Injury Prevention on Your Court

Preview:

Citation preview

Injury Prevention on Your Court2017

Stephan Esser MD, USPTAwww.tennismedicine.com

Goals

• Review 3 major concepts related to injury

• Explore opportunities for prevention

• Practice some on site assessment

• Have Fun

Concepts related to Injury

• Time

• Technique

• Training/Conditioning

Time

• Frequency

• Duration

• Volume

• The Too’s

– Too Far, Too Fast, Too Soon

• Inadequate Recovery Time

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

Technique

• Common technical errors which increase the risk of injury

Upper extremity Injury

• Late Contact– Forehand• Medial Epicondylitis, wrist injuries, shoulder injuries

– Backhand• Lateral Epicondylitis (tennis elbow), wrist injuries,

shoulder injuries

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

Open Stance Forehand

• Dominant Hip Loaded in Internal Rotation

– Loss of range of motion

– Increased rates of hip injury

Open Stance Forehand

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

Abbreviated Service Motion

• Bringing the racket up when midway back increases risk of “rotator cuff impingement”

• May encourage limited use of core and legs

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

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

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

Volley Grip Type

• Continental– Symmetric raquet face side to side– Wrist in an “L conformation”/neutral position of

support and stability

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

Training/Conditioning

• Consider body regions for– Inadequacy vs Overdevelopment– Overuse and Misuse

Training/Conditioning

• Shoulder– Common patterns• Tight pecs, Weak Posterior shoulder

– Answer• Stretch pecs, Strengthen Posterior Shoulder

Training/Conditioning

• Handout/Breakout

Training/Conditioning

• Use movement screen to evaluate “at risk” players

• Confirm players participating in age/goal/play level appropriate cross training

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

Thank You!

Stephan Esser MD, USPTAwww.tennismedicine.com

Recommended