The effects of ball impact location and grip tightness on the arm, racquet and ball for one-handed tennis backhand groundstrokes

Wrist Motion Assessment in Tennis Players using Three-Dimensional Motion Capture and Dynamic Electromyography

Background  Tennis players often present with ulnar-sided wrist pain, which may reflect repetitive stress and/or faulty mechanics. There is a role for investigating the biomechanics of tennis strokes and how they may relate to wrist pathology. The purpose of this study was to investigate whether three-dimensional motion capture technology and dynamic electromyography (EMG), when used to study groundstrokes in elite junior tennis players, reveals patterns of upper extremity motion that may correlate with the development of clinically relevant pathology. Case Description  Three-dimensional kinematic and EMG data were collected from two United States Tennis Association-ranked adolescent tennis players during groundstrokes. There were several observed differences in the two players' degree and timing of pronation/supination, ulnar/radial deviation, and flexion/extension during their strokes. Clinical Significance  Advanced motion capture technology facilitates a nuanced understanding of complex movements involved in groundstroke production. This methodology may be useful for identifying athletes who are at risk for injury and guiding rehabilitation for players experiencing pain. Level of Evidence  IV.

Epicondylopathia humeri radialis

BACKGROUND

Lateral epicondylitis is a common orthopaedic condition often massively restricting the quality of life of the affected patients. There are a wide variety of treatment options - with varying levels of evidence.

METHOD

The following statements and recommendations are based on the current German S2k guideline Epicondylopathia radialis humeri (AWMF registry number: 033 - 2019). All major German specialist societies participated in this guideline, which is based on a systematic review of the literature and a structured consensus-building process.

OUTCOMES

Lateral epicondylitis should be diagnosed clinically and can be confirmed by imaging modalities. The Guidelines Commission issues recommendations on clinical and radiological diagnostic workup. The clinical condition results from the accumulated effect of mechanical overload, neurologic irritation and metabolic changes. Differentiating between acute and chronic disorder is helpful. Prognosis of non-surgical regimens is favourable in most cases. Most cases spontaneously resolve within 12 months. In case of unsuccessful attempted non-surgical management for at least six months, surgery may be considered as an alternative, if there is a corresponding structural morphology and clinical manifestation. At present, it is not possible to recommend a specific surgical procedure.

CONCLUSION

This paper provides a summary of the guideline with extracts of the recommendations and statements of its authors regarding the pathogenesis, prevention, diagnostic workup as well as non-surgical and surgical management.

Hand and Wrist Injuries in Tennis Players

PURPOSE OF REVIEW

The purpose of this article is to review common hand and wrist injuries experienced by tennis players.

RECENT FINDINGS

A myriad of different wrist pathologies can be seen in tennis players ranging from metacarpal and carpal stress fractures to triangular fibrocartilage injuries and ulnar impaction. These vary depending upon the nature of the player, stroke mechanics, and time point within the season. A broad differential should guide work-up and management of wrist pain in tennis players.

Skill level and forearm muscle fatigue effects on ball speed in tennis serve

This study determined the effect of skill level (ITN 3 vs. ITN 8) on the tennis serve biomechanics and analysed the impact of forearm fatigue on dominant arm mechanisms between the two groups (expert vs. non-expert tennis players). The motion capture system with 17 reflective markers attached on anatomic landmarks of the participant was used for data collection. A total of 12 expert and 11 non-expert tennis players performed the required serving tasks. The ball speed of the expert group was significantly faster than that of the non-expert group during non-fatigued and fatigued states (p < 0.001). The wrist radial/ulnar deviation angle at impact was significantly different between non-fatigued and fatigued states for top-spin (p = 0.030) and flat serves (p = 0.018). A significant increase in extensor carpi ulnaris (ECU) and extensor carpi radialis (ECR) muscle activity during extension (p < 0.010) was observed, with that of the ECU being an ulnar deviation. Both the ECU and ECR might contribute to wrist joint and racket handle stability for the coming acceleration and impact while fatigue occurs. Fatigue might substantially influence non-experts' dominant forearms because of the significantly different elbow joint angles and dominant arm syndromes they displayed as compared with the experts.

Wrist Injuries in Tennis Players: A Narrative Review

The wrist/hand complex forms the crucial final link in the kinetic chain between the body and the racquet and therefore has a number of important roles in the production of all tennis strokes. However, the internal and external loads that are created at the wrist during these strokes have the potential to contribute to pain and injury. Therefore, the purposes of this narrative review are to (1) determine the extent of the problem of wrist pain/injury in tennis players, (2) identify bony and soft tissue structures of the wrist that are susceptible to damage as a result of tennis play and (3) explore factors that may influence the development of wrist pain/injury in tennis players. The epidemiological data revealed two important points. First, some evidence suggests wrist pain/injury accounts for a higher percentage of total injuries in more recent studies (2014-2015) than in early studies (1986-1995). Second, the relative frequency of wrist pain/injury compared with other well-recognized problem areas for tennis players such as the shoulder complex, elbow and lumbar spine is noticeably higher in more recent studies (2014-2015) than in early studies (1986-1995), particularly among females. Collectively, this would seem to indicate that the problem of wrist pain/injury has increased in the modern game. In fact, some wrist injuries appear to be related to the use of certain forehand grip types and the predominant use of the two-handed backhand. While the loads experienced at the wrist during tennis stroke production seem to be below threshold levels for a single event, the cumulative effects of these loads through repetition would appear to be an important consideration, especially when inadequate time is allowed to complete normal processes of repair and adaptation. This is supported by the evidence that most wrist injuries in tennis are associated with overuse and a chronic time course. The complex interaction between load, repetition, and training practices in tennis, particularly among young developing players who choose a path of early specialization, needs to be further explored.

Medical reasons behind player departures from male and female professional tennis competitions

BACKGROUND

The number of retirements, withdrawals, and "lucky losers" (the replacement of a player who withdraws before the start of the tournament by a losing player from the qualifying round) from professional tennis tournaments has increased, but the reasons behind such departures have not yet been analyzed. An official consensus statement has been conducted to allow a general categorization of injuries in tennis.

PURPOSE

To determine the reasons for departure and injury rates in professional tennis.

STUDY DESIGN

Descriptive epidemiology study.

METHODS

All reasons for departures were collected from official Association of Tennis Professionals (ATP) and Women's Tennis Association (WTA) web pages. All tournaments apart from the 4 major competitions (the Australian Open, French Open, Wimbledon, and US Open) were included for the period 2001-2012 for men and women. Personal data, tournament information, surface, match setting, date, and reason were obtained for each departure scenario.

RESULTS

Variations in departure and injury rates were seen throughout the season. Women left and were injured significantly more than men. Women mainly left because of thigh injuries, whereas men left mainly because of back injuries. Playing surface only had an influence on the risk of lower back injuries. Only women's departures were affected by the tournament round.

CONCLUSION

A high number of departures from tournaments have occurred during the past 10 years on the ATP and WTA circuits. Injuries were the main reasons of these departures, regardless of the type of departure and player sex. The back and thigh were the main locations of injuries for men and women, respectively.

Effects of string stiffness on muscle fatigue after a simulated tennis match

We tested the influence of string stiffness on the occurrence of forearm muscle fatigue during a tennis match. Sixteen tennis players performed two prolonged simulated tennis matches with low-stiffness or high-stiffness string. Before and immediately after exercise, muscle fatigability was evaluated on the forearm muscles during a maximal intermittent gripping task. Groundstroke ball speeds and the profile of acceleration of the racquet frame at collision were recorded during each match. The peak-to-peak amplitude of acceleration and the resonant frequency of the frame were significantly greater with high- (5060 ± 1892 m/s(2) and 204 ± 29 Hz, respectively) than with low-stiffness string (4704 ± 1671 m/s(2) and 191 ± 16 Hz, respectively). The maximal and the averaged gripping forces developed during the gripping task were significantly reduced after the tennis match with high- (-15 ± 14%, and -22 ± 14%, respectively), but not with low-stiffness string. The decrease of ball speed during the simulated matches tended to be greater with high- than with low-stiffness string (P = .06). Hence, playing tennis with high-stiffness string promotes forearm muscle fatigue development, which could partly contribute to the groundstroke ball speed decrement during the game.