive 227, 228
mid-section 108-14 ulnar wrist pain 226
physiological effects 51-2 ultrasound therapy 217
programme design 137-8 United States Food Guide Pyramid 54
spinal injury prevention 108,110-14, 217 United States Tennis Association (USTA)fitness testing
upper body 114-23
protocol 124,125-37
unweighting 3
upperback exercises 116,117-20
upper extremity
injuries
epidemiology 223
prevention 114-23
rehabilitation 266,268-9
318 INDEX intoxication 72-3
see also fluid
upper extremity (continued) weights 270-1
movements wheelchair tennis 294
approach shot 21 Williams, Venus 278
backhand 14,18 Wolff-Parkinson-White syndrome 82
forehand 13,14 women's tennis 293
serve 9,lO see also female tennis players; Sanex WTA Tour: sex
muscular imbalances 115-16
training 114-23 differences
see also elbow: forearm: hand; shoulder: wrist wrist
upright row exercise 119 anatomy and biomechanics 223-4
urine production 70 brace 224,231
curl extension exercise 120,121,122
vaccinations 98 curl flexion exercise 120,121,122
valgus stress overload syndrome 242-5 dorsiflexion test 235
varicose veins 99 injuries 223-32
vasovagal reaction 80
vastus medialis, electrical stimulation 195 epidemiology 223
venous thrombosis 99 evaluation 224-5
ventilation, maximal voluntary 51 neurovascular 230-1
vertebrae 204 return to play 231-2
tendon 225-6
compression fractures 215 movements 223
vertebral ring apophyses, abnormal 216 approach shot 23
vertical jump 134 backhand 14,18,223
vibrations forehand 11-12,13,223
serve 9,223
dampeners 35,240 volley 20-1,223
racket frame 30-1,237-8,239-40 pain, ulnar 226
role in tennis elbow 239-40 strength and endurance exercises 117,119-20
strings 31, 35 stress fractures 231
video photography 26 stretches 115, 231-2
viral gastroenteritis 85, 98 ulnar deviation 223
viral upper respiratory tract infections 83-4 `writer's cramp' 233
vital capacity 51 WTA Tour see Sanex WTA Tour
vitamin C 63,64
X-rays see radiographs
vitamin E 63,64
young tennis players 139-45
vitamins 63-4 age eligibility rules 92,293
B-complex 63 biomechanics and skill acquisition 141-2
burnout 92,293
vitreous, blood in 77-8 fluid and electrolyte balance 66,69
VO,,,x 47, 50-1,52,82 heat tolerance 67-8
volley 19-21 injuries 139-40
causation 139
backswing 19 epidemiology 139
follow-through 2 1 treatment 140
forwardswing to impact 19-21 knee problems 194,200
split step 19 lower extremity injuries 40,41
wrist movement 20-1,223 maladaptations 140-1
prehabilitation 142-5
warm-up exercise shoulder injuries 249
food and fluid intake 58, 70-1 spine injuries 213
injury prevention aspects 202,217
Zeifgebers 96
warts 92 zinc 63,66
`washerwoman's elbow' 233 `zone,playing in the' 278, 279-80
wasp stings 89-90
water
body, deficit 66-7,71
intake
duringplay 58-60, 71
postmatch 72
prematch 70