Musculoskeletal injury profiles in professional Women’s Tennis Association players

Tennis Injuries Among German League Players: Investigating Patterns and Epidemiology of Acute and Chronic Injuries

Purpose

While injuries among elite tennis athletes are extensively documented, a notable research gap exists regarding tennis injuries among club-level players. This study examines tennis injuries in German league players, with a particular emphasis on the impact of racquet properties and court surfaces, distinguishing between chronic and acute injuries.

Patients and Methods

Retrospectively analyzing data from 600 tennis players over a 1.5-year period, a standardized questionnaire covered anthropometrics, injury characteristics, equipment usage, and court surface conditions.

Results

The study identified 1012 tennis-related injuries, averaging 1.7 per player. Acute injuries predominantly affected the lower extremity (56%), with ankle injuries being the most prevalent, and ligaments were the most commonly affected structures (36.4%). Chronic complaints (reported by 364 athletes) focused on the upper extremity (63.2%), primarily tendon injuries (56.8%). Racket properties exhibited no significant impact on chronic upper extremity injuries.

Conclusion

This study highlights a high incidence of acute lower extremity injuries, especially ankle ligament injuries, among German league tennis players. It offers crucial insights for devising targeted injury prevention strategies applicable to amateur, semi-professional, and professional tennis players, despite finding no significant link between racquet material and chronic upper extremity injuries.

Retirements of professional tennis players in second- and third-tier tournaments on the ATP and WTA tours

The demands of professional tennis, including physical and psychological aspects, contribute to the frequency of retirements at elite levels of the sport. The aim of this study was to analyze epidemiological patterns and risk factors associated with retirements in previous ATP and WTA Tour tournaments. A retrospective cohort study was conducted. This study focused on previous ATP and WTA Tour tournaments. The ATP database encompassed 584,806 matches, while the WTA database included 267,380 matches. To assess retirements, potential risk factors such as playing surface, tournament category, match round, and player age were analyzed. Incidence rates were calculated for the period between 1978-2019 for men and 1994-2018 for women. The overall incidence rate was 1.56 (95%CI: 1.54, 1.59) and 1.36 (95%CI: 1.33, 1.39) retirements per 1000 games played in male and female competitions, respectively. Retirements increased over the years. Higher incidence rates were observed on hard (1.59 [95%CI: 1.56, 1.63] and 1.39 [95%CI: 1.34, 1.44]) and clay (1.60 [95%CI: 1.57, 1.63] and 1.36 [95%CI: 1.32, 1.41]) compared to grass courts (0.79 [95%CI: 0.65, 0.94] and 1.06 [95%CI: 0.88, 1.27]). Risk factors differed by gender, with tournament category significant in males (IRR: 1.23 [95%CI: 1.19, 1.28] in ITF vs ATP) and match round in females (IRR: 0.92 [95%CI: 0.88, 0.98] in preliminary vs final). This study provides valuable insights for coaches, players, support teams, and epidemiologists regarding retirements and associated risk factors in previous ATP and WTA Tour tournaments, contributing to injury prevention strategies.

Epidemiology of Musculoskeletal Injuries in Tennis Players During the French Open Grand Slam Tournament From 2011 to 2022

Background

The epidemiology of musculoskeletal injuries at the Australian Open, Wimbledon, and US Open tennis tournaments has been investigated in recent studies; however, there is no published literature on the incidence of musculoskeletal injuries at the French Open.

Purpose

To describe the incidence, location, and type of musculoskeletal injuries in tennis players during the French Open tournament from 2011 to 2022.

Study Design

Descriptive epidemiology study.

Methods

A review was performed of all injuries documented by a multidisciplinary medical team during the French Open from 2011 to 2022. All musculoskeletal injuries that occurred during the main draw of the female and male singles or doubles matches were included. Descriptive statistics were used to summarize the data. Injury locations were grouped into regions as well as into upper limb, trunk, and lower limb.

Results

In total, there were 750 injuries in 687 tennis players, resulting in a mean of 62.5 injuries per tournament; however, there were no obvious trends in injury incidence over the time frame evaluated. The number of injuries in female and male players was similar (392 vs 358, respectively). The most common injury regions were the thigh/hip/pelvis (n = 156), ankle/foot (n = 114), and spine (n = 103). The most common injury types were muscle-related (n = 244), tendon-related (n = 207), and joint-related (n = 163), and the most affected muscles were the adductors (n = 45), rectus abdominis (n = 38), and lumbar muscles (n = 25).

Conclusion

Over the 12-year period from 2011 to 2022 female and male players experienced similar numbers of musculoskeletal injuries, with most injuries occurring in the lower limbs compared with the upper limbs and trunk.

Epidemiology of MRI-detected muscle injury in athletes participating in the Tokyo 2020 Olympic Games

OBJECTIVE

Muscle injury is one of the most common injuries occurring at the Olympic Games often with devastating consequences. Epidemiological injury surveillance is recognised by the IOC as essential for injury prevention and management. We aimed to describe the incidence, anatomical location and classification of MRI-detected muscle injuries in athletes who participated in the Tokyo 2020 Olympic Games.

METHODS

Two board-certified orthopaedic surgeons, highly experienced in reviewing MRIs, independently and retrospectively reviewed all MRIs collected at the Tokyo 2020 Olympic Games from clinical reports generated by board-certified musculoskeletal radiologists at the IOC Polyclinic. The presence and anatomical site of muscle injuries were classified as: type a: myofascial/peripheral; type b: muscle belly or musculotendinous junction; and type c: injury which extends into the tendon, with reference to the British Athletics Muscle Injury Classification.

RESULTS

Fifty-nine MRI-detected muscle injuries were seen in 40 male and 19 female athletes. 24 athletes (41%) were unable to fully compete in their event. Fifty-two injuries (88%) involved lower extremity muscles with hamstring muscle injuries most common (32 of 59, 54%). Half of all muscle injuries occurred in athletes participating in athletics (30 of 59, 51%). 21 athletes (35%) sustained type a injuries, 14 athletes (24%) type b injuries and 24 athletes (41%) type c injuries. Of athletes with type c injuries, 18 (75%) did not complete their competition, a rate significantly higher than types a and b (OR 14.50, 95% CI 4.0 to 51.9, p<0.001).

CONCLUSION

For athletes sustaining muscle injuries during the Olympic Games, our study demonstrates the prognostic relevance of muscle injury anatomical site and severity for predicting completion or non-completion of an Olympic athlete's competition.

Ankle Sprain in Young Athletes: A 2-Year Retrospective Study at a Multisport Club

Objective  The present study aimed to analyze ankle sprains in young athletes of basketball, futsal, artistic gymnastics, trampoline, tennis, judo, and volleyball over 2 seasons. Methods  Data of 529 athletes in the 1 ^st year and of 495 athletes in the 2 ^nd year of analysis were investigated from the injury record database of a sports club. The following data were considered: the demographic characteristics (age, body mass, height, and sex), the mechanism (contact or noncontact), the severity, the moment at which the injury occurred, and the recurrence. Also, the incidence rate, the injury risk of the first ankle sprain, and the incidence rate ratio between sports were calculated. Results  The athletes sustained 124 ankle sprains in the 2 years of analysis. The majority occurred during training (76.6%) and lead to absence from sports practice (75.8%). The injury recurrence was low: 2 athletes (1.6%) had a recurrence in the same year and 5 (4.0%) in the following year. The incidence rate (0.79 to 12.81 per 1,000 hours) and the injury risk (1.14 to 19.44%) varied among sports. Volleyball, basketball, and futsal presented the highest injury rate incidence. Tennis, gymnastics, and trampoline showed the lowest injury rate incidence. Judo showed an incidence rate different from those of basketball and volleyball in the 1 ^st year and similar to those of other sports in the 2 ^nd year. Conclusion  Ankle sprain greatly impacted sports practice and presented characteristics that differ among the investigated sports. These findings may contribute to developing preventive injury programs.

Calf Strain in Athletes

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Calf strain is a common condition. In high-performance athletes, calf strain contributes to a substantial absence from competition.

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Player age and history of a calf strain or other leg injury are the strongest risk factors for calf strain injury and reinjury.

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Although the diagnosis is often clinical, magnetic resonance imaging and ultrasound are valuable to confirm the location of the strain and the grade of injury.

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Nonoperative treatment is effective for most calf strain injuries. Operative management, although rarely indicated, may be appropriate for severe cases with grade-III rupture or complications.

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Further investigation is necessary to elucidate the benefits of blood flow restriction therapy, deep water running, lower-body positive pressure therapy, platelet-rich plasma, and stem cell therapy for calf strain rehabilitation.

Epidemiology of Musculoskeletal Injuries in Adult Athletes: A Scoping Review

Background and Objectives: Sport-related musculoskeletal injuries (MSK-Is) are a common health issue in athletes that can lead to reduced performance. The aim of this scoping review was to synthetize available evidence on injury incidence rates (IIRs), types, and sites that affect the musculoskeletal (MSK) system of adult athletes. Materials and Methods: We performed a scoping review on the Pubmed database limiting our search to 33 Olympic sports. Results: We identified a total of 1022 papers, and of these 162 were examined in full for the purpose of this review. Archery was the sport with the highest risk of injuries to the upper extremities, marathons for the lower extremities, and triathlon and weightlifting for the body bust. In the majority of the sports examined, muscle/tendon strain and ligament sprain were the most common MSK-Is diagnoses, while athletics, karate, and football were the sports with the highest IIRs, depending on the methods used for their calculations. Conclusions: Our scoping review highlighted the general lack and dishomogeneity in the collection of data on MSK-Is in athletes.

Scapular Dyskinesis Is Not an Isolated Risk Factor for Shoulder Injury in Athletes: A Systematic Review and Meta-analysis

BACKGROUND

Scapular dyskinesis has been considered a risk factor for athletic shoulder injury; however, findings in the prospective literature have demonstrated mixed results.

PURPOSE

To determine if scapular dyskinesis increases the risk of shoulder injury in athletes.

STUDY DESIGN

Meta-analysis.

METHODS

A systematic search was conducted on the MEDLINE, CINAHL Plus, SPORTDiscus, and Embase databases to identify prospective studies examining scapular dyskinesis and shoulder injury risk in athletes. Studies were included if they assessed participants using a dynamic scapular assessment at baseline and monitored for the development of shoulder injury. Data from the studies were subject to meta-analysis using the Mantel-Haenszel method to produce a pooled risk ratio.

RESULTS

Seven studies were eligible for inclusion, resulting in 212 shoulder injuries observed across 923 athletes. Scapular dyskinesis was present in 46% of participants, and these athletes had an injury rate of 25%. The presence of scapular dyskinesis displayed a trend to increase the risk of shoulder injury, but this was not statistically significant (risk ratio, 1.07; 95% CI, 0.85-1.34; P = .59).

CONCLUSION

Scapular dyskinesis was not significantly associated with the development of shoulder injury in athletes.

REGISTRATION

CRD42019133089 (PROSPERO).

Common and Less Well-known Upper-limb Injuries in Elite Tennis Players

A recent increase in epidemiology studies on injuries in elite tennis players has helped to shed light on the types of injuries these athletes sustain. This article reviews the common upper-limb injuries in elite players and includes less well known, but important, injuries. A search was conducted to identify current relevant studies involving elite tennis players. Injury frequency rates, injuries by regions, and types of injuries together with a list of commonly reported injuries in the upper limb were established. This list was then reviewed and refined by a sports medicine physician who cares for elite tennis players to include both those injuries of the upper limb that are common and those that are less well known but still important and frequently encountered. Common injuries include internal shoulder impingement, rotator cuff pathology, labral tears, elbow tendinopathies, as well as extensor carpi ulnaris tendinopathies and subluxation. Posterior shoulder instability, distal humeral bone stress, elbow medial collateral ligament, and nondominant wrist ulnar collateral ligament injuries are not commonly reported injuries, but they are of significant clinical importance.

Acute Tennis Injuries in the Recreational Tennis Player

Background:

Epidemiological studies on tennis injuries are mainly conducted in either elite professional or junior players. Injury patterns might differ in the recreational tennis player.

Purpose:

To investigate acute injuries in the recreational tennis–playing population with an additional focus on acute injuries that require surgical treatment.

Study Design:

Case series; Level of evidence, 4.

Methods:

A retrospective data analysis was conducted among patients who sustained an acute tennis injury between January 2013 and December 2018 and who had treatment administered at a single university hospital. Demographic data, diagnosis, body region of the trauma, injury mechanism, and treatment methods were recorded. Data were evaluated using descriptive statistics.

Results:

A total of 449 patients sustained 467 injuries (148 female, 301 male; mean age, 43.6 years; range, 8.2-84.4 years). The injuries occurred throughout the year, with an increased prevalence in the summer months. Injuries occurred in the lower extremity in 59%, the upper extremity in 30%, and the head and trunk in 11%. The main reason for an injury was a twist of a specific joint (n = 194) or a fall (n = 102). Harmless contusion or strains were the most common injury (49%). Ankle sprains were the most common serious injury, occurring in 11% of patients. Fractures occurred in 54 cases (12%). Overall, 9% of patients were treated surgically (fractures, n = 13; meniscal tears, n = 8; Achilles tendon ruptures, n = 6), and surgery was advised to another 1% who did not receive surgery at the study hospital.

Conclusion:

Typical acute injuries in recreational tennis players differ from acute injuries in elite and junior players, with an increased fracture occurrence. The main causes of acute tennis injuries are falls and twists, with 10% of injuries needing surgical treatment, mainly for fractures, meniscal tears, and Achilles tendon ruptures.

Age and sex-related upper body performance differences in competitive young tennis players

Objective

The aims of this study were to analyze the shoulder functional profile of young male and female tennis players and to establish the relationship among physical variables and serve speed.

Methods

A total of 128 Spanish tennis players (Under-13 (n = 32/32 males/females) and Under-15 (n = 36/28 males/females), were tested during National training camps. Tests included passive shoulder range of motion (ROM) for both internal (IR) and external rotation (ER) and isometric strength (i.e., IR and ER) of the dominant/non-dominant shoulders, medicine ball throws (MBT), and serve speed. Age and sex pairwise comparisons were carried using the Hedges’ g index (d_g).

Results

Results showed age and sex effects on serve speed and all MBT, with males showing greater changes (1.51≤d_g≤1.98) with age than females (0.92≤d_g≤1.35; p<0.05). U15 males showed higher (p<0.05) absolute shoulder IR and ER strength than U13, with only significant differences between males and females in the U15. Regarding ROM, U15 males showed a decreased IR ROM compared to U13 (d_g = -0.84; p<0.05) and higher significant IR bilateral deficit (d_g = 0.51; p<0.05). The distances obtained in the different MBT were the variables more correlated to serve speed.

Conclusion

The present results suggest that shoulder strength, medicine ball throws and serve speed increased along with age in young elite tennis players of both sexes. However, a decreased range of motion and bilateral deficit for glenohumeral internal rotation is evident in male under-15 tennis players. Muscle strength, power and shoulder range of motion are key factors for serve speed in young tennis players.

Acute effects of a single tennis match on passive shoulder rotation range of motion, isometric strength and serve speed in professional tennis players

Shoulder pain has been associated with glenohumeral internal rotation deficit (GIRD) and a reduction in external rotation (ER) strength; however, in tennis players, there is scarce evidence regarding the impact of a single match on shoulder range of motion (ROM), strength and serve speed. The aim of this study was to determine the acute effect of a single tennis match on shoulder rotation ROM, isometric strength and serve speed. Twenty-six professional tennis players participated in the study (20.4±4.4 years; 10.5±3.2 years tennis expertise; 20.5±5.4 h/week training). Passive shoulder external (ER-ROM) and internal rotation ROM (IR-ROM), ER and IR isometric strength were measured before and after a single tennis match (80.3±21.3 min) in both shoulder´s. Moreover, the total arc of motion (TAM) and ER/IR strength ratio were calculated. Video analysis was used to assess the number of serves and groundstrokes, while a radar gun was utilized to measure maximal ball speed. In the dominant shoulder, compared to pre-match levels, IR-ROM was significantly reduced (-1.3%; p = 0.042), while ER-ROM (5.3%; p = 0.037) and TAM (3.1%; p = 0.050) were significantly increased. In the non-dominant shoulder, ER-ROM (3.7%; p = 0.006) was increased. Furthermore, in the dominant shoulder, the isometric ER strength was significantly reduced after the match (-4.8%; p = 0.012), whereas serve speed was not significantly reduced after match (-1.16%; p = 0.197). A single tennis match leads to significant reductions in shoulder ROM (e.g., IR of the dominant shoulder) and isometric strength (e.g., ER of the dominant shoulder). This study reveals the importance of recovery strategies prescription aiming at minimize post-match alteration in the shoulders.

A systematic review of shoulder injury prevalence, proportion, rate, type, onset, severity, mechanism and risk factors in female artistic gymnasts

OBJECTIVES

Systematically review shoulder injury prevalence, proportion, rate, type, onset, severity, mechanism, risk factors in female artistic gymnasts.

METHODS

PubMed, Web of Science, Scopus, Cochrane Library were searched on 7/01/2017. Original studies reporting data for female artistic gymnasts only, of any age or level were included. Quality assessment was undertaken using Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.

RESULTS

Fifteen observational studies were included. Thirteen were poor/fair quality. Shoulder injury prevalence (0%-86.9%) was higher in international (29.2%) versus national (20%) gymnasts. As a proportion of all injuries, shoulder injuries made up 4.2%-7.5%. Rates (0.35-5.7/1000 athlete exposures) were greater during practice (5.0/1000) than competition (2.4/1000). Multidirectional instability (33.8%, 37.7%) and musculotendinous injury (26.6%-90.9%) were the most common injury. In four studies 66.2%-100% of total shoulder injuries were acute onset. Most (59.3%) shoulder injuries were minor, 7.4% required surgery and 80% caused symptoms post-retirement. Asymmetric bars were the most frequent mechanism of shoulder injury. One study reported excessive shoulder stretching, hyperlaxity and instability as significant (p < 0.001) potential risk factors.

CONCLUSIONS

Shoulder injuries are a problem among female artistic gymnasts. Interventional studies reporting age and competition level-specific data may guide prevention strategy implementation.