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Olsen AA, Li A, Johnson DD, Manson HC. Pickleball Primer: An Overview of Common Injuries, Treatment, and Optimization Strategies in Pickleball Athlete. J Am Acad Orthop Surg 2024; 32:763-770. [PMID: 38773841 DOI: 10.5435/jaaos-d-23-00705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 04/13/2024] [Indexed: 05/24/2024] Open
Abstract
Pickleball is one of the fastest growing sports in the United States with millions of players nationwide. It is a relatively appealing sport because of its ease of access, low impact, and highly social atmosphere, allowing players of all ages to participate. As the number of players continues its dramatic increase, player injuries are certain to increase in turn. There is little to no orthopaedic research on pickleball-related injuries and a paucity of data regarding treatment and prevention strategies. This summary was designed to familiarize orthopaedic surgeons with the basics of the sport and highlight potential pickleball-related injuries they may encounter in practice.
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Affiliation(s)
- Aaron A Olsen
- From the Bone and Joint Sports Medicine Institute, Naval Medical Center Portsmouth, Portsmouth, VA
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Qiu B, Sholtis C, Ketonis C. Initial PROMIS Scores Correlate With Operative and Nonoperative Management of Lateral Epicondylitis. Hand (N Y) 2024; 19:709-714. [PMID: 36564976 PMCID: PMC11284984 DOI: 10.1177/15589447221142885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Lateral epicondylitis (LE) is a common source of elbow pain. Treatment options include physical therapy (PT), corticosteroid injection, or surgery, but the efficacy of each remains unclear. In this study, we compare Patient-Reported Outcomes Measurement Information System (PROMIS) scores between patients treated both operatively and nonoperatively for LE. METHODS Patients presenting to a tertiary academic medical center from February 2015 to December 2018 with a diagnosis of LE were identified. Those with initial and follow-up PROMIS physical function (PF), pain interference (PI), and Depression scores were included and stratified according to treatment. Single-factor analysis of variance testing was used to compare PROMIS scores between intervention types. RESULTS In all, 982 patients were initially identified with the diagnosis of LE and documented PROMIS scores. Initial treatment consisted of 266 patients receiving formal PT, 238 patients receiving injections, 20 patients undergoing surgery, and 296 patients receiving no formal treatment. At final follow-up, 235 (44.8%) patients had been treated with isolated PT, 237 (45.1%) with injections, and 52 (9.9%) with surgery. Patients who underwent formal PT had the highest initial PF scores when compared with all other interventions. Patients who underwent operative management had higher initial PI scores than those who pursued nonoperative management. CONCLUSIONS Patient-Reported Outcomes Measurement Information System PF and PI may be useful for determining which treatment course patients suffering from LE are likely to pursue. Pain as a limiting factor in daily living may be a better indication for operative management as opposed to physical metrics.
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Affiliation(s)
- Bowen Qiu
- University of Rochester Medical Center, NY, USA
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Krueckel J, Szymski D, Lenz J, Fluegel J, Weber J, Achenbach L, Meffert R, Alt V, Fehske K. Tennis Injuries Among German League Players: Investigating Patterns and Epidemiology of Acute and Chronic Injuries. Open Access J Sports Med 2024; 15:67-75. [PMID: 38975566 PMCID: PMC11226988 DOI: 10.2147/oajsm.s460907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 05/07/2024] [Indexed: 07/09/2024] Open
Abstract
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.
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Affiliation(s)
- Jonas Krueckel
- Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - Dominik Szymski
- Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - Julia Lenz
- Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - Julian Fluegel
- Department of Orthopaedic Surgery, Arcus Clinics Pforzheim, Pforzheim, Germany
| | - Johannes Weber
- Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - Leonard Achenbach
- Department of Orthopaedic Surgery, Koenig Ludwig Haus Wuerzburg, Wuerzburg, Germany
| | - Rainer Meffert
- Department of Trauma Surgery, University Hosptial Wuerzburg, Wuerzburg, Germany
| | - Volker Alt
- Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - Kai Fehske
- Department of Trauma Surgery, University Hosptial Wuerzburg, Wuerzburg, Germany
- Department of Orthopedic and Trauma Surgery, Johanniter Waldkrankenhaus Bonn, Bonn, Germany
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Ghattas YS, Zeblisky P, Cassinat J, Aceto M, Spindler KP, Cannada LK. Pickleball-Related Fractures in the United States From 2002 to 2022: An Analysis Using the NEISS Database. Orthop J Sports Med 2024; 12:23259671241255674. [PMID: 38881851 PMCID: PMC11179465 DOI: 10.1177/23259671241255674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 02/02/2024] [Indexed: 06/18/2024] Open
Abstract
Background Pickleball is one of the fastest-growing sports in the United States, with more than an 11-fold increase in injuries from 2010 to 2019. Purpose To (1) determine the prevalence and demographic variables associated with pickleball-related fractures among patients evaluated at emergency departments in the United States between 2002 and 2022 and (2) identify variables influencing patient disposition status. Study Design Descriptive epidemiology study. Methods The US Consumer Product Safety and Commission's publicly available database, the National Electronic Injury Surveillance System (NEISS), was used in this study. Analyses consisted of descriptive statistics for fracture prevalence and demographic variables as well as univariate analysis for disposition status (discharged home vs hospital admission). Results A total of 397 pickleball-related fractures were recorded between 2002 and 2022, which indicated a 90-fold increase in our study period. Based on weighted national average of NEISS sampling, this equated to approximately 5400 fractures annually. Players who sustained pickleball fractures were primarily aged >60 years (n = 344 [87%]; P < .001) and female (n = 273 [69%]; P < .001). Most fractures involved the upper extremity (n = 262 [66%]; P < .001), with the most common ones involving the radius (n = 79 [30%]), humerus (n = 22 [8%]), and ulna (n = 8 [3%]). Fractures were due most commonly to falls (n = 365 [92%]; P < .001) and occurred in the winter months (n = 142 [36%]; P < .001). There was a significant difference in disposition status, with most patients discharged (n = 320 [81%] vs n = 77 [19%] for hospital admission; P < .001). Univariate analysis revealed that age >60 years, male sex, and fractures to the trunk and lower extremity all led to significantly increased odds of being admitted (odds ratios: 2.27, 2.31, 2.89, and 13.8, respectively). Conclusion Between 2002 and 2022, there was a 90-fold increase in pickleball-related fractures. Most fractures were of the upper extremity after a fall in women aged >60 years. Despite female fracture predominance, men were 2.3 times more likely to be admitted after sustaining a fracture.
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Affiliation(s)
- Yasmine S Ghattas
- University of Central Florida College of Medicine, Orlando, Florida, USA
| | - Peter Zeblisky
- University of Central Florida College of Medicine, Orlando, Florida, USA
| | - Joshua Cassinat
- University of Central Florida College of Medicine, Orlando, Florida, USA
| | - Matthew Aceto
- University of Central Florida College of Medicine, Orlando, Florida, USA
| | - Kurt P Spindler
- Cleveland Clinic Florida, Sports Medicine, Weston, Florida, USA
| | - Lisa K Cannada
- University of Central Florida College of Medicine, Orlando, Florida, USA
- Novant Health, Charlotte, North Carolina, USA
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Hank M, Miratsky P, Ford KR, Clarup C, Imal O, Verbruggen FF, Zahalka F, Maly T. Exploring the interplay of trunk and shoulder rotation strength: a cross-sport analysis. Front Physiol 2024; 15:1371134. [PMID: 38737828 PMCID: PMC11082744 DOI: 10.3389/fphys.2024.1371134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 03/28/2024] [Indexed: 05/14/2024] Open
Abstract
Introduction: Trunk and shoulder strength are consistently shown to be involved in performance limitations, as well as contributing to stability, power output, and reducing the risk of injury. Although their biomechanical interaction is a critical aspect for athletes, there is limited research on the relationship between trunk and shoulder strength in sports where upper body mechanics are critical for optimal performance. Purpose: This study examined the differences and relationships between trunk rotational strength and shoulder rotational strength among athletes participating in mixed martial arts (MMA), tennis, swimming, and baseball. Methods: Maximal voluntary contraction tests were performed to evaluate strength of 39 professional adult male athletes from disciplines of MMA (n = 6), tennis (n = 11), swimming (n = 11) and baseball (n = 11). Peak force data were used in sports comparison and relationship analysis between trunk and shoulder rotation strength parameters. Results: The findings revealed a complex and significant relationship between trunk and shoulder strength, with unique patterns for each athletic discipline. Tennis players exhibited a strong correlation between trunk bilateral differences and internal shoulder rotation, while other disciplines demonstrated a more balanced use of trunk asymmetry. Swimmers displayed the best interactions between trunk and shoulder overall, emphasizing the aquatic environment's biomechanical demands. In MMA, the strongest correlation was between shoulder internal and external rotation with the trunk, mainly due to the number of defensive movements in addition to offensive ones. Baseball pitchers showed a significant correlation between internal/external shoulder rotation strength ratio and trunk asymmetry. Conclusion: While no differences in peak force variables were found, unique relationships between trunk and shoulder rotational performance were discovered. The results suggest a long-term sport-specific adaptation of the trunk-shoulder interaction in sports that require upper limb power movements. It seems, that the relationship between the various parameters of trunk and shoulder was influenced by the movement stereotype of each sport. Therefore, recognition of sport-specific interactions is critical to the development of effective training programs that enhance performance and potentially reduce injury risk in different sports. Researchers and practitioners should focus on longitudinally monitoring fluctuations in TRS and SRS relationships throughout each sport season and examining potential associations with injury incidence.
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Affiliation(s)
- Mikulas Hank
- Sport Research Center, Faculty of Physical Education and Sport, Charles University, Prague, Czechia
| | - Petr Miratsky
- Sport Research Center, Faculty of Physical Education and Sport, Charles University, Prague, Czechia
| | - Kevin R. Ford
- Department of Physical Therapy, High Point University, High Point, NC, United States
| | | | - Osman Imal
- Sport Research Center, Faculty of Physical Education and Sport, Charles University, Prague, Czechia
| | - Ferdia Fallon Verbruggen
- Sport Research Center, Faculty of Physical Education and Sport, Charles University, Prague, Czechia
| | - Frantisek Zahalka
- Sport Research Center, Faculty of Physical Education and Sport, Charles University, Prague, Czechia
| | - Tomas Maly
- Sport Research Center, Faculty of Physical Education and Sport, Charles University, Prague, Czechia
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Gulati A, Desai V. Return to Play in the Professional Athlete. Semin Musculoskelet Radiol 2024; 28:107-118. [PMID: 38484763 DOI: 10.1055/s-0043-1778028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
The management of any injury in elite athletes poses unique challenges distinct from the general population because the goal is rapid recovery and return to play (RTP) while simultaneously managing residual symptoms and minimizing risk of reinjury. The time required for treatment, recovery, and return to peak performance can have consequences for both the athlete and his or her team: financial implications, psychological stressors, team dynamics, and future performance. RTP after an injury in the professional athlete requires a complex decision-making process with many stakeholders. Several factors influence this decision, not the least of which is the type and mechanism of injury. This article provides an overview of the RTP process including nonmedical factors that may influence this decision, common injuries seen in professional athletes, injury patterns particular to certain popular sports, and imaging guidelines for such injuries.
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Affiliation(s)
- Aishwarya Gulati
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Vishal Desai
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania
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Tian Y, He B, Tsymbal A. Comprehensive secondary prevention of lateral epicondylitis in young tennis players. Res Sports Med 2024; 32:160-173. [PMID: 35726857 DOI: 10.1080/15438627.2022.2090252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/23/2022] [Indexed: 10/18/2022]
Abstract
The research aims to increase the efficiency of the training process for young tennis players old based on lateral epicondylitis secondary prevention methods. Tennis players with apparent residual effects of lateral epicondylitis were selected for the study and divided into experimental (18 boys and 14 girls) and control groups (18 boys and 13 girls). The experimental group was trained according to the developed technique, and the control group as per standard one. The results of goniometry in the experimental group showed the normalization of the motion amplitude in extension and supination. The motor density of the training session applying the complex technique for the secondary prevention of lateral epicondylitis in the experimental group increased on average from 66.6% to 82.2% in boys and from 65.7% to 80.0% in girls.
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Affiliation(s)
- Yu Tian
- Sports Department, Henan Institute of Technology, Xinxiang, Henan, China
| | - Bing He
- Department of Physical Education, China Pharmaceutical University, NanJing, Jiangsu, China
| | - Alexandr Tsymbal
- Department of Pathophysiology, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Thomas E, Giustino V, Ferrisi E, Patti A, Cassarino M, Drid P, Bianco A. Incidence of injuries and associated risk factors in a sample of Italian recreational padel players. J Sports Med Phys Fitness 2023; 63:1324-1330. [PMID: 37791828 DOI: 10.23736/s0022-4707.23.15221-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
BACKGROUND Padel is a racket sport similar to tennis, which since the COVID-19 pandemic has been gaining popularity among recreational players. Despite its popularity, epidemiological studies are still lacking. This study aimed to identify the prevalence of injuries among Italian recreational padel players and associated risk factors. METHODS A questionnaire was administered to 127 recreational padel players between January 2022 to March 2022. The questionnaire consisted of questions to collect information regarding intrinsic and extrinsic factors related to padel practice, injury location, and injury typology. Frequencies and proportions were calculated for variable description. Binomial logistic regression was adopted to identify potential risk factors. RESULTS Of the 127 participants, 100 (78.8%) reported having had an injury during the previous year. Such injury in most cases (37%) resulted in an absence from padel from 8 to 28 days. The most common injury locations were lower leg/Achilles tendon (17.1%) and elbow (13.8%), while the most common injury typologies were tendinopathies (33.6%) and contusions (14.9%). Among the identified risk factors the amount of time played padel (3.5-5 hours/week), racket type (round), and racket weight (either not knowing or 356-375 g) resulted in an increase in the probability of occurring an injury. CONCLUSIONS Recreational padel results in a high percentage of injuries. These frequently result in tendinopathies of the Achilles tendon and elbow. Inadequate racket characteristics and the amount of time played could contribute to an increase in injury incidence.
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Affiliation(s)
- Ewan Thomas
- Sport and Exercise Sciences Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Valerio Giustino
- Sport and Exercise Sciences Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Emanuele Ferrisi
- Sport and Exercise Sciences Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Antonino Patti
- Sport and Exercise Sciences Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy -
| | | | - Patrik Drid
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Antonino Bianco
- Sport and Exercise Sciences Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
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Llanes AC, Deckey DG, Zhang N, Curley KL, Curley ND, Chhabra A, Neal MT. Lower-Extremity Injuries Predominate in American High School Tennis Players. Arthrosc Sports Med Rehabil 2023; 5:100811. [PMID: 37881190 PMCID: PMC10594564 DOI: 10.1016/j.asmr.2023.100811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 08/20/2023] [Indexed: 10/27/2023] Open
Abstract
Purpose To describe injury epidemiology in U.S. adolescent tennis players between 2014 and 2018 via the High School Reporting Information Online (HS RIO) database. Methods The HS RIO database was queried for injury data on high school tennis players as reported by athletic trainers between 2014 and 2018. Injuries were analyzed according to athlete demographics, injury type, location, and context. Variables of interest between male and female athletes were compared using Pearson χ2 test or Fisher exact test. Results In total, 176 injuries in high school tennis players between 2014 and 2018 were identified in the HS RIO database. Overall, 25.6% (45/176) occurred in the ankle, 12.5% (22/176) in the knee, and 9.7% (17/176) in the wrist. The most common types of injuries were ligament sprains and muscle strains at 35.2% (62/176) and 17.6% (31/176) of injuries, respectively. Although most injuries were unrelated to contact, such as overuse and heat exertion or stroke, 28.7% (47/176) of injuries were the result of rotation around a planted foot/inversion of the foot. We found no difference in injury patterns between male and female high school tennis athletes. Conclusions We found no difference in injury patterns between male and female U.S. high school tennis athletes. The ankles, knees, and wrists were the most commonly injured areas in this population. The most common types of injuries were ligament sprains and muscle strains. Although many injuries were new, athletes rarely required surgery and returned to play. Finally, we found no difference in injury patterns between male and female high school tennis athletes. Clinical Relevance The epidemiology of injuries among high school tennis players is poorly understood. The information from this study will help us to understand these injuries and how we may be able to better prevent them.
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Affiliation(s)
- Aaron C. Llanes
- University of Arizona College of Medicine, Phoenix, Arizona, U.S.A
| | - David G. Deckey
- Department of Orthopaedic Surgery, Mayo Clinic Hospital, Phoenix, Arizona, U.S.A
| | - Nan Zhang
- Department of Quantitative Health Sciences, Mayo Clinic, Scottsdale, Arizona, U.S.A
| | - Kara L. Curley
- Department of Neurologic Surgery, Mayo Clinic Hospital, Phoenix, Arizona, U.S.A
| | | | - Anikar Chhabra
- Department of Orthopaedic Surgery, Mayo Clinic Hospital, Phoenix, Arizona, U.S.A
| | - Matthew T. Neal
- Department of Neurosurgery and Spine, Roper St. Francis, Charleston, South Carolina, U.S.A
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Wood D, Reid M, Elliot B, Alderson J, Mian A. The expert eye? An inter-rater comparison of elite tennis serve kinematics and performance. J Sports Sci 2023; 41:1779-1786. [PMID: 38155177 DOI: 10.1080/02640414.2023.2298102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 12/13/2023] [Indexed: 12/30/2023]
Abstract
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.
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Affiliation(s)
- Dylan Wood
- University of Western Australia & Tennis Australia, Perth, Australia
| | - Machar Reid
- University of Western Australia & Tennis Australia, Perth, Australia
| | - Bruce Elliot
- School of Human Sciences, University of Western Australia, Perth, Australia
| | | | - Ajmal Mian
- School of Mathematics and Computer Science, University of Western Australia, Perth, Australia
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D A, Sudhan M A, Chandran S, Nuhmani S, Ahsan M, Alghadir AH, Khan M. Effects of modified sleeper stretch and modified cross-body stretch on upper limb functions and shoulder ROM in tennis players: a randomized trial. Sci Rep 2023; 13:9124. [PMID: 37277413 DOI: 10.1038/s41598-023-35977-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 05/26/2023] [Indexed: 06/07/2023] Open
Abstract
Tennis players often experience posterior shoulder pain due to restricted internal rotation (IR) range of motion (ROM) of the glenohumeral joint. No research has compared the effects of modified sleeper stretch (MSS) versus modified cross-body stretch (MCBS) on tennis players' upper limb functions and IR ROM. The study aimed to compare the efficacy of modified sleeper and cross-body adduction stretch in improving shoulder IR ROM and upper limb functions in tennis players. Thirty male lawn tennis players (aged 20 to 35 years) with more than 15° glenohumeral IR deficiency on the dominant side compared to the non-dominant side were recruited and divided into two groups: Modified sleeper stretch group (MSSG) and modified cross-body stretch group (MCBSG). MSSG received MSS, and MCBSG received MCBS, 3-5 repetitions once daily for 4 weeks. Upper limb functions were measured using the Disability of the Arm, Shoulder, and Hand (DASH) scale, and the IR ROM of the shoulder joint was measured using a universal goniometer. Both groups observed significant (p < 0.05) DASH scores and IR ROM improvements. DASH scores decreased by 85% in MSSG and 79.60% in MCBSG. IR ROM increased by 94.64% in MSSG and 89.52% in MCBSG. No significant differences (p > 0.05) were found in post-intervention DASH scores and IR ROM values between both groups. MSS and MCBS improved upper limb functions and IR ROM of the shoulder joint in the selected sample population of lawn tennis players. No difference was observed between both stretching techniques in improving upper limb functions and IR ROM of the shoulder joint.
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Affiliation(s)
- Anjupriya D
- Co-operative Institute of Health Sciences, Thalassery, Kerala, India
| | - Aparna Sudhan M
- Co-operative Institute of Health Sciences, Thalassery, Kerala, India
| | - Shilpa Chandran
- Co-operative Institute of Health Sciences, Thalassery, Kerala, India
| | - Shibili Nuhmani
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammad Ahsan
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ahmad H Alghadir
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box. 10219, Riyadh, 11433, Saudi Arabia
| | - Masood Khan
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box. 10219, Riyadh, 11433, Saudi Arabia.
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Sudah SY, Menendez ME, Garrigues GE. Nonoperative Treatment of the Biceps-Labral Complex. Phys Med Rehabil Clin N Am 2023; 34:365-375. [PMID: 37003658 DOI: 10.1016/j.pmr.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
The long head of the biceps and superior labrum should be evaluated as an interdependent functional unit. A focused patient history and physical examination including multiple provocative tests should be performed alongside advanced imaging studies to obtain an accurate diagnosis. Nonoperative treatment modalities including nonsteroidal anti-inflammatory drugs, glucocorticoid injections, and a standardized physical therapy regimen should be exhausted before operative intervention. Significant improvements in pain, functional outcomes, and quality of life are achieved in patients treated nonoperatively. Although these outcomes are less consistent for overhead athletes, return to play and performance metrics seem comparable to those who undergo surgery.
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Affiliation(s)
- Suleiman Y Sudah
- Department of Orthopedics, Monmouth Medical Center, 300 2nd Avenue, Long Branch, NJ 07740, USA
| | - Mariano E Menendez
- Oregon Shoulder Institute at Southern Oregon Orthopedics, 2780 East Barnett Road, 200, Medford, OR 97504, USA
| | - Grant E Garrigues
- Department of Orthopaedic Surgery, Rush University Medical Center, Midwest Orthopaedics at Rush, 1611 West Harrison Street, Orthopedic Building, Suite 400, Chicago, IL 60612, USA.
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Lateral epicondylitis of the elbow: an up-to-date review of management. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2023; 33:201-206. [PMID: 35031850 DOI: 10.1007/s00590-021-03181-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 12/07/2021] [Indexed: 10/19/2022]
Abstract
Lateral epicondylitis, also known as tennis elbow, is an overuse tendinopathy of the common extensor origin of the elbow in patients involved in repetitive movement of the wrist and forearm. Lateral epicondylitis is a self-limiting condition, with operative management only recommended in severe, recalcitrant cases. This article reviews the recent updates on operative and non-operative management of lateral epicondylitis.
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Casals M, Jimenez S, Caparros T, Martínez-Gallego R, Baiget E. Scoping review and quality of studies on the epidemiology of pickleball injuries. APUNTS SPORTS MEDICINE 2023. [DOI: 10.1016/j.apunsm.2023.100403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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Muñoz D, Coronado M, Robles-Gil MC, Martín M, Escudero-Tena A. Incidence of Upper Body Injuries in Amateur Padel Players. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16858. [PMID: 36554736 PMCID: PMC9779620 DOI: 10.3390/ijerph192416858] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/02/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
The objectives of this study were to analyze the injuries suffered during the previous year by amateur padel players according to the characteristics of the racket, their usual volume of practice and their experience in padel. A total of 950 amateur players (X age: 31.68 years; X weight: 70.84 kg; X height: 170.9 cm) participated voluntarily, completing an ad-hoc questionnaire. The results indicated that the appearance of the injuries and their location was different according to the sex of the amateur padel players. Men had a higher incidence of muscle and ligament injuries in the shoulder, and tendon injuries in the elbow. On the other hand, women had a greater probability of having muscle injuries in the shoulder and arm, ligament injuries in the elbow and bone injuries in the wrist and elbow. In general, tendon injuries were the most common injury in padel and the shoulder and elbow were the most affected areas. Moreover, men tend to use heavy (CSR = 6.0), fiberglass or carbon (CSR = 2.1), diamond-shaped rackets (CSR = 3.2), with a hard core (CSR = 4.4) and with two or more over grips (CSR = 2.7). Women usually use less heavy (CSR = 6.0), round-shaped rackets (CSR = 4.9), with a soft core (CSR = 4.4) and with one or no over grips (CSR = 2.7). In addition, men tend to play padel more often and have been practicing for longer. In conclusion, although the risk of injury depends on many factors, we identified that the characteristics of the racket, the volume of weekly practice, the experience of the player and the gender of the player are fundamental aspects to take into account for the prevention of injuries in amateur padel players.
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Affiliation(s)
- Diego Muñoz
- Department of Musical, Plastic and Corporal Expression, Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
| | - Manuel Coronado
- Department of Musical, Plastic and Corporal Expression, Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
| | - María C. Robles-Gil
- Department of Musical, Plastic and Corporal Expression, Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
| | | | - Adrián Escudero-Tena
- Training Optimization and Sport Performance Research Group (GOERD), Sport Science Faculty, University of Extremadura, 10005 Caceres, Spain
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16
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Benitez CL, Daniels B, Colvin AC. Point-of-care radiology service at the US Open Tennis Championships. Skeletal Radiol 2022; 51:2257-2261. [PMID: 35876863 DOI: 10.1007/s00256-022-04128-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/13/2022] [Accepted: 07/13/2022] [Indexed: 02/02/2023]
Abstract
Professional tennis tournaments have onsite sports medicine physicians who oversee the athletes' overall health during competition, including musculoskeletal injury and general illnesses. The medical team is composed of orthopedic and non-operative sports medicine physicians. Frequently, the tournament doctors require imaging to localize and grade musculoskeletal injuries and to make decisions regarding treatment, safe training, and return to match play. The most versatile and readily available imaging modality to evaluate for acute musculoskeletal injury is point-of-care ultrasonography. In 2015, a dedicated radiology service was created at the US Open by bringing in a musculoskeletal radiologist who would perform ultrasounds in a formal and consistent manner. In addition, the radiologist was tasked with onsite radiography as well as review of all MRI examinations done at the imaging center. This article describes how this radiology service was implemented, what types of studies were performed and the advantages of having an onsite musculoskeletal radiologist at the tournament. This service allowed the medical team to provide the comprehensive and efficient medical care required in a major professional tennis event. It also showed the value of having the in-person expertise of the musculoskeletal radiologist in the sports medicine team. This same model could be applied to other professional sporting events.
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Affiliation(s)
- Carlos L Benitez
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Brian Daniels
- Department of Orthopedics and Sports Medicine, Nemours Children's Hospital, Orlando, FL, USA
| | - Alexis C Colvin
- Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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17
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Vasenina E, Hammert WB, Kataoka R, Dankel SJ, Buckner SL. Injuries and Strength Training Practices in Collegiate Tennis. Sports (Basel) 2022; 10:sports10100149. [PMID: 36287762 PMCID: PMC9611280 DOI: 10.3390/sports10100149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 11/23/2022] Open
Abstract
Strength and conditioning practices may influence injury rates in the sport of tennis. Methods: Coaches reported the number injuries over the past year. Coaches were also surveyed on whether their training program included training related to upper-body or lower-body strength, power, muscle growth, and eccentric exercise. Separate regression analyses were run in the upper and lower body to examine the relationship between injuries and participation in training focused on strength, power, growth, and maximal eccentric exercise. A total of 111 coaches were surveyed. The most frequent injuries observed were ankle sprains (144 injures), followed by paraspinal muscle strains (126 injuries). When pooled, there were a total of 355 lower-body and 260 upper-body injuries. Strength and conditioning practices explained 9.9% of the variance of injury rates in the upper body (R2 = 0.099). The only significant predictor of upper-body injury was participation in upper-body muscle growth training (β = 1.613, p = 0.013). In addition, training practices explained 11.1% of the variance of injury in the lower body (R2 = 0.111). Coaches value injury prevention exercise, sports-specific training and flexibility and mobility training the most, with muscle growth and maximal power ranked lowest. Additionally, the most frequent injuries observed in collegiate tennis players were ankle sprains (144 injures), followed by paraspinal muscle strains (126 injuries).
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Affiliation(s)
- Ecaterina Vasenina
- Exercise Science Program, University of South Florida, Tampa, FL 33620, USA
| | - William B. Hammert
- Exercise Science Program, University of South Florida, Tampa, FL 33620, USA
| | - Ryo Kataoka
- Exercise Science Program, University of South Florida, Tampa, FL 33620, USA
| | - Scott J. Dankel
- Department of Health and Exercise Science, Rowan University, Glassboro, NJ 08028, USA
| | - Samuel L. Buckner
- Exercise Science Program, University of South Florida, Tampa, FL 33620, USA
- Correspondence: ; Tel.: +1-954-296-3146
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Musa RM, Hassan I, Abdullah MR, Latiff Azmi MN, Abdul Majeed APP, Abu Osman NA. A longitudinal analysis of injury characteristics among elite and amateur tennis players at different tournaments from electronic newspaper reports. Front Public Health 2022; 10:835119. [PMID: 36033746 PMCID: PMC9399393 DOI: 10.3389/fpubh.2022.835119] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 07/11/2022] [Indexed: 01/21/2023] Open
Abstract
The non-complexity of tennis, coupled with its health benefits, renders it appealing and encourages varying competitions at different levels of age, gender, and expertise. However, the rapid increase in the participation rates witnesses a surge in injury occurrences, prompting the need for in-depth analysis to facilitate immediate intervention. We employed a media content analysis technique in which tennis-associated articles published in the last 5 years were examined. A total of 207 news reports were gathered and screened for analysis. Subsequently, 71 articles were excluded from the study due to content duplications or summary updates of existing news articles, while 23 news articles were also excluded from the study due to inappropriateness. Finally, 113 news reports directly related to injury in tennis were coded and analyzed. We examined various types of injuries reported from the screened articles with respect to their status (fresh, recurrent, and recovery) across expertise levels i.e., elite, or amateur. Similarly, the incidence of injury occurrences based on the types of tournaments the players engage in was also investigated. A chi-square analysis was employed to achieve the objectives of the study. Occurrences of tennis-associated injuries are disseminated across expertise levels [χ ( 18 ) 2 = 16.542; p = 0.555], with knee, hip, elbow, and shoulder injuries being highly prevalent in both elite and amateur players. Nevertheless, it was noted that elite players suffered a staggering 72.60% of injury-related problems, while amateur players sustained 27.40% of injuries. Moreover, the status of injury spreads based on types of tournaments [χ ( 4 ) 2 = 3.374; p = 0.497], with higher occurrences of fresh and recurrent injuries, while low recovery rates were observed. The findings further demonstrated that injuries are sustained regardless of tournament types [χ ( 36 ) 2 = 39.393; p = 0.321]. However, most of the injuries occurred at international tournaments (85%). Whereas, only 5.30% of the injuries occurred at national/regional tournaments while 9.70% were unidentified. It could be deduced from the findings of this investigation that elite players are more prone to injuries compared with amateur players. Furthermore, the most common tennis-related injuries affect the lower, trunk, and upper regions of the body, respectively. A large number of the reported tennis injuries are fresh and recurrent, with a few recoveries. The international tennis tournaments are highly attributed to injury occurrences as opposed to the national/regional tournaments. The application of the media-based data mining technique is non-trivial in projecting injury-related problems that could be used to facilitate the development of an injury index peculiar to the tennis sport for prompt intervention.
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Affiliation(s)
- Rabiu Muazu Musa
- Centre for Fundamental and Continuing Education, Universiti Malaysia Terengganu, Kuala Nerus, Terengganu, Malaysia
| | - Isyaku Hassan
- Faculty of Languages and Communication, Universiti Sultan Zainal Abidin, Gong Badak Campus, Kuala Nerus, Terengganu, Malaysia
| | - Mohamad Razali Abdullah
- East Coast Environmental Research Institute Universiti Sultan Zainal Abidin, Kuala Nerus, Terengganu, Malaysia
| | - Mohd Nazri Latiff Azmi
- Faculty of Languages and Communication, Universiti Sultan Zainal Abidin, Gong Badak Campus, Kuala Nerus, Terengganu, Malaysia
| | - Anwar P. P. Abdul Majeed
- Innovative Manufacturing, Mechatronics and Sports Laboratory, Faculty of Manufacturing Engineering, Universiti Malaysia Pahang, Pekan, Malaysia
- School of Robotics, XJTLU Entrepreneur College (Taicang), Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Noor Azuan Abu Osman
- Centre for Applied Biomechanics, Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
- Chancellery, Universiti Tenaga Nasional, Kajang, Malaysia
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Ličen T, Kalc M, Vogrin M, Bojnec V. Injury Prevention in Tennis Players, Linking the Kinetic Chain Approach With Myofascial Lines: A Narrative Review With Practical Implications. Strength Cond J 2022. [DOI: 10.1519/ssc.0000000000000669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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20
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Descriptive Epidemiology of Injuries in Professional Speedball Athletes. J Sport Rehabil 2022; 31:778-784. [PMID: 35468588 DOI: 10.1123/jsr.2021-0372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 01/25/2022] [Accepted: 02/28/2022] [Indexed: 11/18/2022]
Abstract
CONTEXT Speedball is an increasingly popular racquet sport played in more than 25 countries. Our objective was to describe injury incidence and patterns among Egyptian national-level speedball athletes. DESIGN Descriptive epidemiological. METHODS We conducted a survey of athletes who were registered with the Egyptian Speedball Federation during the 2018-2019 professional season. The survey inquired about injury types and athlete exposures (AEs). The response rate was 63% (100/160 athletes). Respondent ages ranged from 18 to 41 years. We analyzed demographic characteristics; number, location, and mechanism of injuries; treatment; and speedball participation time lost because of injury. RESULTS Of 100 respondents, 65 reported having sustained at least one injury during the season for a total of 90 injuries and a rate of 4.7 injuries per 1000 AEs (95% confidence interval, 3.7 to 5.7). More injuries occurred during practice (77%) than during competition (23%). Thirty percent of respondents reported having missed a competition because of injury. The most frequent anatomic locations of injury were the shoulder (50%; 2.4/1000 AEs), elbow (14%; 0.68/1000 AEs), and low back (9%; 0.4/1000 AEs). The most frequently cited causes of injury were increased intensity of training (40%) and lack of warming up (18%). Seventy-seven percent of injured respondents underwent treatment by a health care professional, and 9% of these respondents underwent surgery. CONCLUSION The shoulder was the most common anatomic location for injuries in speedball athletes. Our results suggest that attention should be directed toward sport-specific injury prevention and intervention strategies because speedball is a fast-growing sport in several countries.
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Rice RP, Roach K, Kirk-Sanchez N, Waltz B, Ellenbecker TS, Jayanthi N, Raya M. Age and Gender Differences in Injuries and Risk Factors in Elite Junior and Professional Tennis Players. Sports Health 2022; 14:466-477. [PMID: 35037501 PMCID: PMC9214903 DOI: 10.1177/19417381211062834] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
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.
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Affiliation(s)
- Robyn Porter Rice
- Department of Physical Therapy, Miller School of Medicine, University of Miami, Miami, Florida,Robyn Porter Rice, PT, PhD, Department of Physical Therapy, Miller School of Medicine, University of Miami, 5915 Ponce de Leon Boulevard, Coral Gables FL 33146 () (Twitter: @RiceRobynp)
| | - Kathryn Roach
- Department of Physical Therapy, Miller School of Medicine, University of Miami, Miami, Florida
| | - Neva Kirk-Sanchez
- Department of Physical Therapy, Miller School of Medicine, University of Miami, Miami, Florida
| | - Bret Waltz
- DocWaltz LLC, Scottsdale, Arizona,USTA Player Development, Orlando, Florida
| | - Todd S. Ellenbecker
- Vice President Medical Services, ATP Tour, Ponte Vedra Beach, Florida,Rehab Plus Sports Therapy Scottsdale, Scottsdale, Arizona
| | - Neeru Jayanthi
- Emory Sports Medicine Center, Department of Orthopedic Surgery and Family Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Michele Raya
- Department of Physical Therapy, Miller School of Medicine, University of Miami, Miami, Florida
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22
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Johansson F, Cools A, Gabbett T, Fernandez-Fernandez J, Skillgate E. Association Between Spikes in External Training Load and Shoulder Injuries in Competitive Adolescent Tennis Players: The SMASH Cohort Study. Sports Health 2022; 14:103-110. [PMID: 34693828 PMCID: PMC8655479 DOI: 10.1177/19417381211051643] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Few studies have examined the association between the acute:chronic workload ratio (ACWR) and complaints/injuries in young tennis players. Primary aims of this study were to investigate if accumulated external workload "spikes" in ACWR of tennis training, match play, and fitness training, and to see if high or low workload/age ratio were associated with the rate of shoulder complaints/injuries in competitive adolescent tennis players. Additional aims were to report the incidence of complaints/injuries stratified by sex and level of play and to describe shoulder injury characteristics. HYPOTHESIS Rapid increases in external workload are associated with the incidence of shoulder complaints and injuries. STUDY DESIGN A cohort study. LEVEL OF EVIDENCE Level 3. METHODS At baseline, 301 adolescent competitive tennis players, 13 to 19 years, were screened and followed weekly for 52 weeks with questionnaires, in the years 2018 to 2019. Information about time-varying accumulated external workload spikes (uncoupled ACWR >1.3), and workload/age ratio, in 252 uninjured players were used in Cox regression analyses with the outcomes shoulder complaints (≥20) and injuries (≥40) (Oslo Sports Trauma Research Center Overuse Injury Questionnaire). RESULTS For each additional workload spike in tennis training/match play, the hazard rate ratio (HRR) was 1.26 (95% CI, 1.13-1.40) for a shoulder complaint and 1.26 (95% CI, 1.15-1.39) for a shoulder injury. The HRR for fitness training was 1.11 (95% CI, 1.02-1.20) for a shoulder complaint and 1.18 (95% CI, 1.09-1.27) for a shoulder injury. Workload/age ratio was not associated with the rate of shoulder complaints or injuries. CONCLUSION Accumulated external workload spikes of tennis training, match play, and/or fitness training are associated with a higher rate of shoulder complaints and shoulder injuries in competitive adolescent tennis players. CLINICAL RELEVANCE Consistency in training load on a weekly basis is most likely more beneficial for adolescent tennis players regarding shoulder complaints/injuries than a training schedule comprising rapid increases (ie, spikes) in workload.
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Affiliation(s)
- Fredrik Johansson
- Tennis Research and Performance Group, MUSIC, Department of Health Promotion Sciences, Sophiahemmet University, Stockholm, Sweden
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Naprapathögskolan–Scandinavian College of Naprapathic Manual Medicine, Stockholm, Sweden
| | - Ann Cools
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University Hospital, Ghent, Belgium
| | - Tim Gabbett
- Gabbett Performance Solutions, Brisbane, Clayfield, Queensland, Australia
- Centre for Health Research, University of Southern Queensland, Ipswich, Queensland, Australia
| | | | - Eva Skillgate
- Tennis Research and Performance Group, MUSIC, Department of Health Promotion Sciences, Sophiahemmet University, Stockholm, Sweden
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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23
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Evaluation and treatment of shoulder injuries in tennis players: a review. CURRENT ORTHOPAEDIC PRACTICE 2022. [DOI: 10.1097/bco.0000000000001073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Surveillance of Injury Types, Locations, and Intensities in Male and Female Tennis Players: A Content Analysis of Online Newspaper Reports. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312686. [PMID: 34886410 PMCID: PMC8656957 DOI: 10.3390/ijerph182312686] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/26/2021] [Accepted: 11/27/2021] [Indexed: 11/17/2022]
Abstract
The popularity of modern tennis has contributed to the increasing number of participants at both recreational and competitive levels. The influx of numerous tennis participants has resulted in a wave of injury occurrences of different types and magnitudes across both male and female players. Since tennis injury harms both players' economic and career development, a better understanding of its epidemiology could potentially curtail its prevalence and occurrences. We used online-based tennis-related injury reports to study the prevalence, location types, and injury intensities in both male and female tennis players for the past five years. It is demonstrated from the chi-square analysis that injury occurrences are significantly associated with a specific gender (χ2(18) = 50.773; p = 0.001), with male players having a higher risk of injury manifestation (68.10%) as compared with female players (31.90%). Nonetheless, knee, hip, ankle, and shoulder injuries are highly prevalent in both male and female players. Moreover, the injury intensities are distributed across gender (χ2(2) = 0.398; p = 0.820), with major injuries being dominant, followed by minor injuries, whilst a few cases of career-threatening injuries were also reported. It was similarly observed that male players recorded a higher degree of both major, minor, and career-threatening injuries than female players. In addition, male players sustained more elbow, hip, knee, shoulder, and thigh injuries than female players. Whereas, female players mostly suffered from Achilles and back injuries, ankle and hamstring injuries affected both genders. The usage of online newspaper reports is pivotal in characterizing the epidemiology of tennis-related injuries based on locations and gender to better understand the pattern and localization of injuries, which could be used to address the problem of modern tennis-related injuries.
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Evidenced-Based Management of Tennis Elbow. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2021. [DOI: 10.1007/s40141-021-00322-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Fett J, Oberschelp N, Vuong JL, Wiewelhove T, Ferrauti A. Kinematic characteristics of the tennis serve from the ad and deuce court service positions in elite junior players. PLoS One 2021; 16:e0252650. [PMID: 34292954 PMCID: PMC8297898 DOI: 10.1371/journal.pone.0252650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 05/19/2021] [Indexed: 11/18/2022] Open
Abstract
PURPOSE According to the official rules of the International Tennis Federation, players have to serve alternately from two different positions: the deuce (right, D) and the ad court (left, AD) side. This study aimed to compare body and ball kinematics of flat serves from both service sides. METHODS In a controlled, semi-court laboratory setting, 14 elite male junior players served eight flat first serves to a target field directed to the receiver's body from both service positions in a matched and counterbalanced order. An 8-camera-Vicon-System was used to capture the 3D-landmark trajectories. RESULTS The mean service velocity was found to be similar on both sides (D: 151.4 ± 19.8 vs. AD: 150.5 ± 19.4 km/h), while multiple characteristics of the serve and ball kinematics differed significantly (p < .05). At starting, the front-foot angle relative to the baseline (D: 39.7±17.6° vs. AD: 31.1±17.4°) and lateral distance between the feet (D: 16.3 ± 12.9 cm vs. AD: 26.2 ± 11.9 cm) were significantly different. During the service, upper torso range of motion from maximum clockwise rotation until impact was significantly greater on the deuce court (D: 130.5 ± 19.8° vs. AD: 126.7 ± 21.1°). This was especially pronounced in foot-back technique players. Further, differences in the lateral ball impact location (D: 30.0 ± 24.1 cm vs. AD: 10.3 ± 23.3 cm) were observed. CONCLUSIONS Changing the service side affects the serve and ball kinematics in elite junior tennis players. Our results underline biomechanical differences regarding the starting position (feet and upper torso) as well as the movement and ball kinematics which could be relevant for skill acquisition, injury prevention and performance enhancement.
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Affiliation(s)
- Janina Fett
- Department of Training & Exercise Science, Faculty of Sport Science, Ruhr University Bochum, Bochum, Germany
| | - Nils Oberschelp
- Department of Training & Exercise Science, Faculty of Sport Science, Ruhr University Bochum, Bochum, Germany
| | - Jo-Lâm Vuong
- Department of Training & Exercise Science, Faculty of Sport Science, Ruhr University Bochum, Bochum, Germany
| | - Thimo Wiewelhove
- Department of Training & Exercise Science, Faculty of Sport Science, Ruhr University Bochum, Bochum, Germany
| | - Alexander Ferrauti
- Department of Training & Exercise Science, Faculty of Sport Science, Ruhr University Bochum, Bochum, Germany
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Patel H, Lala S, Helfner B, Wong TT. Tennis overuse injuries in the upper extremity. Skeletal Radiol 2021; 50:629-644. [PMID: 33009583 DOI: 10.1007/s00256-020-03634-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 09/26/2020] [Accepted: 09/27/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Tennis is a popular sport with high levels of participation. This article aims to describe how upper extremity overuse injuries occur in relation to tennis biomechanics and to review their imaging characteristics and implications for management. In particular, we will review the imaging patterns of internal impingement, scapular dyskinesis, lateral and medial epicondylitis, ulnar collateral ligament insufficiency, valgus extension overload, capitellar osteochondritis dissecans, extensor carpi ulnaris tendinosis and instability, tenosynovitis, triangular fibrocartilage complex injuries, and carpal stress injuries. CONCLUSION Tennis is a complex and physically demanding sport with a wide range of associated injuries. Repetitive overloading commonly leads to injuries of the upper extremity. An understanding of the underlying mechanisms of injury and knowledge of these injury patterns will aid the radiologist in generating the correct diagnosis in both the professional and recreational tennis athlete.
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Affiliation(s)
- Hanisha Patel
- New York Presbyterian Hospital - Columbia University Medical Center, 622 W 168th Street, New York, NY, 10032, USA.
| | - Sonali Lala
- Division of Musculoskeletal Radiology, New York Presbyterian Hospital - Columbia University Medical Center, 622 W 168th Street, New York, NY, 10032, USA
| | - Brett Helfner
- Zwanger and Pesiri Radiology, 150 Sunrise Hwy, Lindenhurst, New York, NY, 11757, USA
| | - Tony T Wong
- Division of Musculoskeletal Radiology, New York Presbyterian Hospital - Columbia University Medical Center, 622 W 168th Street, New York, NY, 10032, USA
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Šlosar L, de Bruin ED, Fontes EB, Plevnik M, Pisot R, Simunic B, Marusic U. Additional Exergames to Regular Tennis Training Improves Cognitive-Motor Functions of Children but May Temporarily Affect Tennis Technique: A Single-Blind Randomized Controlled Trial. Front Psychol 2021; 12:611382. [PMID: 33790833 PMCID: PMC8005621 DOI: 10.3389/fpsyg.2021.611382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 02/23/2021] [Indexed: 12/23/2022] Open
Abstract
This study evaluated the effects of an exergame program (TennisVirtua-4, Playstation Kinect) combined with traditional tennis training on autonomic regulation, tennis technique, gross motor skills, clinical reaction time, and cognitive inhibitory control in children. Sixty-three children were randomized into four groups (1st - two exergame and two regular trainings sessions/week, 2nd - one exergame and one regular training sessions/week, 3rd - two regular trainings sessions/week, and 4th - one regular training session/week) and compared at baseline, 6-month immediately post intervention and at 1-year follow-up post intervention. At 6-month post intervention the combined exergame and regular training sessions revealed: higher breathing frequency, heart rate (all ps ≤ 0.001) and lower skin conductance levels (p = 0.001) during exergaming; additional benefits in the point of contact and kinetic chain elements of the tennis forehand and backhand technique (all ps ≤ 0.001); negative impact on the shot preparation and the follow-through elements (all ps ≤ 0.017); higher ball skills (as part of the gross motor skills) (p < 0.001); higher percentages of clinical reaction time improvement (1st -9.7% vs 3rd group -7.4% and 2nd -6.6% vs 4th group -4.4%, all ps ≤ 0.003) and cognitive inhibitory control improvement in both congruent (1st -20.5% vs 3rd group -18.4% and 2nd -11.5% vs 4th group -9.6%, all ps ≤ 0.05) and incongruent (1st group -19.1% vs 3rd group -12.5% and 2nd group -11.4% vs 4th group -6.5%, all ps ≤ 0.001) trials. The 1-year follow-up test showed no differences in the tennis technique, clinical reaction time and cognitive inhibitory control improvement between groups with the same number of trainings per week. The findings support exergaming as an additional training tool, aimed to improve important cognitive-motor tennis skills by adding dynamics to the standardized training process. Caution should be placed to planning this training, e.g., in a mesocycle, since exergaming might decrease the improvement of specific tennis technique parts of the trainees. (ClinicalTrials.gov; ID: NCT03946436).
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Affiliation(s)
- Luka Šlosar
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
| | - Eling D de Bruin
- Institute of Human Movement Sciences and Sport, Department Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Eduardo Bodnariuc Fontes
- Research Group in Physical Activity, Cognition and Behavior, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Matej Plevnik
- Department of Kinesiology, Faculty of Health Sciences, University of Primorska, Izola, Slovenia
| | - Rado Pisot
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
| | - Bostjan Simunic
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
| | - Uros Marusic
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia.,Department of Health Sciences, Alma Mater Europaea - ECM, Maribor, Slovenia
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Vitale K, Liu S. Pickleball: Review and Clinical Recommendations for this Fast-growing Sport. Curr Sports Med Rep 2021; 19:406-413. [PMID: 33031206 DOI: 10.1249/jsr.0000000000000759] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Pickleball is a single or doubles volley sport played with paddles and ball on a hardcourt. Growing in popularity in recent years, injuries can occur similar to racquet sports; however, there is a scarcity of references in the literature for sports medicine providers encountering these athletes and injuries. This review provides clinicians treating pickleball athletes with an overview of the sport, a case study demonstrating the significant injuries that can occur in pickleball, and a review of the available literature. We provide a discussion on common pickleball injuries, injury prevention strategies, and event coverage recommendations to better equip sports medicine providers with a base of knowledge and a clinical approach to treat these athletes, or "picklers," who enjoy this fast-growing sport.
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Affiliation(s)
- Kenneth Vitale
- Department of Orthopedic Surgery, Division of Sports Medicine, University of California San Diego School of Medicine, La Jolla, CA
| | - Steven Liu
- School of Medicine, Eastern Virginia Medical School, Norfolk, VA
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Shannon N, Cable B, Wood T, Kelly J. Common and Less Well-known Upper-limb Injuries in Elite Tennis Players. Curr Sports Med Rep 2021; 19:414-421. [PMID: 33031207 DOI: 10.1249/jsr.0000000000000760] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
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.
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Affiliation(s)
| | - Brian Cable
- Clinical Orthopaedic Surgery, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA
| | - Timothy Wood
- Clinical Orthopaedic Surgery, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA
| | - John Kelly
- Clinical Orthopaedic Surgery, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA
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Roy V, Lee L, Uihlein M, Roy I, Lee K. Ultrasonographic comparison of the lateral epicondyle in wheelchair-user (and able-bodied) tennis players: A pilot study. J Spinal Cord Med 2021; 44:29-36. [PMID: 30994414 PMCID: PMC7919900 DOI: 10.1080/10790268.2019.1603898] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Objective: To evaluate whether manual wheelchair use and wheelchair tennis are associated with increased risk of lateral epicondylosis (LE). We hypothesized that the prevalence of LE would be highest in WC tennis players, followed by tennis players, WC users, and able-bodied subjects.Study design: Prospective cross-sectional pilot study.Setting: Milwaukee VAMC (clinic), National Veterans Wheelchair Games 2016 (medical event coverage).Participants: Wheelchair users, able-bodied controls, tennis players, non-tennis players.Interventions: Subjects meeting inclusion criteria underwent ultrasound examination of the dominant elbow evaluating for characteristics of LE (n = 83).Outcome measurements: Prevalence of LE between groups. Statistical analysis included odds ratios (OR), univariate and multivariate logistic regression.Results: There was no significant difference in diagnosis of LE between groups when comparing prevalence, unadjusted odds ratios, and predicted probabilities. When adjusted for age, able-bodied controls and tennis players had a similar increase in probability of LE with age; this effect was not seen for wheelchair users. Wheelchair users diagnosed with LE on US had spent significantly more time in a wheelchair (23 vs 13 years) than those with a negative diagnosis.Conclusions: Tennis playing in able bodied controls did not increase risk of LE. In wheelchair users, tennis playing does not appear to be associated with LE, though duration of wheelchair use appears to be a significant predictor of LE.Level of evidence: Level II.
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Affiliation(s)
- Vivian Roy
- Department of Physical Medicine & Rehabilitation, Medical College of Wisconsin, Milwaukee, Wisconsin, USA,Division of Spinal Cord Injury, Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin, USA,Correspondence to: Vivian Roy, Department of Physical Medicine & Rehabilitation, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Leah Lee
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Michael Uihlein
- Department of Physical Medicine & Rehabilitation, Medical College of Wisconsin, Milwaukee, Wisconsin, USA,Division of Spinal Cord Injury, Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin, USA
| | - Ishan Roy
- Department of Physical Medicine & Rehabilitation, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Kenneth Lee
- Department of Physical Medicine & Rehabilitation, Medical College of Wisconsin, Milwaukee, Wisconsin, USA,Division of Spinal Cord Injury, Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin, USA
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Abstract
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.
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Affiliation(s)
- Rami G. Alrabaa
- Department of Orthopedic Surgery, Columbia University Medical Center, 622 W 168th Street, PH-11, New York, NY 10032 USA
| | - Mario H. Lobao
- Department of Orthopedic Surgery, Columbia University Medical Center, 622 W 168th Street, PH-11, New York, NY 10032 USA
| | - William N. Levine
- Department of Orthopedic Surgery, Columbia University Medical Center, 622 W 168th Street, PH-11, New York, NY 10032 USA
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Lubis AMT, Wisnubaroto RP, Ilyas EI, Ifran NNPPS. Glenohumeral internal rotation deficit in non-pitcher overhead athletic athletes: case series analysis of ten athletes. Ann Med Surg (Lond) 2020; 58:138-142. [PMID: 32983434 PMCID: PMC7493035 DOI: 10.1016/j.amsu.2020.08.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/21/2020] [Accepted: 08/21/2020] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND The glenohumeral internal rotation deficit (GIRD) is diagnosed when there is a loss of 20° of internal rotation compared to the contralateral shoulder. This condition has already been well described in a group of throwing athletes, i.e. baseball pitchers. However, athletic athletes such as javelin throwers, discus throwers, hammer throwers, shot putters may also be susceptible to this condition. Reports are lacking to recognize these symptoms as GIRD for these group of athletes. We aim to evaluate these subgroups of athletes for the possibility of GIRD. MATERIALS AND METHODS We examined ten athletes (javelin, hammer throwers, and shot putters) for signs of GIRD. Signs of loss of internal rotation were assessed by measuring shoulder range of motion (internal rotation and external rotation) in supine position and posterior shoulder tightness test. Complaints of shoulder pain, evidence of scapular malposition, inferior medial border prominence, coracoid pain and malposition, and dyskinesis of scapular movement (SICK) scapula, posterior shoulder flexibility test were examined. RESULTS The athletes had a mean training period of 3.8 years. One athlete had complaints of mild pain on their dominant shoulder. Two athletes had GIRD (20° and 25°) with no posterior shoulder tightness. Three athletes had posterior shoulder tightness, but normal total shoulder ROM (195°, 180°, and 185°). Three athletes had increased external rotation (105°, 100°, 125°). No subjects had scapular dyskinesia nor SICK scapula syndrome. All athletes had normal total shoulder ROM. CONCLUSION Glenohumeral internal rotation deficit could be present in non-pitcher overhead athletics athletes.
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Affiliation(s)
- Andri MT. Lubis
- Department of Orthopaedic & Traumatology, Faculty of Medicine Universitas Indonesia, Jakarta, 10430, Indonesia
- Department of Orthopaedic & Traumatology, Cipto Mangunkusumo General Hospital, Jakarta, 10430, Indonesia
| | - Rizky P. Wisnubaroto
- Department of Orthopaedic & Traumatology, Faculty of Medicine Universitas Indonesia, Jakarta, 10430, Indonesia
- Department of Orthopaedic & Traumatology, Cipto Mangunkusumo General Hospital, Jakarta, 10430, Indonesia
| | - Ermita I. Ilyas
- Department of Physiology, Faculty of Medicine, Universitas Indonesia, Central Jakarta, Jakarta, 10430, Indonesia
| | - Nadia NPPS. Ifran
- Department of Orthopaedic & Traumatology, Faculty of Medicine Universitas Indonesia, Jakarta, 10430, Indonesia
- Department of Orthopaedic & Traumatology, Cipto Mangunkusumo General Hospital, Jakarta, 10430, Indonesia
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Acquaye G, Quartey J, Kwakye S. Pattern of injuries amongst tennis players in Accra, Ghana. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2020; 76:1429. [PMID: 32832711 PMCID: PMC7433294 DOI: 10.4102/sajp.v76i1.1429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 05/12/2020] [Indexed: 11/17/2022] Open
Abstract
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.
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Affiliation(s)
| | - Jonathan Quartey
- Department of Physiotherapy, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana
| | - Samuel Kwakye
- Physiotherapy Unit, Medical Department, West African Football Academy, Sogakope, Ghana
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Berardi M, Lenabat P, Fabre T, Ballas R. Beach tennis injuries: a cross-sectional survey of 206 elite and recreational players. PHYSICIAN SPORTSMED 2020; 48:173-178. [PMID: 31356120 DOI: 10.1080/00913847.2019.1650307] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Objectives: Although a million people regularly play beach tennis (BT) through the world there is no published information on BT injuries. The aim of this study was to describe the epidemiology of BT injuries, and to identify differences between injured and non-injured players.Methods: This was a retrospective cross-sectional epidemiology study of 206 BT players from Réunion Island describing the injuries occurring in BT. A questionnaire was developed to capture the type and chronicity of the injuries they had suffered over the prior three years. Comparisons were made between elite, regional and recreational players.Results: There were 178 injuries in 92 players (44.7%), which was an incidence of 1.81 injuries per 1000 hours of play. There were 77 acute injuries (23.8% of players, incidence of 0.78 injuries/1000 hrs.) and 101 chronic injuries (30.6% of players, incidence of 1.03 injuries/1000 hrs.). The shoulder was the most frequently injured area. The main upper limb injuries were chronic tendinopathy while most acute injuries occurred in the lower limbs. The incidence of lateral epicondylitis at the elbow was 0.36 per 1000 hours of play, or a prevalence of 4.2%. The incidence of injuries in elite players was less than that in non-ranked players (1.71 vs 2.04 injuries/1000 hours play). Recreational players more often had chronic injuries (p < 0.001).Conclusion: Information about musculoskeletal injuries is invaluable for healthcare professionals involved in the care of athletes. Such knowledge can be used to guide the medical surveillance of athletes and to help develop injury prevention strategies.
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Affiliation(s)
- Marco Berardi
- Service de médecine, Centre Hospitalier Robert Boulin, Libourne, France
| | - Pascal Lenabat
- Service de médecine du sport, Centre Hospitalier Gabriel Martin, Saint Paul, France
| | - Thierry Fabre
- Service de chirurgie orthopédique et traumatologie, CHU Bordeaux, Bordeaux Cedex, France
| | - Richard Ballas
- Service de chirurgie orthopédique, Centre Hospitalier Gabriel Martin, Saint Paul, France
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Shafiee E, Farzad M, Macdermid J, Smaeel Beygi A, Vafaei A, Farhoud A. Cross-cultural adaptation and measurement properties of the Patient-Rated Tennis Elbow Evaluation for the Persian language. HAND THERAPY 2020. [DOI: 10.1177/1758998320910177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Introduction The Patient-Rated Tennis Elbow Evaluation (PRTEE) questionnaire is a tool designed for self-assessment of forearm pain and disability in patients with tennis elbow. The aims of this study were to translate and cross-culturally adapt the PRTEE questionnaire into Persian and evaluate its reliability and construct validity. Methods The PRTEE questionnaire was translated into and cross-culturally adapted to Persian in 90 consecutive patients with tennis elbow, according to well-established guidelines. Reliability was tested by means of test–retest and internal consistency. The measurement error was measured by calculating the standard error of measurement. Based on the standard error of measurement, the minimum detectable change was calculated. To evaluate construct and convergent validity, correlation with the PRTEE with the Disabilities of the Arm, Shoulder and Hand questionnaire and Visual analogue scale was used. Results In the process of cross-cultural adaptation, two items (6 and 8) were modified. In item 6, the term “door knob” was changed to “turn a key”, and in the item 8, “cup of coffee” was changed to “cup of milk”. Item-total correlations were greater than 0.55 (ranged from 0.55 to 0.76), internal consistency was high (Cronbach’s alpha, 0.94) and a high intraclass correlation coefficient (0.98) indicated excellent reliability of the P-PRTEE. The standard error of measurement and minimum detectable change were 5.40 and 14.24, respectively. The Persian version of the PRTEE questionnaire (P-PRTEE) shows strong construct and convergent validity ( r values = 0.85, p < 0.05). Conclusions The P-PRTEE is valid and reliable in assessing disability and pain in Persian patients with tennis elbow. The excellent psychometric properties of the P-PRTEE endorse the use of this questionnaire in clinical settings.
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Affiliation(s)
- Erfan Shafiee
- Physical Therapy and Surgery, Western University, London, Ontario
- Occupational therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Maryam Farzad
- Physical Therapy and Surgery, Western University, London, Ontario
- Clinical Research Lab, Hand and Upper Limb Centre, St. Joseph’s Health Centre, London, Ontario
- Occupational therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Joy Macdermid
- Physical Therapy and Surgery, Western University, London, Ontario
- Clinical Research Lab, Hand and Upper Limb Centre, St. Joseph’s Health Centre, London, Ontario
- Rehabilitation Science, McMaster University, Hamilton, Ontario
| | - Amirreza Smaeel Beygi
- Occupational therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Atefeh Vafaei
- Occupational therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Amirreza Farhoud
- Imam Hospital Complex, Tehran University of Medical Sciences, Joint Reconstruction Center, Tehran, Iran
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Vincent HK, Vincent KR. Rehabilitation and Prehabilitation for Upper Extremity in Throwing Sports: Emphasis on Lacrosse. Curr Sports Med Rep 2019; 18:229-238. [PMID: 31385839 DOI: 10.1249/jsr.0000000000000606] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
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.
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Affiliation(s)
- Heather K Vincent
- Department of Orthopaedics and Rehabilitation, UF Health Sports Performance Center, University of Florida, Gainesville, FL
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George A, Saltzman MD, Hsu WK. The Effect of an Arthroscopic Orthopaedic Procedure on a Professional Tennis Player's Career. Cureus 2019; 11:e5654. [PMID: 31720133 PMCID: PMC6822996 DOI: 10.7759/cureus.5654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Orthopaedic injuries can significantly impact the careers of professional tennis players. It is currently unknown how professional tennis players fare after arthroscopic surgery. For the purpose of this study, players ranked in the Association of Tennis Professionals (ATP) and Women’s Tennis Association (WTA) who underwent arthroscopic surgery of any joint between 1996 and 2016 were identified through a well-established, previously published protocol of injury reports and public archives. Performance statistics both before and after surgery, time to return (TTR) to play, and career length following surgery were collected for each player. Statistical analysis was performed with significance accepted at a probability value (p) of <0.05. A total of 55 (39 males and 16 females) players met the inclusion criteria (shoulder, n = 15; elbow, n = 15; wrist, n = 13; hip, n = 12). The average age of the players at the time of surgery was 25.8 (±4) years, and the average career length before surgery was 8.4 (±4) years. Tennis players who underwent arthroscopic shoulder surgery experienced a longer TTR to play (279 days, p <0.01), as well as a greater decline in their rankings, both in the first and second years postoperatively (p <0.01 and p = 0.01, respectively), compared to all other surgical cohorts. Players who underwent surgery on the elbow, wrist, and hip had no significant decline in the ranking by the second postoperative year. There were no significant differences between genders. This study represents the largest database of professional tennis players who have undergone arthroscopic surgery and may allow physicians to provide evidence-based recommendations about expectations after surgical treatment.
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Affiliation(s)
- Andrew George
- Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Matthew D Saltzman
- Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Wellington K Hsu
- Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, USA
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Confino J, Irvine JN, O'Connor M, Ahmad CS, Lynch TS. Hip Injuries in Overhead Athletes. OPER TECHN SPORT MED 2019. [DOI: 10.1053/j.otsm.2019.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Minghelli B, Cadete J. Epidemiology of musculoskeletal injuries in tennis players: risk factors. J Sports Med Phys Fitness 2019; 59:2045-2052. [PMID: 31311243 DOI: 10.23736/s0022-4707.19.09842-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Tennis practice involves repetitive stresses through several strokes and movements during several hours. These factors can lead to injuries on musculoskeletal structures. This study aims to determine injury epidemiology in tennis players, as well as their type, location, mechanism of injury and risk factors. METHODS The sample was constituted by 218 tennis athletes, aged 9 to 72, being 156 (71.6%) male. The measurement instrument was a questionnaire concerning characterization of the population, and aspects related to the modality and injuries. RESULTS 86 athletes (39.4%) referred having an injury in a 12-month period, totalizing 107 injuries, and 76 athletes (34.9%) in a 6-month period, totalizing 95 injuries. There were 3.49 injuries per 1000 hours of tennis training. The most common injuries were joint injuries (29.5%), following by tendinopathy (22.1%), located in the ankle (20%) and wrist (15.8%), both occurred by service (23.2%). Tennis athletes who trained three times or more per week had 2.29 higher probability of injury (95% CI: 1.28-4.13; P=0.006), those who trained more than 4.5 hours per week had 2.04 more chances (95% CI: 1.16-3.60; P=0.013), those who were elite tennis players had 2.81 more chances (95% CI: 1.41-5.59; P=0.003), and those who trained on a clay court more frequently, had 4.11-fold higher probability of injury (95% CI: 1.46-11.55; P=0.007). CONCLUSIONS In the analyzed sample, data revealed a high prevalence of injuries in tennis athletes, being joint injuries the most common type of injuries, and the most affected body area were the ankle and the wrist.
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Affiliation(s)
- Beatriz Minghelli
- Research Unit in Education and Community Intervention (RECI), Jean Piaget Algarve School of Health, Piaget Institute, Lisbon, Portugal -
| | - Jéssica Cadete
- Jean Piaget Algarve School of Health, Piaget Institute, Lisbon, Portugal
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Abstract
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.
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Affiliation(s)
- Joseph A Gil
- Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN, 55901, USA
| | - Sanjeev Kakar
- Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN, 55901, USA.
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Eriksrud O, Ghelem A, Cabri J. Isokinetic strength training of kinetic chain exercises of a professional tennis player with a minor partial internal abdominal oblique muscle tear - A case report. Phys Ther Sport 2019; 38:23-29. [PMID: 31039484 DOI: 10.1016/j.ptsp.2019.04.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 04/13/2019] [Accepted: 04/19/2019] [Indexed: 11/30/2022]
Abstract
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).
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Affiliation(s)
- Ola Eriksrud
- Department of Physical Performance, Norwegian School of Sports of Sciences, Oslo, Norway.
| | | | - Jan Cabri
- Department of Physical Performance, Norwegian School of Sports of Sciences, Oslo, Norway
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44
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Pirruccio K, Weltsch D, Baldwin KD. Kickball and Its Underappreciated Pediatric Injury Burden: An 18-Year Retrospective Epidemiological Study. Orthop J Sports Med 2019; 7:2325967119835894. [PMID: 31044142 PMCID: PMC6446429 DOI: 10.1177/2325967119835894] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background: Kickball is a popular childhood game most frequently played during gym class or recess at schools throughout the United States (US). Despite this, the national health burden of injuries associated with kickball has never been explored in the US pediatric population. Purpose: To report national estimates and demographic characteristics of pediatric patients presenting to US emergency departments between 2000 and 2017 with kickball-associated injuries. Study Design: Descriptive epidemiology study. Methods: This study retrospectively analyzed the National Electronic Injury Surveillance System (NEISS) database (2000-2017) to identify annual cases of injuries associated with playing kickball presenting to US emergency departments in the pediatric population (age ≤18 years). Results: On average, 10,644 (95% CI, 8671-12,618) pediatric kickball-associated injuries presented to US emergency departments each year. There was no significant change in the number of injuries between the years 2000 (n = 10,331; 95% CI, 7781-12,881) and 2017 (n = 9407; 95% CI, 7233-11,582) (P = .64). Patients frequently sustained sprains, strains, or muscle tears (34.4%; 95% CI, 32.4%-36.5%) and fractures (24.8%; 95% CI, 23.1%-26.5%); these injuries most commonly affected the ankle (13.7%; 95% CI, 12.2%-15.2%) and the fingers of the hand (17.1%; 95% CI, 15.5%-18.7%). The greatest proportion of injuries occurred in male patients (60.7%; 95% CI, 58.7%-62.7%) who were 10 to 12 years of age (44.8%; 95% CI, 43.0%-46.6%), with over half of kickball-associated injuries occurring at school (54.1%; 95% CI, 50.7%-57.5%). Conclusion: Despite kickball’s ubiquity as a schoolyard game, its associated injuries remain largely underappreciated. This is particularly unjustified when considering that the annual pediatric injury burden associated with playing kickball surpasses that of other sports acknowledged as carrying a high injury risk, such as martial arts or tennis.
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Affiliation(s)
- Kevin Pirruccio
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Daniel Weltsch
- Division of Orthopaedics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Orthopaedic Surgery, The Chaim Sheba Medical Center at Tel Hashomer affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Keith D Baldwin
- Division of Orthopaedics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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45
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Williams K, Hebron C. The immediate effects of serving on shoulder rotational range of motion in tennis players. Phys Ther Sport 2018; 34:14-20. [DOI: 10.1016/j.ptsp.2018.08.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 08/13/2018] [Accepted: 08/14/2018] [Indexed: 10/28/2022]
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46
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Šlosar L, Šimunič B, Pišot R, Marusic U. Validation of a Tennis Rating Score to evaluate the technical level of children tennis players. J Sports Sci 2018; 37:100-107. [PMID: 29893161 DOI: 10.1080/02640414.2018.1483184] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The purpose of this study was to create a valid and reliable assessment scale for the evaluation of three basic tennis strokes (forehand, backhand, serve) for 6-12-year-old tennis players, named the Tennis Rating Score for Children (TRSC). Altogether 60 players (21: forehand, 22: backhand, 17: serve) were video recorded (30 frames per second) while performing three main tennis strokes and later evaluated using the TRSC by five tennis trainers at Day 1 and Day 7. Agreement between days and raters was examined using the intraclass correlation coefficients (ICC). A Pearson's correlation was calculated to determine convergent validity (score related to participant's level of experience). The reliability between raters was very high for all three main strokes (ICCFOREHAND = 0.874; ICCBACKHAND = 0.877; ICCSERVE = 0.877). The intra-rater test-retests ICCs were also very high (ICCFOREHAND = 0.885; ICCBACKHAND = 0.891; ICCSERVE = 0.887). A large (rFOREHAND = 0.660) and very large (rBACKHAND = 0.730; rSERVE = 0.772) Pearson's correlations were found between all the ratings and the level of experience. The TRSC is shown to be highly reliable and valid when assessing technical skills in novice players, when compared to actual assessment from coaching experts; this tool may be helpful for tennis coaches to make a more objective diagnostic of the technical level of young tennis players.
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Affiliation(s)
- Luka Šlosar
- a Applied Kinesiology, Faculty of Health Sciences , University of Primorska , Koper , Slovenia
| | - Boštjan Šimunič
- b Institute for Kinesiology Research , Science and Research Centre Koper , Koper , Slovenia
| | - Rado Pišot
- b Institute for Kinesiology Research , Science and Research Centre Koper , Koper , Slovenia.,c Faculty of Sport , University of Ljubljana , Ljubljana , Slovenia
| | - Uros Marusic
- b Institute for Kinesiology Research , Science and Research Centre Koper , Koper , Slovenia.,d Department of Health Sciences , Alma Mater Europaea - ECM , Maribor , Slovenia
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47
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Johnson JE, Fullmer JA, Nielsen CM, Johnson JK, Moorman CT. Glenohumeral Internal Rotation Deficit and Injuries: A Systematic Review and Meta-analysis. Orthop J Sports Med 2018; 6:2325967118773322. [PMID: 29845083 PMCID: PMC5967160 DOI: 10.1177/2325967118773322] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background: There is an association between throwing activity and glenohumeral internal rotation deficit (GIRD). An 18° to 20° deficit has been adopted as the standard definition of pathological GIRD, but specific findings as to how GIRD relates to an injury are inconsistent. Purpose: To systematically review the literature to clarify the definition of GIRD diagnosis for adolescent and adult overhead athletes and to examine the association between GIRD and an increased risk of injuries in these athletes. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review of the literature was performed. Observational studies comparing glenohumeral internal rotation range of motion (ROM) in injured and uninjured overhead athletes were included for the meta-analysis. Studies of adolescent and adult athletes were analyzed separately. ROM was compared for the injured and uninjured groups, and a weighted mean GIRD was estimated. To account for potential heterogeneity across studies, both fixed- and random-effects models were used to calculate a standardized mean difference (SMD). Results: Nine studies of level 3 or 4 evidence were included. From these, 12 study groups (4 adolescent, 8 adult) comprising 819 overhead athletes (226 injured, 593 uninjured) were included in the meta-analysis. The estimated SMD in GIRD between the injured and uninjured groups was 0.46 (95% CI, 0.15-0.77; P < .01) for the overall sample. The between-group effect was larger for adults (SMD, 0.60 [95% CI, 0.18 to 1.02]; P < .01) than adolescents (SMD, 0.20 [95% CI, –0.24 to 0.63]; P = .13). The weighted mean GIRD for the injured and uninjured groups was 13.8° ± 5.6° and 9.6° ± 3.0°, respectively, which also differed by age group. Moderate study heterogeneity was observed (I2 = 69.0%). Conclusion: Based on this systematic review, the current definition of pathological GIRD may be too conservative, and a distinct definition may be required for adolescent and adult athletes. While the results indicate a link between internal rotation deficits and upper extremity injuries in the overhead athlete, higher quality prospective research is needed to clarify the role that GIRD plays in future injuries to overhead athletes of various ages.
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Affiliation(s)
- Jordan E Johnson
- Jerry M. Wallace School of Osteopathic Medicine, Campbell University, Lillington, North Carolina, USA
| | - Joshua A Fullmer
- Jerry M. Wallace School of Osteopathic Medicine, Campbell University, Lillington, North Carolina, USA
| | - Chaseton M Nielsen
- Jerry M. Wallace School of Osteopathic Medicine, Campbell University, Lillington, North Carolina, USA
| | - Joshua K Johnson
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, Utah, USA
| | - Claude T Moorman
- Department of Orthopedic Surgery, Carolinas Medical Center, Charlotte, North Carolina, USA
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48
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Pas HIMFL, Bodde S, Kerkhoffs GMMJ, Pluim B, Tiemessen IJH, Tol JL, Verhagen E, Gouttebarge V. Systematic development of a tennis injury prevention programme. BMJ Open Sport Exerc Med 2018; 4:e000350. [PMID: 29719728 PMCID: PMC5926669 DOI: 10.1136/bmjsem-2018-000350] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2018] [Indexed: 12/26/2022] Open
Abstract
Introduction Despite an injury incidence of up to 3.0/1000 hours of play, there are no published tennis injury prevention programmes. This article aims to describe the developmental process of TennisReady, an e-health tennis-specific injury programme for adult recreational tennis players. Five-step approach A bottom-up, five-step approach was used with the Knowledge Transfer Scheme as a guideline. During the first step, a problem statement among targeted users was carried out. 475 (partially) completed surveys and group interviews (n=8) revealed a preference for an app-based prevention intervention of 10–15 min. As a second step, a systematic review was performed to identify prevention strategies in tennis. None were found. In step 3, during two expert group meetings (n=18), the findings of the first two steps were discussed and goals were formulated. Relevant and potential exercises for the programme were discussed. A subgroup of a total of six physical therapists, physicians and trainers developed the content of the programme in step 4. Step 5 included an evaluation of the exercises in 33 recreational tennis players. Participants evaluated the exercises during training sessions with trainers involved in the programme’s development or their colleagues. Participants evaluated the programme through standardised surveys or group interviews. Based on this evaluation, the programme was adjusted by altering exercises and frequencies, and it was evaluated in a second target group (n=27). The second evaluation did not result in any major changes to the final prevention programme. Conclusion Through a five-step approach guided by the Knowledge Transfer Scheme, we developed an e-health tennis-specific prevention programme for adult tennis players. This 10 min intervention will require testing in a randomised controlled setting.
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Affiliation(s)
- Haiko I M F L Pas
- Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam Movement Sciences, University of Amsterdam, Amsterdam, The Netherlands.,Academic Center for Evidence-Based Sports Medicine (ACES), Amsterdam, The Netherlands.,AMC/VUmc IOC Research Center, Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam, The Netherlands
| | - Stefan Bodde
- Department of Sports Medicine, Royal Netherlands Lawn Tennis Association, Amersfoort, The Netherlands
| | - Gino M M J Kerkhoffs
- Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam Movement Sciences, University of Amsterdam, Amsterdam, The Netherlands.,Academic Center for Evidence-Based Sports Medicine (ACES), Amsterdam, The Netherlands.,AMC/VUmc IOC Research Center, Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam, The Netherlands
| | - Babette Pluim
- Department of Sports Medicine, Royal Netherlands Lawn Tennis Association, Amersfoort, The Netherlands
| | | | - Johannes L Tol
- Academic Center for Evidence-Based Sports Medicine (ACES), Amsterdam, The Netherlands.,Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Evert Verhagen
- AMC/VUmc IOC Research Center, Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam, The Netherlands.,Department of Public and Occupational Health, Amsterdam Movement Sciences, VU University Medical Center Amsterdam, Amsterdam, The Netherlands.,Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa.,Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Victoria, Australia
| | - Vincent Gouttebarge
- Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam Movement Sciences, University of Amsterdam, Amsterdam, The Netherlands.,Academic Center for Evidence-Based Sports Medicine (ACES), Amsterdam, The Netherlands.,AMC/VUmc IOC Research Center, Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam, The Netherlands.,Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa.,Dutch Consumer Safety Institute, Amsterdam, The Netherlands
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49
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Lin DJ, Wong TT, Kazam JK. Shoulder Injuries in the Overhead-Throwing Athlete: Epidemiology, Mechanisms of Injury, and Imaging Findings. Radiology 2018; 286:370-387. [PMID: 29356641 DOI: 10.1148/radiol.2017170481] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The unparalleled velocity achieved by overhead throwers subjects the shoulder to extreme forces, resulting in both adaptive changes and pathologic findings that can be detected at imaging. A key biomechanical principle of throwing is achieving maximum external rotation, which initially leads to adaptive changes that may result in a pathologic cascade of injuries. In addition to the well-established concepts of glenohumeral internal rotation deficit and internal impingement, osseous and soft-tissue injuries of the shoulder unique to overhead athletes are illustrated. The epidemiology and biomechanics of throwing injuries are reviewed, and examples from the authors' institutional experience with competitive, collegiate, and professional baseball players are provided to demonstrate the constellation of unique imaging findings seen in overhead throwing athletes. Given the widespread popularity of baseball, and other sports relying on overhead throwing motions at all playing levels from recreational to professional, it is important for radiologists in various practice settings to be familiar with the special mechanisms, locations, and types of shoulder injuries seen in the overhead throwing population. © RSNA, 2018.
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Affiliation(s)
- Dana J Lin
- From the Department of Radiology, New York-Presbyterian Hospital, Columbia University Medical Center, 622 W 168th St, MC-28, New York, NY 10032
| | - Tony T Wong
- From the Department of Radiology, New York-Presbyterian Hospital, Columbia University Medical Center, 622 W 168th St, MC-28, New York, NY 10032
| | - Jonathan K Kazam
- From the Department of Radiology, New York-Presbyterian Hospital, Columbia University Medical Center, 622 W 168th St, MC-28, New York, NY 10032
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50
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Fu MC, Ellenbecker TS, Renstrom PA, Windler GS, Dines DM. Epidemiology of injuries in tennis players. Curr Rev Musculoskelet Med 2018; 11:1-5. [PMID: 29340975 PMCID: PMC5825333 DOI: 10.1007/s12178-018-9452-9] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
PURPOSE OF REVIEW To review the recent literature regarding the epidemiology of tennis injuries at all levels of play, and to discuss recent findings in injury surveillance by the Association of Tennis Professionals (ATP). RECENT FINDINGS Following the release of a consensus statement in 2009 calling for standardized documentation and analysis of tennis-related injuries, multiple studies have been published describing longitudinal injury incidences at Grand Slam tournaments and the Davis Cup. Recent efforts by the ATP have further elucidated injury patterns on tour. There have also been recent high-quality studies on injury trends among collegiate and elite junior tennis players, bringing attention to musculoskeletal injuries and systemic illnesses that young tennis players may be susceptible to. Recent efforts in injury surveillance by the ATP and at the collegiate and junior levels have highlighted injury trends that will help guide injury prevention strategies at various levels of play.
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Affiliation(s)
- Michael C Fu
- Sports Medicine and Shoulder Service, Hospital for Special Surgery, 535 E 70th St, New York, NY, 10021, USA.
| | - Todd S Ellenbecker
- ATP World Tour and Select Physical Therapy Scottsdale Sports Clinic, Scottsdale, AZ, USA
| | | | - Gary S Windler
- South Carolina Sports Medicine & Orthopaedics Center, Charleston, SC, USA
| | - David M Dines
- Sports Medicine and Shoulder Service, Hospital for Special Surgery, 535 E 70th St, New York, NY, 10021, USA
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