Energy flow analysis during the tennis serve: comparison between injured and noninjured tennis players

Impact loading exercise induced osteogenesis from childhood to early adulthood in tennis players aged 8-30 years

Osteogenesis with impact-loading exercise is often assessed by the extra bone growth induced in the loaded arm of tennis players. We used PRISMA to explore % bone mineral content (BMC) and area (BA) asymmetry in players 8-30 years according to weekly training hours, age, sex, maturity, and bone segment. Proper statistics for 70 groups were extracted by two reviewers from 18 eligible studies of low risk of bias (< 35, STROBE) and good quality (> 70%). The quality of the review was high (AMSTAR, 81%). Using "random effects" we tested moderation-specific meta-comparisons and meta-regressions. The loaded bones % hypertrophy was higher in BMC (19%) than BA (10%), and, with BMC and BA merged, in boys (17%) than girls (13%), in humerus (19%) than radius-ulna (14%), and in pubertal (19%) players. Weekly training hours were more important (43%) than sex (17%), puberty (14%) and bone (15%) in BMC, and puberty (48%) was more important than weekly training hours (19%), sex (12%), and radius-ulna (5%) in BA. The loaded bones % hypertrophy correlated with weekly training hours highly (> 0.60) in all maturity groups for BMC and BA, and moderately (0.41) in early adults for BA; it also correlated with age (≥ 0.60) in children and peripubertal players, but not (0.037) with starting age. Impact loading exercise favors mineralization twice than bone expansion, while puberty favors bone expansion about three times more than mineralization. The bone gains are higher for boys than girls, and for peripubertal than older players. The bone growth implications are discussed considering limitations and future research.

The effects of strength and conditioning interventions on serve speed in tennis players: a systematic review and meta-analysis

Background

Tennis performance is highly influenced by serve speed. This review aimed to evaluate and quantitatively compare the efficacy of popular strength and conditioning (S&C) training methods in enhancing the speed of the ball in the serves of tennis players.

Methods

Following PRISMA guidelines, a systematic search was conducted in the Scopus, Web of Science, SportsDiscuss, and PubMed databases without date constraints, up to July 2024. Studies included in this meta-analysis met PICOS criteria: a) randomized controlled trials with healthy tennis players, b) isolated or combined S&C training programs, c) evaluation of tennis serve speed, and d) adequate data to compute effect sizes (ESs). The PEDro scale was used to assess methodological quality.

Results

Out of 271 identified papers, 16 studies of moderate to high quality were included in the meta-analysis. Resistance training demonstrated a small but significant effect on serve speed (ES = 0.53; p < 0.001), while multimodal training exhibited a moderate and significant effect (ES = 0.79; p = 0.001). However, core training did not have a significant effect on serve speed (ES = 0.32, p = 0.231).

Conclusion

The findings suggested that S&C interventions, including resistance and multimodal training, were beneficial for increasing serve speed in tennis players. Further high-quality research is recommended to confirm this conclusion.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/display_ record.php?RecordID=519790, identifier CRD42024519790.

Uncovering the hidden mechanics of upper body rotations in tennis serves using wearable sensors on Dutch professional players

Background

It is assumed that the tennis serve is performed according to the kinetic chain principle in which a proximal-to-distal sequence in peak angular velocities of subsequent body segments can be observed to reach high end point ball velocities. The aim of the present study was to investigate if the magnitude and (intersegmental) timing of peak angular velocities of body segments in professional tennis players are different between first and second serves and if they are associated with serve performance.

Methods

Eight (two female and six male) professional tennis players performed each 48 tennis serves on a tennis court. Serve performances: Ball speed and accuracy were measured with a PlaySight system. Kinematics were assessed with a custom made high-end inertial measurement units (IMUs) system, sampled at 1,000 Hz. Magnitudes of, as well as the intersegmental timing between, three dimensional peak angular velocities of the pelvis, trunk, and dominant upper arm were analysed in relation to ball speed and accuracy with generalized estimating equations.

Results

Peak angular velocities of the pelvis, trunk and upper arm were significantly higher in the first compared to the second serve. The intersegmental timing did not show significant differences. Also, the intersegmental timing was not associated with the ball speed. Ball speed was significantly positively associated with peak angular velocities of the trunk and upper arm on both the first and second serve. Accuracy was positively associated with the peak trunk angular velocity and intersegmental timing between the pelvis and trunk in the first serve. Accuracy was negatively associated with peak trunk angular velocity in the second serve.

Conclusion

The arm movement is important to produce high ball speed during a tennis serve. Additionally, the trunk, proximal to the upper arm in the kinetic chain, showed associations with ball speed. In contrast to the upper arm also with accuracy. Interestingly, professional players do not strictly follow a proximal-to-distal sequence. Intersegmental timing appears to be less important in the tennis serve compared to the segmental angular velocities, which were higher in the first compared to the second serve. Future research should investigate the uncovered role of the trunk in relation to tennis serve performance.

Whole-body energy transfer strategies during football instep kicking: implications for training practices

Knowledge of whole-body energy transfer strategies during football instep kicking can help inform empirically grounded training practices. The aim of this study was thus to investigate energy transfer strategies of 15 semi-professional players performing kicks for speed and accuracy. Three-dimensional kinematics and GRFs (both 1000 Hz) were incorporated into segment power analyses to derive energy transfers between the support leg, torso, pelvis and kick leg throughout the kick. Energy transferred from support leg (r = 0.62, P = 0.013) and torso (r = 0.54, P = 0.016) into the pelvis during tension arc formation and leg cocking was redistributed to the kick leg during the downswing (r = 0.76, P < 0.001) and were associated with faster foot velocities at ball contact. This highlights whole-body function during instep kicking. Of particular importance were: (a) regulating support leg energy absorption, (b) eccentric formation and concentric release of a 'tension arc' between the torso and kicking hip, and (c) coordinated proximal to distal sequencing of the kick leg. Resistance exercises that replicate the demands of these interactions may help develop more powerful kicking motions and varying task and/or environmental constraints might facilitate development of adaptable energy transfer strategies.

Research on the difference of stroke characteristics and stroke effect between different stroke duration of table tennis players

This study aimed to explore the differences in joint kinematic characteristics and stroke effect between fast and slow strokes of table tennis players. Thirty-four table tennis players were randomly selected as participants for this experiment. A high-speed infrared motion capture system was used to collect kinematic data of the right-side upper and lower limb joints during strokes. Simultaneously, a high-speed camera was used to measure the stroke effect. According to the duration of a stroke, the stroke data were classified into two types: fast-stroke and slow-stroke using a two-step clustering algorithm. The duration of the three phases of fast-stroke was shorter, with faster ball speed and stronger spin. Compared with slow-stroke, fast-stroke exhibited shorter displacements in the three lower limb joints and faster linear velocities in the three upper limb joints. In addition, the motion angles of the knee and ankle joints were smaller, while the angles of the hip, shoulder, and elbow joints were larger, with higher angular velocities. Increasing the extension speed of the lower limbs, the flexion speed of the elbow joints, and the wrist movement speed can achieve fast strokes, enhancing ball speed and spin. Small and quick hip joint movement can effectively transfer energy to the upper limbs, increasing the movement speed of the elbow and wrist joints, thus improving the ball speed and spin of the stroke.

How the acceleration phase influences energy flow and the resulting joint moments of the throwing shoulder in the deceleration phase of the javelin throw

Introduction

The throwing motion in the javelin throw applies high loads to the musculoskeletal system of the shoulder, both in the acceleration and deceleration phases. While the loads occurring during the acceleration phase and their relationship to kinematics and energy flow have been relatively well investigated, there is a lack of studies focusing the deceleration phase. Therefore, the aim of this study is to investigate how the throwing arm is brought to rest, which resultant joint torques are placed on the shoulder and how they are influenced by the kinematics of the acceleration phase.

Methods

The throwing movement of 10 javelin throwers were recorded using a 12-infrared camera system recording at 300 Hz and 16 markers placed on the body. Joint kinematics, kinetics and energy flow were calculated between the touchdown of the rear leg and the timepoint of maximum internal rotation after release +0.1 s. Elastic net regularization regression was used to predict the joint loads in the deceleration phase using the kinematics and energy flow of the acceleration phase.

Results

The results show that a significant amount of energy is transferred back to the proximal segments, while a smaller amount of energy is absorbed. Furthermore, relationships between the kinematics and the energy flow in the acceleration phase and the loads placed on the shoulder joint in the deceleration phase, based on the elastic net regularized regression, could be established.

Discussion

The results indicate that the loads of the deceleration phase placed on the shoulder can be influenced by the kinematics of the acceleration phase. For example, an additional upper body forward tilt can help to increase the braking distance of the arm and thus contribute to a reduced joint load. Furthermore, the energy flow of the acceleration phase can be linked to joint stress. However, as previously demonstrated the generation of mechanical energy at the shoulder seems to have a negative effect on shoulder loading while the transfer can help optimize the stress. The results therefore show initial potential for optimizing movement, to reduce strain and improve injury prevention in the deceleration phase.

Mechanical energy flow in torso during baseball toss batting

The purpose of this study was to clarify the relationship between the efficiency of mechanical energy flow in the torso and bat head speed at impact. Ninety-eight amateur baseball players batted a light ball tossed from the pitcher direction 3.2 m away. The batting motion and ground reaction forces acting on each foot were recorded using a motion capture system and two force plates, respectively. The mechanical powers of the joint forces and joint torques were calculated to measure the generation, absorption, and transfer of mechanical energy in the torso. The transfer efficiency of mechanical energy in the torso was defined as the ratio of the mechanical energy inflow into the thorax from the torso joint to the mechanical energy outflow from the pelvis to the torso joint. The correlation coefficient between the bat head speed and transfer efficiency of mechanical energy in the torso was very low. Conversely, the mechanical energy flow in the torso was significantly correlated to the bat head speed. Therefore, the results suggest that the torso in baseball batting is not utilised for the generation of mechanical energy but acts as a pathway for the transfer of mechanical energy.

Relationships Between Force-Time Curve Variables and Tennis Serve Performance in Competitive Tennis Players

ABSTRACT

Fourel, L, Touzard, P, Fadier, M, Arles, L, Deghaies, K, Ozan, S, and Martin, C. Relationships between force-time curve variables and tennis serve performance in competitive tennis players. J Strength Cond Res 38(9): 1667-1674, 2024-Practitioners consider the role of the legs in the game of tennis as fundamental to achieve high performance. But, the exact link between leg actions and high-speed and accurate serves still lacks understanding. Here, we investigate the correlation between force-time curve variables during serve leg drive and serve performance indicators. Thirty-six competitive players performed fast serves, on 2 force plates, to measure ground reaction forces (GRF). Correlation coefficients describe the relationships between maximal racket head velocity, impact height, and force-time curve variables. Among all the variables tested, the elapsed time between the instants of maximal vertical and maximal anteroposterior GRF ( r = -0.519, p < 0.001) and the elapsed time between the instant of maximal anteroposterior GRF and ball impact ( r = -0.522, p < 0.001) are the best predictors of maximal racket velocity. Maximal racket head velocity did not significantly correlate with the mean or maximal vertical GRF or with the mean or maximum rate of vertical force development. The best predictor for impact height is the relative net vertical impulse during the concentric phase ( r = 0.772, p < 0.001). This work contributes to a better understanding of the mechanical demands of tennis serve motion and gives guidelines to improve players preparation and performance. Trainers should encourage their players to better synchronize their upward and forward pushing action during the serve to increase maximal racket head velocity. Players should also aim to improve their relative net vertical impulse to increase impact height through strength training and technical instructions.

The reliability, variability and minimal detectable change of multiplanar isometric trunk strength testing using a fixed digital dynamometer

Trunk strength plays a vital role in athletic performance, rehabilitation and general health, however, current assessment methods are expensive, non-portable or unreliable. This study aimed to investigate the within- and between-session reliability, variability, standard error of measurement and minimal detectable change (MDC) of trunk strength in the sagittal (flexion and extension) and frontal planes (left and right lateral flexion) using a fixed digital dynamometer. Eighteen participants (ten men and eight women) attended two sessions separated by 7 days. Participants were fitted with a trunk harness which was secured to an immovable base via a digital dynamometer. Three maximal voluntary isometric contractions were completed across four positions (prone, supine, left-side recumbent and right-side recumbent, respectively) on a glute-hamstring raise machine. All positions demonstrated excellent reliability and low variability within session (ICC: 0.95-0.98; CV: 5-7%) and between sessions (ICC: 0.98-0.99; CV: 4-6%), across all positions. The between-session MDC ranged from 8% (prone) to 13% (right-side recumbent), translating to absolute values between 2.9 and 3.2 kg across all positions. Maximal isometric force testing using a fixed digital dynamometer provides reliable measurements of multiplanar trunk strength, providing a practical method for use in clinical practice.

Current concepts: pathology in the overhead athlete's lateral elbow

The lateral elbow is subjected to increasing compressive force in response to repetitive valgus stress. Alterations or deficiencies in overhead mechanics and the kinetic chain may predispose an athlete to injury. Evaluation includes a focused elbow physical examination and imaging, supplemented by a robust screening of core strength, balance, and mechanics of the kinetic chain. Treatment of osteochondritis dissecans, a common lateral elbow pathology, varies based on stability of the lesion, with variable, but often positive outcomes. Proper pitching mechanics, kinetic chain integrity, and workload management provide potential opportunities for prevention.

Biophysical characterization of the tennis serve: A systematic scoping review with evidence gap map

OBJECTIVES

We aimed to assess the available evidence on the biophysics of the tennis serve, mapping the populations, interventions, contexts and other relevant information to highlight what is already known and to identify gaps in the literature.

DESIGN

Systematic scoping review with evidence gap map.

METHODS

The protocol was designed according to PRISMA 2020, Prisma-ScR guidelines and the Cochrane Handbook. The searches were conducted on July 20, 2022 and updated on April 1, 2023, in PubMed, Scopus and Web of Science (core collection). The risk of bias assessment was performed using the Cochranes method for nonrandomized studies (RoBANS) and a narrative synthesis of the main findings was performed and supplemented with an evidence gap map.

RESULTS

Most trials were found on serve kinematics and kinetics (95 %), analyzing only flat serves (84 and 72 %, respectively). Few trials focused on physiology (20 %; e.g. biomarkers), under-19, left or both-handed, female and intermediate beginner or starter players (29, 17, 8 and 7 %, respectively). We found a preponderance of low and unclear risk of bias (63 and 31 %, respectively) and only 7 % high, particularly, on the assessment of confounding variables.

CONCLUSIONS

The current scoping review reveals a few trials on physiological rather than biomechanical variables, as well as the absence of the kick and slice serve, foot-back and foot-up serve, and left-handed, female, and young player analyses. We did not find systematic mistakes or limitations in the design, conduct, or analysis that would distort the results, since only 7 % presented a high risk of bias.

Is isokinetic shoulder strength a determinant of serve ball velocity in tennis?

The tennis serve is closely related to the quality of the tennis match. However, the isokinetic parameters associated with the tennis serve are still unclear. The aim of this study was to investigate the relationships between ball velocity and isokinetic shoulder strength in tennis serve and to determine isokinetic strength parameters that can predict tennis serve velocity. A total of 13 elite male athletes (16.8 ± 1.5 years) voluntarily participated in the study. The athletes' shoulder internal-external rotation, extension-flexion and abduction-adduction strengths were measured with 5-5-15 repetitions at 60°/s, 180°/s, 240°/s angular velocities. Later, the athletes' 1st, 2nd, and average serve ball speeds were determined using a handheld radar gun. Significant correlations were found between ball speed and isokinetic tennis serve strength (r = 0.556-0.819; p < 0.05). The correlations between ball speed and isokinetic strength performance were higher at 180°/s and 240°/s angular velocities. Extension (240°/s; r = 0.819), flexion (180°/s; r = 0.755), abduction (240°/s; r = 0.733), adduction (240°/s; r = 0.684) and internal rotation (180°/s; r = 0.803) were highly correlated with ball velocity. These findings suggest that strength training to increase the ball speed of the tennis serve should be performed fast at high angular velocities and planning should focus on the strength of extension, flexion, abduction, adduction and internal rotation.

Role of kinetic chain in sports performance and injury risk: a narrative review

The kinetic chain refers to the body's intricate coordination of various segments to perform a specific activity involving precise positioning, timing, and speed. This process is based on task-oriented and activity-specific pre-programmed muscle activation patterns enhanced by repeated practice. It demands muscular eccentric strength, joint flexibility, and musculotendinous elastic energy storage. The body core (lumbopelvic-hip complex) forms the kinetic chains' central point of activities in most sports because it facilitates load transfers to and from the limbs. The kinetic chain relationship with fascia, peripheral nerves, and tensegrity is fundamental to holistic human body movements. The kinetic chain function demands neuromuscular, sensorimotor, and neurocognitive control. Any blockage or defect in the kinetic chain can develop compensatory patterns, high demands on distal parts, and overuse and overload injuries. Taking a holistic approach and evaluating the integrity of the kinetic chain in athletes can significantly enhance efforts to improve sports performance and mitigate injury risk.

The expert eye? An inter-rater comparison of elite tennis serve kinematics and performance

This study examined the reliability of expert tennis coaches/biomechanists to qualitatively assess selected features of the serve with the aid of two-dimensional (2D) video replays. Two expert high-performance coaches rated the serves of 150 male and 150 female players across three different age groups from two different camera viewing angles. Serve performance was rated across 13 variables that represented commonly investigated and coached (serve) mechanics using a 1-7 Likert rating scale. A total of 7800 ratings were performed. The reliability of the experts' ratings was assessed using a Krippendorffs alpha. Strong agreement was shown across all age groups and genders when the experts rated the overall serve score (0.727-0.924), power or speed of the serve (0.720-0.907), rhythm (0.744-0.944), quality of the trunk action (0.775-1.000), leg drive (0.731-0.959) and the likelihood of back injury (0.703-0.934). They encountered greater difficulty in consistently rating shoulder internal rotation speed (0.688-0.717). In high-performance settings, the desire for highly precise measurement and large data sets powered by new technologies, is commonplace but this study revealed that tennis experts, through the use of 2D video, can reliably rate important mechanical features of the game's most important shot, the serve.

Energy flow in men's javelin throw and its relationship to joint load and performance

Background

Performance in javelin throwing is dependent on the release speed and therefore the energy transferred to the javelin. Little is known about the flow of mechanical energy in javelin throwing and whether there is a connection to joint loading and throwing performance. The purpose of the study was therefore to investigate (1) the energy flow within the kinetic chain of the throwing arm, (2) how it is related to performance and joint loads and (3) how joint forces and torques are used to transfer, generate and absorb mechanical energy.

Methods

The kinematics of 10 experienced javelin throwers were recorded using a 12-camera infrared system. 16 markers were placed on the athlete's body, five on the javelin to track the movement of each segment. A segmental power analysis was carried out to calculate energy flow between upper body, upper arm, forearm and hand. Stepwise regression analysis was used to calculate the variable that best predicts release speed and joint loads.

Results

The results indicate that the higher the peak rate of energy transfer from the thorax to the humerus, the higher the release speed and the joint loads. While there were no differences between the peak rate of energy transfer in the different joints, the energy transferred differed depending on whether joint forces or torques were used. It can be further shown that higher joint torques and thus higher rotational kinetics at the shoulder are linked to higher release speeds. Thus, the movements of the upper body can be of great influence on the result in javelin throwing. Furthermore, the data show that athletes who are able to transfer more energy through the shoulder, rather than generate it, experience a smaller joint loading. An effective technique for improved energy transfer can thus help perform at the same level while lowering joint stress or have higher performance at the same joint loading.

Kinetic chain revisited: consensus expert opinion on terminology, clinical reasoning, examination, and treatment in people with shoulder pain

BACKGROUND

The purpose of this study was to reach consensus on the most appropriate terminology and issues related to clinical reasoning, examination, and treatment of the kinetic chain (KC) in people with shoulder pain among an international panel of experts.

METHODS

A 3-round Delphi study that involved an international panel of experts with extensive clinical, teaching, and research experience in the study topic was conducted. A search equation of terms related to the KC in Web of Science and a manual search were used to find the experts. Participants were asked to rate items across 5 different domains (terminology, clinical reasoning, subjective examination, physical examination, and treatment) using a 5-point Likert-type scale. An Aiken coefficient of validity (V) ≥0.7 was considered indicative of group consensus.

RESULTS

The participation rate was 30.2% (n = 16), whereas the retention rate was high throughout the 3 rounds (100%, 93.8%, and 100%). A total of 15 experts from different fields and countries completed the study. After the 3 rounds, consensus was reached on 102 items: 3 items were included in the "terminology" domain; 17 items, in the "rationale and clinical reasoning" domain; 11 items, in the "subjective examination" domain; 44 items, in the "physical examination" domain; and 27 items, in the "treatment" domain. Terminology was the domain with the highest level of agreement, with 2 items achieving an Aiken V of 0.93, whereas the domains of physical examination and treatment of the KC were the 2 areas with less consensus. Together with the terminology items, 1 item from the treatment domain and 2 items from the rationale and clinical reasoning domain reached the highest level of agreement (V = 0.93 and V = 0.92, respectively).

CONCLUSION

This study defined a list of 102 items across 5 different domains (terminology, rationale and clinical reasoning, subjective examination, physical examination, and treatment) regarding the KC in people with shoulder pain. The term "KC" was preferred and a agreement on a definition of this concept was reached. Dysfunction of a segment in the chain (ie, weak link) was agreed to result in altered performance or injury to distal segments. Experts considered it important to assess and treat the KC in particular in throwing or overhead athletes and agreed that no one-size-fits-all approach exists when implementing shoulder KC exercises within the rehabilitation process. Further research is now required to determine the validity of the identified items.

Conversion of Upper-Limb Inertial Measurement Unit Data to Joint Angles: A Systematic Review

Inertial measurement units (IMUs) have become the mainstay in human motion evaluation outside of the laboratory; however, quantification of 3-dimensional upper limb motion using IMUs remains challenging. The objective of this systematic review is twofold. Firstly, to evaluate computational methods used to convert IMU data to joint angles in the upper limb, including for the scapulothoracic, humerothoracic, glenohumeral, and elbow joints; and secondly, to quantify the accuracy of these approaches when compared to optoelectronic motion analysis. Fifty-two studies were included. Maximum joint motion measurement accuracy from IMUs was achieved using Euler angle decomposition and Kalman-based filters. This resulted in differences between IMU and optoelectronic motion analysis of 4° across all degrees of freedom of humerothoracic movement. Higher accuracy has been achieved at the elbow joint with functional joint axis calibration tasks and the use of kinematic constraints on gyroscope data, resulting in RMS errors between IMU and optoelectronic motion for flexion-extension as low as 2°. For the glenohumeral joint, 3D joint motion has been described with RMS errors of 6° and higher. In contrast, scapulothoracic joint motion tracking yielded RMS errors in excess of 10° in the protraction-retraction and anterior-posterior tilt direction. The findings of this study demonstrate high-quality 3D humerothoracic and elbow joint motion measurement capability using IMUs and underscore the challenges of skin motion artifacts in scapulothoracic and glenohumeral joint motion analysis. Future studies ought to implement functional joint axis calibrations, and IMU-based scapula locators to address skin motion artifacts at the scapula, and explore the use of artificial neural networks and data-driven approaches to directly convert IMU data to joint angles.

Association of trunk and lower limb factors with shoulder complaints and sport performance in overhead athletes: A systematic review including GRADE recommendations and meta-analysis

OBJECTIVE

To identify the association of trunk and lower limb factors with shoulder complaints and sport performance in overhead athletes.

METHODS

Search performed at PubMed/Medline, Embase, CINAHL, LILACS, Cochrane, Web of Science and SPORTDiscus for observational studies. Methodological quality and strength of the evidence was assessed with the Newcastle-Ottawa Scale and GRADE. Meta-analysis and effects sizes analysis were calculated when possible.

RESULTS

Sixty-five studies were included. Low to very-low evidence suggests no association of trunk/lower limb strength, endurance, power, jump or balance with shoulder complaints and/or throwing performance. Athletes with shoulder complaints performed worse in trunk stability and endurance tests (mean difference: -6.83 (95%CI: -8.78, -4.88)). Athletes with high throwing performance presented better results in CMJ, horizontal jump, power measures and knee extension strength. For swimmers, there was no association of trunk/lower limb endurance with shoulder complaints (moderate evidence) and no association of balance and swimming performance (low evidence). Better trunk/lower limb strength, power and vertical jumps measures were associated with better swimming performance.

CONCLUSIONS

In methodologically similar studies, some trunk/lower limb outcomes are associated with shoulder complaint or sport/swimming performance. Results should be considered with caution and future studies should use better methodologies.

There is no rush to upgrade the tennis racket in young intermediate competitive players: The effects of scaling racket on serve biomechanics and performance

Introduction

Scaling the equipment of young athletes is justified by the constraints-led approach introduced in motor learning. The aim of the present study is to analyze the effect of racket scaling on the serve biomechanics and performance parameters for young tennis players (between 8 and 11 years-old).

Methods

Nine young intermediate competitive tennis players (age: 9.9 ± 1.0 years) performed maximal effort flat serves with three different rackets (scaled 23 inches, scaled 25 inches and full-size 27 inches) in a randomized order. A radar measured ball speed while shoulder and elbow kinetics and upper and lower limb kinematics were calculated with a 20-camera optical motion capture system. Repeated measures ANOVAs were used to analyze the effect of the three rackets on ball speed, percentage of serve in, serve kinematics and kinetics.

Results

No significant differences in ball speed, maximal racket head velocity and percentage of serve in were observed between the three rackets. The lowest maximal upper limb kinetics and the highest upper limb maximal angular velocities were obtained with the scaled 23 inches racket.

Discussion

Using scaled rackets has the advantage to decrease shoulder and elbow loadings without reducing serve performance. Consequently, the present results incite tennis coaches and parents to not upgrade too soon the size of the racket in young intermediate tennis players to avoid overuse injury risks in the long term. Our results showed that the full-size 27 inches racket induced higher lower limb kinematics. As a consequence, occasionally serving with a fullsize racket can be a sparingly interesting intervention to help young tennis players to intuitively and immediately increase their leg drive action, allowing a more functional representation of the elite junior serve.

Effects of an 8-week multimodal program on thoracic posture, glenohumeral range of motion and serve performance in competitive young tennis players

Introduction

Intensive tennis practice is known to generate sport-specific adaptations at the shoulder region and influence the sagittal spinal curvature. However, increased thoracic kyphosis decreases the shoulder functional capacity, which could limit tennis performance. Therefore, the aim of this study was to investigate the effects of an 8-week multimodal program on thoracic posture, glenohumeral range of motion, and serve performance in competitive young tennis players.

Methods

Eighteen male and four female players (age: 16.0 ± 2.4 years, height: 170.7 ± 11.0 cm; mass: 62.1 ± 11.5 kg; International Tennis Number: 3-4) performed their regular training during 8 weeks, which was used as a reference period, and implemented a multimodal program including stretching, strengthening, and myofascial release exercises, four times per week during 8 additional weeks, which corresponded to the intervention period. The thoracic curvature angle and mobility, the biacromial and interscapular distances, the glenohumeral range of motion and the tennis serve performance were assessed three times, i.e., before and after the regular training and after the 8-week multimodal program.

Results

The results showed that the 8-week regular training had no significant effects on thoracic curvature angle [effect size (ES) = 0.02-0.36, p = 0.06-0.46] and mobility (ES = 0.05-0.26, p = 0.13-0.42), biacromial (ES = 0.05, p = 0.18) and interscapular distances (ES = 0.03, p = 0.45), ranges of motion in glenohumeral internal (ES = 0.04, p = 0.43) and external rotation (ES = 0.43, p = 0.06), and tennis serve accuracy (ES = 0.33, p = 0.07) and velocity (ES = 0.09, p = 0.35). The 8-week multimodal program increased moderately the thoracic mobility (ES = 0.55, p = 0.01), moderately to strongly the serve accuracy and velocity (ES = 0.65, p = 0.003, for both), strongly decreased the interscapular distance (ES = 1.02, p < 0.001), and strongly increased the range of motion in glenohumeral internal (ES = 0.90, p < 0.001) and external rotation (ES = 1.49, p < 0.001).

Discussion

These findings indicated that an 8-week multimodal program, including spine and glenohumeral mobility and shoulder girdle strength exercises, performed four times per week during 8 weeks, is moderately relevant to rectify the sagittal thoracic curvature in competitive tennis players, while such a program may help regain the range of motion in glenohumeral rotation without tennis serve performance impairment.

Fastball pitching performance only slightly decreases after mobility impediment of the pelvis and trunk-Do (catch-up) compensation strategies come into play?

Background

Baseball pitching performance can be mechanically explained by the summation of speed principle and the principle of optimal coordination of partial momenta. Impeding optimal energy generation or transfer by or between the pelvis and trunk segments could provide valuable insight into possible compensation or catch-up mechanisms that may manifest themselves based on these principles.

Aim

The aim of the present study was to explore the effects of experimentally impeding the mobility of and between the pelvis and trunk segments (1) on ball speed and mechanical peak joint power, and (2) on mechanical peak load of the elbow and shoulder joints at maximal external rotation (MER) during fastball pitching.

Methods

Eleven elite baseball pitchers (mean age 17.4, SD 2.2 years; mean pitching experience 8.9, SD 3.0 years) were instructed to throw at least 15 fastballs as fast and accurately as possible under two conditions. One condition involved impeding the mobility of the pelvis and trunk segments to hamper their ability to rotate independently, which consequently should affect the separation time, defined as the time interval between the pelvis and trunk peak angular velocities. In the other condition, pitchers threw unimpeded. Ball speed, mechanical peak joint power and peak net moment of the elbow and shoulder at MER were compared between conditions using Generalized Estimating Equations (GEE).

Results

In the impeded pitching condition, the mean difference of the separation time was 12.4 milliseconds [95% CI (4.0, 20.7)] and for ball speed 0.6 mph [95% CI (0.2, 0.9)] lower compared to the unimpeded condition. Only the peak pelvic angular velocity, in addition to the trunk, upper arm and forearm, was 45 deg/s [95% CI (24, 66)] higher impeded condition. The mean differences of the joint power and net moments at the shoulder and elbow did not reach statistical significance.

Conclusion

In elite adolescent baseball, the observed pitching performance after experimentally impeding pelvic and trunk mobility undermines a potential distal catch-up strategy based on the summation of speed principle. The increased peak pelvic angular velocity may indicate a compensation strategy following the optimal coordination of partial momenta principle to practically maintain pitching performance.

Energy flow through the lower extremities in high school baseball pitching

It is generally accepted that most of the energy transferred to the ball during a baseball pitch is generated in the trunk and lower extremities. Therefore, purpose of this study was to assess the energy flow through the lower extremities during a baseball pitch. It was hypothesised that the (stabilising) leading leg mainly transfers energy in a distal-to-proximal order as a kinetic chain while the (driving) trailing leg generates most energy, primarily at the hip. A joint power analysis was used to determine the rates of energy (power) transfer and generation in the ankles, knees, hips and lumbosacral joint (L5-S1) for 22 youth pitchers. Analyses showed that the leading leg mainly transfers energy upwards in a distal-to-proximal order just before stride foot contact. Furthermore, energy generation was higher in the trailing leg and primarily arose from the trailing hip. In conclusion, the legs contribute differently to the energy flow where the leading leg acts as an initial kinetic chain component and the trailing leg drives the pitch by generating energy. The actions of both legs are combined in the pelvis and passed on to the subsequent, more commonly discussed, open kinetic chain starting at L5-S1.

Pelvis and Trunk Energy Flow in Collegiate Softball Pitchers With and Without Upper Extremity Pain

BACKGROUND

The softball pitch is a full-body motion, where efficient proximal to distal energy flow through the kinetic chain is said to reduce stress at the upper extremity. Although altered trunk kinematic parameters are associated with upper extremity pain in softball pitchers, further research is needed to determine whether differences exist in proximal energy flow between softball pitchers with and without pain.

HYPOTHESIS/PURPOSE

To examine pelvis and trunk energy flow during the acceleration phase of the pitch in collegiate softball pitchers with and without upper extremity pain. It was hypothesized that those with upper extremity pain would have less energy flowing into the proximal ends of the pelvis and trunk as well as less energy flowing out of the distal ends of the pelvis and trunk during the acceleration phase when compared with pitchers who did not have upper extremity pain.

STUDY DESIGN

Descriptive laboratory study.

METHODS

A total of 54 female National Collegiate Athletic Association Division I softball pitchers (age, 20.2 ± 2.0 years; height, 173.5 ± 6.9 cm; weight, 78.5 ± 11.5 kg) were assigned to pain (n = 17) and pain-free (n = 38) groups. Participants pitched 3 maximal effort rise-balls for a strike, and the average of the 3 trials was used for analysis. Kinematic data were collected at 100 Hz using an electromagnetic tracking system. A segment power analysis was performed to quantify energy flow for the pelvis and trunk. The Mann-Whitney U test was used to compare pelvis and trunk energy flow during the acceleration phase of the pitch as well as pitch velocity between collegiate softball pitchers with and without upper extremity pain.

RESULTS

No significant differences were found between pelvis and trunk energy flow during the acceleration phase or pitch velocity between collegiate softball pitchers with and without upper extremity pain (all P values >.057).

CONCLUSION

Previous research determined that kinematic parameters differ between collegiate pitchers with and without upper extremity pain. However, the current study found no difference in pelvis and trunk energy flow or pitch velocity. Although altered kinematics in collegiate pitchers with upper extremity pain may serve as compensation patterns to maintain pitch velocity and proximal energy flow, future research is needed to confirm this postulation.

CLINICAL RELEVANCE

The lack of energy flow differences between upper extremity pain groups suggests that pitchers may adapt their biomechanics to maintain trunk and pelvis energy flow patterns. Coaches, athletes, and clinicians should know that movement adaptations can allow for maintained performance levels but may result in the presence of pain that may manifest in other deleterious and injury-susceptible biomechanics.

Grip position affects upper limb kinematic chain during tennis double-handed backhand topspin strokes: considerations for transitioning tennis grip position technique

The purpose of this study was to compare the upper limb kinematic chain of tennis players using either an eastern or continental non-dominant grip position during the forward swing of the double-handed backhand stroke. Sixteen right-handed tennis players performed backhands using two non-dominant grip positions (eastern and continental), aiming for two cross-court zones (deep and short). Trajectory data were captured using sixty reflective markers attached to the upper limb and racket using a 12-camera Vicon motion capture system (250 Hz). Peak angular velocity was significantly greater for multiple joint rotations at the dominant shoulder and entire non-dominant limb in the eastern grip. Subsequently, greater peak racket head angular velocity and post-impact ball speed were generated by the eastern grip, while shot accuracy was similar between grip types. There was delayed dominant shoulder peak adduction angular velocity for the continental grip, possibly due to a lack of skill familiarity causing changes in coordinative patterns. Collectively, the non-dominant grip position appears to influence proximal and distal upper limb movement. Future research should explore upper limb segment coordination comparing preferred and non-preferred double-handed backhand techniques and complete inter-disciplinary investigations to understand what grip positions are most effective for individuals to learn double-handed backhands.

Disabled Throwing Shoulder 2021 Update: Part 1-Anatomy and Mechanics

The purpose of this article is to provide updated information for sports health care specialists regarding the Disabled Throwing Shoulder (DTS). A panel of experts, recognized for their experience and expertise in this field, was assembled to address and provide updated information on several topics that have been identified as key areas in creating the DTS spectrum. Each panel member submitted a concise presentation on one of the topics within these areas, each of which were then edited and sent back to the group for their comments and consensus agreement in each area. Part 1 presents the following consensus conclusions and summary findings regarding anatomy and mechanics, including: 1) The current understanding of the DTS identifies internal impingement, resulting from a combination of causative factors, as the final common pathway for the great majority of the labral pathoanatomy; 2) intact labral anatomy is pivotal for glenohumeral stability, but its structure does not control or adapt well to shear or translational loads; 3) the biceps plays an active role in dynamic glenohumeral stability by potentiating "concavity compression" of the glenohumeral joint; 4) the ultimate function of the kinetic chain is to optimize the launch window, the precise biomechanical time, and position for ball release to most effectively allow the ball to be thrown with maximum speed and accuracy, and kinetic chain function is most efficient when stride length is optimized; 5) overhead throwing athletes demonstrate adaptive bony, capsular, and muscular changes in the shoulder with repetitive throwing, and precise measurement of shoulder range of motion in internal rotation, external rotation, and external rotation with forearm pronation is essential to identify harmful and/or progressive deficits. LEVEL OF EVIDENCE: Level V, expert opinion.

A Scoping Review on Shoulder Injuries of Wheelchair Tennis Players: Potential Risk-Factors and Musculoskeletal Adaptations

Wheelchair tennis players are prone to develop shoulder injuries, due to the combination of wheelchair propulsion, overhead activities and daily wheelchair activities. A methodical literature search was conducted to identify articles on shoulder complaints in wheelchair tennis, wheelchair sports and tennis. The aims were to identify (1) type of shoulder complaints; (2) possible risk factors for the development of shoulder injuries; (3) musculoskeletal adaptations in the shoulder joint in wheelchair tennis players. Fifteen papers were included in this review, five on wheelchair tennis, three on wheelchair sports and seven on tennis. Type of shoulder complaints were acromioclavicular pathology, osteoarthritic changes, joint effusion and rotator cuff tears. Possible risk factors for the development of shoulder injuries in wheelchair tennis are overhead movements, repetitive activation of the anterior muscle chain and internal rotators, as well as a higher spinal cord injury level. Muscular imbalance with higher values for the internal rotators, increase in external range of motion, decrease in internal range of motion and reduced total arc of motion were the most common proposed musculoskeletal adaptations due to an unbalanced load. These presented risk factors and musculoskeletal adaptations might help researchers, coaches and wheelchair tennis players to prevent shoulder injuries.

More Elevated Fastballs Associated With Placement on the Injured List due to Shoulder Injury

Purpose

To evaluate whether impending shoulder injury was associated with changes in pitch location or velocity immediately preceding injury.

Methods

Pitchers placed on the injured list (IL) due to a shoulder injury between 2015 and 2020 were identified in the Major League Baseball transactions database. Four-seam fastball velocity and frequency of pitch location for each pitch type was collected for each player in the season before placement on the IL and within 1 month of placement on the IL with a minimum of 55 pitches thrown of 1 type. Pitch locations were collected as identified by Baseball Savant’s Game-Day Zones. Game-Day Zones were consolidated into high (above the strike zone midpoint) versus low, arm side (closer to the pitcher’s arm side of the plate) versus opposite side, and within the strike zone versus out of zone. Repeated measures analysis of variance determined differences in four-seam velocity and the location distribution of 4-seam fastballs, change-ups, and breaking balls among each group.

Results

In total, 267 pitchers were placed on the IL for a shoulder injury with the majority diagnosed with inflammation (89/267) followed by strain or sprain (69/267). Four-seam fastball locations significantly increased above the mid-point of the zone (45.9% vs 42.4%, P = .008) and out of the strike zone (48.5% vs 46.5%, P = .011) within a month before IL placement. There was no significant change in 4-seam fastball velocity immediately before IL placement.

Conclusions

Pitchers threw more elevated 4-seam fastballs and out-of-zone 4-seam fastballs in the month before IL placement for shoulder injury. These findings suggest that a loss of 4-seam fastball command decreases with impending shoulder injury.

Level of Evidence

IV, prognostic case series.

Age and Gender Differences in Injuries and Risk Factors in Elite Junior and Professional Tennis Players

BACKGROUND

Elite tennis athletes experience injuries throughout the entire body. Impairments in trunk stability, lower limb flexibility, and hip range of motion (ROM) are modifiable risk factors that can impact injuries and performance. Information on nonmodifiable risk factors such as age and gender is limited. The purpose of this investigation was to provide information on risk factors to direct clinical decision-making and injury prevention and rehab programming in this population.

HYPOTHESIS

Prevalence and location of injuries will differ by age group and gender. Trunk stability, lower limb flexibility, and hip ROM will differ by age group and gender.

STUDY DESIGN

Cross-sectional study.

LEVEL OF EVIDENCE

Level 3.

METHODS

A de-identified database (n = 237; females = 126) from the United States Tennis Association High Performance Profile (HPP) 2014-2015 was used for the analysis. Subjects were elite junior and professional tennis players (mean age 14.6 [range, 9-27] years). The HPP is a tennis-specific assessment and questionnaire that includes retrospective information on injury history. Subjects were categorized by injury, gender, and age. Injury locations were classified by region. Trunk stability measures included drop vertical jump (DVJ), single-leg squat, and prone and side planks. Lower limb measures included hamstring, quadriceps and hip flexor flexibility, and hip rotation ROM.

RESULTS

A total of 46% of athletes reported an injury. Significant differences were found for injury prevalence and location by age group. Adolescent athletes (age 13-17 years) had more trunk injuries, while adult athletes (age ≥18 years) had more lower limb injuries. Adolescent athletes performed worse on DVJ, dominant side plank, and hamstring flexibility compared with young (age ≤12 years) and adult athletes. Significant gender differences in hip ROM included internal rotation on both the dominant and nondominant sides.

CONCLUSION

Impairments in trunk stability, lower limb flexibility, and hip rotation ROM may affect both health and performance outcomes in this population. Elite tennis athletes may benefit from additional off court programming to address trunk and lower limb impairments.

CLINICAL RELEVANCE

Adolescent elite tennis athletes may be at higher risk of trunk injuries. Age, gender, injury history, and impairments should be considered with all assessments and programming.

The Effects of Knee Flexion on Tennis Serve Performance of Intermediate Level Tennis Players

This study aimed to investigate the effects of knee flexion during the preparation phase of a serve on the tennis serve performance, using inertial sensors. Thirty-two junior tennis players were divided into two groups based on their maximum knee flexion during the preparation phase of serve: Smaller (SKF) and Greater (GKF) Knee Flexion. Their racket velocity, racket height, and knee extension velocity were compared during the tennis serve. Inertial sensors tracked participants’ shank, thigh, and racket motions while performing five first, flat, and valid serves. Knee flexion was analysed during the preparation phase of serve, knee extension velocity after this phase, racket velocity just before ball impact, and racket height at impact. Pre-impact racket velocity (mean difference [MD] = 3.33 km/h, p = 0.004) and the knee extension velocity (MD = 130.30 °/s, p = 0.012) were higher in the GKF than SKF; however, racket impact height was not different between groups (p = 0.236). This study’s findings support the importance of larger knee flexion during the preparation phase of serve-to-serve performance. This motion should be seen as a contributor to racket velocity.

Epidemiology of Injuries in National Collegiate Athletic Association Men's Tennis: 2014-2015 Through 2018-2019

CONTEXT

The National Collegiate Athletic Association (NCAA) has sponsored men's tennis programs since 1982. The popularity of tennis has grown, as has sponsorship of men's tennis within NCAA institutions.

BACKGROUND

Continued monitoring of athletic injuries is important for identifying emerging temporal patterns.

METHODS

Exposure and injury data collected in the NCAA Injury Surveillance Program during 2014-2015 through 2018-2019 were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differential injury rates.

RESULTS

The overall injury rate was 4.41 per 1000 athlete-exposures. Lateral ligament complex tears of the ankle (8.5%) were the most reported injury. Trunk (15.1%) and shoulder (13.2%) injuries accounted for the largest proportions of all injuries. Noncontact and overuse were the most common mechanisms of injury among all reported injuries, together accounting for 69.4% of all injuries.

CONCLUSIONS

Findings of this study differed slightly from previous studies, most notably in specific injuries reported. Continued monitoring of specific injury incidence as well as greater participation in injury surveillance is needed to inform the development of nuanced injury prevention strategies for this population.

Effect of Forearm Position on Glenohumeral External Rotation Measurements in Baseball Players

BACKGROUND

Alterations in glenohumeral internal rotation (GIR), glenohumeral external rotation (GER), and the total arc of motion (TAM) have been linked with increased injury risk in the shoulder and elbow. These motions have been routinely measured with the forearm in neutral rotation (GIRN, GERN, TAMN). GER capacity appears to be especially important. The throwing motion, however, requires forearm pronation as GER occurs to achieve optimal cocking (GERP). No previous studies have evaluated GERP to determine GER capacity or pronated TAM (TAMP) values.

HYPOTHESIS

There would be significant differences between GERN and TAMN and between GERP and TAMP.

STUDY DESIGN

Cross-sectional.

LEVEL OF EVIDENCE

Level 3.

METHODS

Sixty asymptomatic male Minor League Baseball players (32 pitchers, 28 position players) participated in the study and were tested on the first day of spring training. Passive range of motion measurements were recorded using a long-arm bubble goniometer for GIRN, GERN, and GERP on both arms. TAM was calculated separately as the sum of internal and external rotational measurements under neutral and pronated conditions.

RESULTS

Within pitchers and position players, all measurements were statistically reduced for the throwing arm (P ≤ 0.03) except for GERN of the pitchers. GERP measures were significantly less than GERN for both arms of each group (P < 0.01): pitchers throwing arm +11.8°/nonthrowing arm +4.8°, position players throwing arm = +8.6°/nonthrowing arm +4.0°.

CONCLUSION

The forearm position of pronation, which appears to be mediated by tightness of the biceps, decreases GER capacity and TAM. GER and TAM should be calculated in neutral and pronated positions, considering that 80% of the players have a demonstrated difference between 8° and 12°.

CLINICAL RELEVANCE

Measurement of GERP more accurately reflects the GER required in throwing, allows better quantification of the motion capacity necessary to withstand the loads in throwing, and may suggest interventions for at risk athletes.

Hip Range of Motion and Strength and Energy Flow During Windmill Softball Pitching

CONTEXT

Inadequate hip range of motion (ROM) and isometric strength (ISO) may interfere with energy flow through the kinetic chain and result in increased injury susceptibility.

OBJECTIVE

To examine the relationship of hip ROM and ISO with energy flow through the trunk and pitching-arm segments during the windmill softball pitch in youth athletes. A subsequent purpose was to examine the relationship between energy flow and pitch speed.

DESIGN

Descriptive laboratory study.

SETTING

University research laboratory.

PATIENTS OR OTHER PARTICIPANTS

A sample of 29 youth softball pitchers (age = 11.2 ± 1.3 years, height = 155.0 ± 10.4 cm, mass = 53.2 ± 12.6 kg).

MAIN OUTCOME MEASURE(S)

Bilateral hip internal-rotation and external-rotation (ER) ROM and ISO were measured. Net energy outflow and peak rates of energy outflow from the distal ends of the trunk, humerus, and forearm were calculated for the acceleration phase of the windmill softball pitch, and pitch speed was measured.

RESULTS

Regression analysis revealed an effect of drive-hip ER ISO on the net energy flow out of the distal ends of the trunk (P = .045) and humerus (P = .002). Specifically, increased drive-hip ER ISO was associated with increased net energy outflow from the trunk to the humerus and from the humerus to the forearm. No significant effects of hip ROM or other hip ISO measures were observed. Additionally, pitchers who achieved higher peak rates of distal outflow tended to achieve higher pitch speeds.

CONCLUSIONS

An association was present between drive-hip ER ISO and the net energy flow out of the distal ends of the trunk and humerus during the acceleration phase of the windmill softball pitch, emphasizing the importance of hip and lower body strength in executing the whole-body windmill pitch. Overall, energy-flow analysis is an interesting new way to analyze pitching mechanics and will aid in furthering our understanding of performance and injury risk in windmill softball pitching.

Rotator Cuff Injuries in Tennis Players

PURPOSE OF REVIEW

This review presents epidemiology, etiology, management, and surgical outcomes of rotator cuff injuries in tennis players.

RECENT FINDINGS

Rotator cuff injuries in tennis players are usually progressive overuse injuries ranging from partial-thickness articular- or bursal-sided tears to full-thickness tears. Most injuries are partial-thickness articular-sided tears, while full-thickness tears tend to occur in older-aged players. The serve is the most energy-demanding motion in the sport, and it accounts for 45 to 60% of all strokes performed in a tennis match, putting the shoulder at increased risk of overuse injury and rotator cuff tears. Studies have shown deficits in shoulder range of motion and scapular dyskinesia to occur even acutely after a tennis match. First-line treatment for rotator cuff injuries in any overhead athlete consists of conservative non-operative management with appropriate rest, anti-inflammatory drugs, followed by a specific rehabilitation program. Operative treatment is usually reserved for older-aged players and to those who fail to return to play after conservative measures. Surgical options include rotator cuff debridement with or without tendon repair, biceps tenodesis, and labral procedures. Unlike rotator cuff repairs in the general population, repairs in the elite tennis athlete have less than ideal rates of return to sport to the same level of performance. Rotator cuff injuries are a common cause of pain and dysfunction in tennis players and other overhead athletes. The etiology of rotator cuff tears in tennis players is multifactorial and usually results from microtrauma and internal impingement in the younger athlete leading to partial tearing and degenerative full-thickness tears in older players. Surgical treatment is pursued in athletes who are still symptomatic despite an extensive course of non-operative treatment as outcomes with regard to returning to sport to the same pre-injury level are modest at best. Debridement alone is usually preferred over rotator cuff repairs for partial tears in younger players due to potential over-constraining of the shoulder joint and decreased rates of return to sport after rotator cuff repairs.

Pattern of injuries amongst tennis players in Accra, Ghana

Background

Tennis is a popular global sport characterised by repeated, explosive motions and the involvement of several muscle groups during different strokes, which fluctuates randomly from brief periods of maximal or near maximal work to longer periods of moderate and low intensity activity.

Objectives

To determine the pattern of injuries amongst tennis players in Accra.

Method

A cross-sectional study was conducted, involving 142 male and female participants selected from tennis clubs in Accra and the Accra sports stadium. A standardised tennis injury report form was used to obtain data from participants. Data on the parts of the body mostly injured and the types of injury mostly sustained by the players were summarised and presented appropriately with the use of graphs and pie charts. Assessment of the causes underlying the prevailing injuries to tennis players was also tabulated and comparisons made.

Results

Out of a total of 170 injuries recorded, knee (39 [27.5%]) and shoulder (31 [21.1%]) injuries were the most commonly sustained. Most (80 [56.3%]) tennis injuries occurred during training. Other injuries (26 [18.3%]) occurred during competitions or tournaments whilst 26 (18.3%) occurred during social play. About 10 (7.0%) participants were not certain of the type of activity at the time of injury. The majority (35 [24.65%]) of the players received no treatment for their injuries. However, few of the injuries (20 [14.08%], 14 [9.86%], 6 [4.23%]) sustained were treated by medical personnel, physiotherapists or nurses respectively. There was no association between warm-up before play and cause of injury (p = 0.375). There was also no association between shoe type and cause of injury (p = 0.253).

Conclusion

The majority of the injuries occurred in the upper and lower limbs. Most of these injuries occurred during training with overuse and overexertion being the most common cause.

Clinical implications

It is important to educate tennis players and coaches on injury prevention measures and the use of protective gear during tennis.

Peak horizontal ground reaction forces and impulse correlate with segmental energy flow in youth baseball pitchers

The purpose of this study was to determine associations between horizontal ground reaction force (GRF) kinetics and energy flow (EF) variables in youth baseball players. Twenty-four youth baseball players pitched fastballs in an indoor laboratory while motion capture and force plate data were collected. Horizontal GRF variables were extracted (peak GRF and GRF impulse) while EF was calculated by integrating magnitudes of mechanical powers transferred into and out of the pelvis, trunk, and arm segments via joint force power (JFP) and joint moment power (JMP) components. Peak propulsive GRF of the drive (back) leg correlated with EF into proximal segments, whereas peak braking GRF of the stride (lead) leg correlated with EF into distal segments. Furthermore, peak GRF of the drive leg and GRF impulse of both legs correlated with the JFP components of EF into the pelvis and trunk segments. In contrast, peak GRF and GRF impulse of the stride leg both correlated with the JMP components of EF into the arm segment. These results suggest that horizontal GRF impulse from the drive and stride leg contribute to EF between major segments of the lower and upper extremity. In addition, these results also suggest that propulsion kinetics of the drive leg play a role in transferring linear power via the pelvis and trunk segments in the throwing direction of the pitch, whereas braking kinetics of the stride leg play a role in creating rotational power that is transferred between the trunk and arm segment via the shoulder joint.

Role of the kinetic chain in shoulder rehabilitation: does incorporating the trunk and lower limb into shoulder exercise regimes influence shoulder muscle recruitment patterns? Systematic review of electromyography studies

OBJECTIVE

To investigate the influence of trunk and lower limb motion on electromyography (EMG) muscle activity and recruitment patterns around the shoulder.

DESIGN

Systematic review.

DATA SOURCES

MEDLINE, CINAHL, PEDro, AMED, PubMed, Cochrane Central Register of Controlled trials, Cochrane Database of Systematic reviews, SportsDiscuss and PROSPERO.

ELIGIBILITY CRITERIA

Studies investigating both multiregional kinetic chain (KC) shoulder exercises and localised non-kinetic chain (nKC) shoulder exercises in healthy subjects under the same experimental conditions were included in this review.

RESULTS

KC exercises produced greater EMG activation levels in 5 of 11 studies for the lower trapezius. Of the remaining studies, five found no difference between the exercise types and one favoured nKC exercises. KC exercises produced greater EMG activation levels in 5 of 11 studies for the serratus anterior. Of the remaining studies, three reported the opposite and three found no significant difference between the exercise types. nKC exercises produced greater EMG activation in infraspinatus in three of four studies. KC exercises produced the lowest trapezius muscle ratios in all studies. Studies investigating the upper trapezius, middle trapezius, supraspinatus, subscapularis, biceps brachii, latifissimus dorsi, pectoralis major, deltoid, and trapezius and serratus anterior ratios showed inconsistency.

CONCLUSION

This review found evidence that integrating the KC during shoulder rehabilitation may increase axioscapular muscle recruitment, produce lower trapezius muscle ratios and reduce the demands on the rotator cuff. Stepping appears preferable to squatting.

PROSPERO REGISTRATION NUMBER

CRD42015032557, 2015.

Rehabilitation and Prehabilitation for Upper Extremity in Throwing Sports: Emphasis on Lacrosse

Lacrosse imposes multiple simultaneous physical demands during play including throwing and catching a ball while holding a crosse, running, cutting, and jumping. Often, these skills are completed while experiencing contact from another player leading to both on-and-off platform movements. Other motions include defensive blocking and pushing past defenders. Repetitive motions over sustained durations in practice or competition impart mechanical stresses to the shoulder or elbow joints, supportive muscles, and connective tissue. Preparation for lacrosse participation involves bilateral optimization of strength and durability of stabilizer muscles. Passing and shooting skills are encouraged to be equally effective on both sides; therefore, symmetric strength and flexibility are vital for prehabilitation and rehabilitation efforts. This article will: 1) provide insights on the upper-extremity musculoskeletal demands of lacrosse and related sports with similar throwing motion and 2) describe prehabilitation and rehabilitation methods that improve athlete durability and reduce likelihood of upper-extremity injury.

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.

Isokinetic strength training of kinetic chain exercises of a professional tennis player with a minor partial internal abdominal oblique muscle tear - A case report

OBJECTIVE

To present a case of a right-handed professional tennis player with a left internal abdominal oblique muscle tear sustained while serving. We document the progress of a rehabilitation program consisting of primarily kinetic chain isokinetic strength training where symmetrical measurements (<10% side difference) of force and dynamic postural control were used as criteria for return to sport.

METHODS

Isokinetic exercises (bilateral rotational pull, unilateral vertical press and unilateral anterior push) to target trunk specific demands of the serve (flexion, rotation and lateral flexion) were done using robotic resistance. Dynamic postural control was assessed using the hand reach star excursion balance test (HSEBT). The rehabilitation program lasted 3.5 weeks (eight sessions).

RESULTS

At baseline isokinetic strength tests that imposed concentric muscle function demands of the injured muscle had lower force measurements (range: -32.1 to -71.9%). These force measurements improved (range: 166.1-296.5%) and were symmetrical (range: +1.6 to +7.3%) on return to sport. In addition, the HSEBT test with the greatest asymmetry (-20 cm) improved to symmetrical (+2 cm) on return to sport.

CONCLUSION

Symmetrical isokinetic force and dynamic postural control measurements were successful return to sport criteria as the player since has remained pain free (2 years).

Inter-Session Reliability of the Tennis Serve and Influence of the Laboratory Context

To meet the demand of a player’s entourage (e.g., coaches and medical staff), it is important for the biomechanics specialist to perform repeatable measures. To the best of our knowledge, to date, it has not been demonstrated whether similar results are obtained between two sessions of testing or between laboratory and field sport kinematic protocols with regard to the tennis serve. This study had two primary aims. First, the inter-session repeatability of biomechanical variables of a tennis serve was evaluated. Second, the differences between laboratory and field evaluations were studied. Thirteen national tennis players (ITN 3) performed the same 28 markers’ set laboratory test twice two weeks apart, and other thirteen national players (ITN 3) performed two 4 markers’ set tests both in the laboratory and on an official tennis court one week apart. A 3D motion system was used to measure lower-limb, pelvis, trunk, dominant arm and racket kinematics. A force plate was used to evaluate kinetics of legs’ drive in the laboratory. A personal method based on a point scoring system was developed to evaluate the ball landing location accuracy. We observed that the majority of the studied variables were acceptable for excellent relative reliability for the inter-session analysis. We also showed that the impact of the laboratory versus field context on the player’s serve was limited

Segmental Power Analysis of Sequential Body Motion and Elbow Valgus Loading During Baseball Pitching: Comparison Between Professional and High School Baseball Players

Background:

Pitching-related elbow injuries remain prevalent across all levels of baseball. Elbow valgus torque has been identified as a modifiable risk factor of injuries to the ulnar collateral ligament in skeletally mature pitchers.

Purpose:

To examine how segmental energy flow (power) influences elbow valgus torque and ball speed in professional versus high school baseball pitchers.

Study Design:

Descriptive laboratory study.

Methods:

A total of 16 professional pitchers (mean age, 21.9 ± 3.6 years) and 15 high school pitchers (mean age, 15.5 ± 1.1 years) participated in marker-based motion analysis of baseball pitching. Ball speed, maximum elbow valgus torque (MEV), temporal parameters, and mechanical power of the trunk, upper arm, and forearm were collected and compared using parametric statistical methods.

Results:

Professional pitchers threw with a higher ball speed (36.3 ± 2.9 m/s) compared with high school pitchers (30.4 ± 3.5 m/s) (P = .001), and MEV was greater in professional pitchers (71.3 ± 20.0 N·m) than in high school pitchers (50.7 ± 14.6 N·m) (P = .003). No significant difference in normalized MEV was found between groups (P = .497). Trunk rotation time, trunk power, and upper arm power combined to predict MEV (r = 0.823, P < .001), while trunk rotation time and trunk power were the only predictors of ball speed (r = 0.731, P < .001). There were significant differences between the professional and high school groups in the timing of maximum pelvis rotation velocity (42.9 ± 9.7% of the pitching cycle [%PC] vs 27.9 ± 23.4 %PC, respectively; P < .025), maximum trunk rotation (33 ± 16 %PC vs 2 ± 23 %PC, respectively; P = .001), and maximum shoulder internal rotation velocity (102.4 ± 8.9 %PC vs 93.0 ± 11.7 %PC, respectively; P = .017).

Conclusion:

The power of trunk motion plays a critical role in the development of elbow valgus torque and ball speed. Professional and high school pitchers do not differ in elbow torque relative to their respective size but appear to adopt different patterns of segmental motion.

Clinical Relevance:

Because trunk rotation supplies the power associated with MEV and ball speed, training methods aimed at core stabilization and flexibility may benefit professional and high school pitchers in reducing the injury risk and improving pitching performance.

Evolution of the trophy position along the tennis serve player's development

The trophy position is a coaching cue for the tennis serve that usually corresponds to the racquet high point (RHP) during the preparatory action for the stroke. Mastering this position and its time of occurrence seems essential in overarm movements like in the tennis serve. Clinicians and coaches have a real interest in understanding the trophy position and its evolution during the development of the elite players at different ages. A 3D motion system was used to measure the kinematics of the serve. A group of high-level tennis players were selected for three different age groups: 8 adults (ITN 1), 8 teenagers (ITN 3) and 8 children (ITN 5-6). Results show a modified pattern sequence of the tennis serve between children and adult players. RHP appears earlier relative to impact for children (-0.54 ± 0.10 s) than for adults (-0.36 ± 0.11 s) and teenagers (-0.33 ± 0.05 s) (p = 0.007). At RHP, children present lower trunk transverse plane rotation (p < 0.003) and higher shoulder external rotation (p < 0.003). These positions for the child players may represent an increased risk of shoulder and trunk injury than for older players and contribute to a lower racquet resultant velocity at impact.

Directionally compensated mechanical work provided by the shoulder leads to similar racket velocities during open and square stance forehand groundstrokes in tennis. Eur J Sport Sci 2018;19:902-912. [PMID: 30551731 DOI: 10.1080/17461391.2018.1552720]

The differences between the racket-arm acceleration mechanisms during open and square stance forehand groundstrokes in tennis were examined by quantifying the mechanical work done on the racket arm. We studied 13 advanced tennis players as they performed these strokes at maximum effort and calculated the work using inverse dynamics. The racket head speed was similar between the open and square stances. In the open stance, the lack of weight shifting towards the hitting direction resulted in a lower velocity for the shoulder joint centre in the hitting direction than in the square stance, and less work was done by the shoulder joint force in the hitting direction in the open stance than in the square stance (0.30 ± 0.11 J·kg-1 vs. 0.38 ± 0.16 J·kg-1; p = 0.005). However, in the open stance, the torso rotated more towards the hitting direction and had more upward acceleration, which resulted in more work done by the sideways and upward shoulder joint forces than in the square stance (sideways: 0.07 ± 0.09 J·kg-1 vs. 0.05 ± 0.09 J·kg-1, p = 0.046; upward: 0.08 ± 0.09 J·kg-1 vs. 0.04 ± 0.07 J·kg-1, p = 0.002). Thus, the greater work done by the sideways and upward shoulder joint forces compensated for the lesser work done by the shoulder joint force in the hitting direction in the open stance. In both stances, mainly the horizontal flexion torque and internal rotation torque at the shoulder increased the energy of the racket arm.

The effect of increased shooting distance on energy flow in basketball jump shot

The aim of this study is to clarify the effect of shooting distance on energy flow in basketball jump shot. Ten male right-handed basketball players participated in this study, and three successful shots at three different distances (short condition, equating to a free-throw; long condition, equating to a three-point shot; and mid condition, equating to the mid-point of the short- and long-condition shots) were recorded using a motion capture system and force platforms. Kinetic variables of joints during shooting were analysed using inverse dynamics method. Our results showed that the joint work was not significantly different for short- and mid-condition shots; however, the amount of energy transferred from the torso to the shooting arm by the shoulder joint force increased significantly for the mid-condition shots ([Formula: see text] as opposed to [Formula: see text] J/kg, [Formula: see text]), whereas between the mid- and long-conditions, it was found that the joint work in the lower limbs increased significantly ([Formula: see text] as opposed to [Formula: see text] J/kg, [Formula: see text]). These results suggest that sufficient energy transfer from the lower limbs to the shoot arms is important to keep the motions of the shooting arms approximately constant when shooting from various distances.