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

Background

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

Purpose

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

Study Design

Descriptive epidemiology study.

Methods

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

Results

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

Conclusion

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

Effects of physical training programs on female tennis players' performance: a systematic review and meta-analysis

Background: Tennis is among the world's most popular and well-studied sports. Physical training has commonly been used as an intervention among athletes. However, a comprehensive review of the literature on the effects of physical training programs on female tennis players' performance is lacking. Therefore, this systematic review and meta-analysis aimed to determine the effects of physical training on performance outcomes in female tennis players. Methods: A comprehensive search was conducted on Web of Science, PubMed, SPORTDicus, Scopus, and CNKI from inception until July 2023 to select relevant articles from the accessible literature. Only controlled trials were included if they examined the effects of physical training on at least one measure of tennis-specific performance in female tennis players. The Cochrane RoB tool was employed to assess the risk of bias. The CERT scale was used to examine the quality of program information. The GRADE approach was adopted to evaluate the overall quality of the evidence. The Comprehensive Meta-Analysis software was used for the meta-analysis. Results: Nine studies were selected for the systematic review and seven for the meta-analysis, totaling 222 individuals. The study's exercise programs lasted 6-36 weeks, with training sessions ranging from 30 to 80 min, conducted one to five times per week. Muscle power (ES = 0.72; p = 0.003), muscle strength (ES = 0.65; p = 0.002), agility (ES = 0.69; p = 0.002), serve velocity (ES = 0.72; p = 0.013), and serve accuracy (ES = 1.14; p = 0.002) demonstrated significant improvement following physical training, while no notable changes in linear sprint speed (ES = 0.63; p = 0.07) were detected. Conclusion: Although research on physical training in sports is diversified, studies on training interventions among female tennis players are scarce. This review found that existing training programs yield some favorable outcomes for female tennis players. However, further research with high methodological quality is warranted on the tailoring of specific training programs for female tennis players. There should be more consistent measuring and reporting of data to facilitate meaningful data pooling for future meta-analyses.

Internet Use Amongst Professional Tennis Players

Objective

Next to its well-known benefits, Internet may trigger harmful consequences due to its abuse, thus delineating clinical pictures that are similar to abuse disorders, such as Problematic Internet Use (PIU). The matter becomes more elusive for sportsmen, as data regarding PIU in this specific group are scarce, particularly for tennis players. Therefore, our aim was to assess the prevalence and the features of PIU in a sample of either in current activity or retired professional tennis players, as compared with healthy controls.

Method

Twenty-five professional tennis players were evaluated during two events held in two different European countries and were matched to an equal number of healthy subjects who were not performing any agonistic sport. The characteristics of Internet use were assessed by a specific instrument we developed (QUNT). Statistical analyses were carried out to evaluate both demographic and QUNT features and the possible intergroup differences.

Results

Retired athletes presented statistically significant lower scores compared to both athletes in current activity and control subjects in the "Time spent online" and in the "Addiction to pornography" domains. Athletes in current activity presented statistically significant higher scores compared to retired athletes in the "Ludopathy" and Total score domains. Male athletes had a statistically significant lower score in the "Addiction to pornography" domain compared to both female and male healthy controls.

Conclusions

Tennis players frequently indulge in the use of Internet facilities, particularly those in current activity, thus potentially being more vulnerable to PIU. Men and women seem to use Internet for different activities. The lifestyle that professional tennis players are obliged to follow might provide an explanation of our findings.

Obsessive-Compulsive and Depressive Symptoms in Professional Tennis Players

OBJECTIVE

A moderate sport activity is considered beneficial for both physical and mental health. On the contrary, different studies have shown that professional players may be more vulnerable to suffer from psychological and/or psychiatric disorders. Given the limited information available, the present study aimed to investigate the possible presence of depressive and obsessive-compulsive symptoms or disorders in a group of professional tennis players.

METHOD

Twenty-five current or former professional tennis players (18 men and 7 women; mean age ± SD: 42.32 ± 13.45 years), were recruited within the Italian Tennis Federation during an international competition and during a master meeting of coaches. They were compared with a control group, recruited from university students, doctors and nurses. All of them underwent a psychiatric interview with a structured scale and a psychopathological assessment carried out with the Mini-International Neuropsychiatric Interview (MINI), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Self Assessment Scale for Depression (SAD).

RESULTS

The Y-BOCS total and subscale scores were significantly higher in both current and past athletes than controls. Current athletes showed higher scores at Y-BOCS total, subscales and some items. The majority of the current athletes also showed superstitions and magical thinking.

CONCLUSIONS

The present study demonstrated that professional tennis players show a relevant increase of obsessive-compulsive symptoms and supertistions than controls. Interestingly, current athletes resulted more severe than past ones. Taken together, our findings support the notion that agonistic sport activities of high level require intensive training and compliance to strict daily routines that might represent a sort of vulnerability toward the onset of full-blown obsessive-compulsive disorder (as well as other disorders) in more fragile individuals. Not suprisingly, sport psychological support experts are increasingly needed.

Between-side differences in trunk rotational power in athletes trained in asymmetric sports

BACKGROUND

The asymmetric loading of trunk muscles in sports like golf or tennis may cause side-to-side imbalances in rotational muscle strength and endurance. Such imbalances may be compounded by the presence of low back pain (LBP) and related injuries. However, trunk rotational power is a better predictor of athlete performance, and therefore its ability to reveal these asymmetries/dysbalances should be investigated.

OBJECTIVE

This study compares peak and mean values of power during trunk rotations on the dominant and non-dominant side in golfers, ice-hockey players, tennis players, and an age-matched control group of fit individuals.

METHODS

Groups of 17 golfers, 17 ice-hockey players, 21 tennis players, and 39 fit individuals performed standing trunk rotations to each side with a bar weight of 5.5, 10.5, 15.5, and 20 kg placed on the shoulders. Peak power and mean power in the acceleration phase of trunk rotations were measured using the FiTRO Torso Premium system.

RESULTS

Peak power and mean power in the acceleration phase of trunk rotations were significantly higher on the dominant (D) than non-dominant (ND) side at weights of 5.5 kg (14 and 14%), 10.5 kg (17 and 14%), 15.5 kg (16 and 15%), and 20 kg (16 and 16%) in ice-hockey players, at 5.5 kg (14 and 13%), 10.5 kg (17 and 14%), and 15.5 kg (15% - only peak power) in tennis players, and at 5.5 kg (17 and 18%) and 10.5 kg (19 and 17%) in golfers. However, their values did not differ significantly at these weights (< 10%) in the age-matched control group. The D/ND ratio was the highest in ice-hockey players (1.18, 1.19), followed by golfers (1.16, 1.17) and finally tennis players (1.12, 1.16).

CONCLUSION

Taking into account significantly higher trunk rotational power on the dominant than the non-dominant side in golfers, tennis players and ice-hockey players at lower and/or higher weights and no significant side-to-side differences in a control group of fit individuals, this parameter may be considered specific to their asymmetric loading during trunk rotations. However, whether these asymmetries/dysbalances expressed by the D/ND ratio could also identify the likelihood of LBP, needs to be proven.

The Effect of Training in the Preparatory and Competitive Periods on Trunk Rotational Power in Canoeists, Ice-Hockey Players, and Tennis Players

This study evaluates changes in trunk rotational power at different weights and velocities after the preparatory and competitive periods in ice-hockey players, tennis players, and canoeists. The subjects performed trunk rotations to each side with a barbell of different weights placed on the shoulders (6, 10, 12, 16, 20, 22, and 26 kg) prior to and after 6 weeks of the preparatory period and 6 weeks of the competitive period. The results showed that mean power produced in the acceleration phase of trunk rotations increased significantly at weights from 10 to 26 kg or 6 to 26 kg after the preparatory and competitive periods in tennis players. The values obtained during trunk rotations with weights ≥12 kg also increased significantly after the preparatory period in ice-hockey players, whereas there were no significant changes after the competitive period. Similarly, the mean power during trunk rotations with weights ≥10 kg increased significantly only after the preparatory period in canoeists. Similar changes were observed for the peak power. These findings demonstrate that changes in trunk rotational power reflect the specificity of their training programs. This information may provide a basis for designing exercises focused on improvements of power produced during trunk rotations under loading conditions.

High Incidence of Infraspinatus Muscle Atrophy in Elite Professional Female Tennis Players

BACKGROUND

Isolated infraspinatus muscle atrophy is common in overhead athletes, who place significant and repetitive stresses across their dominant shoulders. Studies on volleyball and baseball players report infraspinatus atrophy in 4% to 34% of players; however, the prevalence of infraspinatus atrophy in professional tennis players has not been reported.

PURPOSE

To investigate the incidence of isolated infraspinatus atrophy in professional tennis players and to identify any correlations with other physical examination findings, ranking performance, and concurrent shoulder injuries.

STUDY DESIGN

Cross-sectional study; Level of evidence, 3.

METHODS

A total of 125 professional female tennis players underwent a comprehensive preparticipation physical health status examination. Two orthopaedic surgeons examined the shoulders of all players and obtained digital goniometric measurements of range of motion (ROM). Infraspinatus atrophy was defined as loss of soft tissue bulk in the infraspinatus scapula fossa (and increased prominence of dorsal scapular bony anatomy) of the dominant shoulder with clear asymmetry when compared with the contralateral side. Correlations were examined between infraspinatus atrophy and concurrent shoulder disorders, clinical examination findings, ROM, glenohumeral internal rotation deficit, singles tennis ranking, and age.

RESULTS

There were 65 players (52%) with evidence of infraspinatus atrophy in their dominant shoulders. No wasting was noted in the nondominant shoulder of any player. No statistically significant differences were seen in mean age, left- or right-hand dominance, height, weight, or body mass index for players with or without atrophy. Of the 77 players ranked in the top 100, 58% had clinical infraspinatus atrophy, compared with 40% of players ranked outside the top 100. No associations were found with static physical examination findings (scapular dyskinesis, ROM glenohumeral internal rotation deficit, postural abnormalities), concurrent shoulder disorders, or compromised performance when measured by singles ranking.

CONCLUSION

This study reports a high level of clinical infraspinatus atrophy in the dominant shoulder of elite female tennis players. Infraspinatus atrophy was associated with a higher performance ranking, and no functional deficits or associations with concurrent shoulder disorders were found. Team physicians can be reassured that infraspinatus atrophy is a common finding in high-performing tennis players and, if asymptomatic, does not appear to significantly compromise performance.

Hip range of motion and association with injury in female professional tennis players

BACKGROUND

Adequate hip range of motion is required for the transfer of energy from the lower to the upper extremity along the kinetic chain. Repetitive rotational stresses in the lower extremities during tennis may lead to sport-specific range of motion adaptations, which may increase the risk of injury to other joints along the kinetic chain.

PURPOSE

To assess whether such range of motion adaptations occur in the hip, and if so, to identify whether they are associated with injury.

STUDY DESIGN

Cross-sectional study; Level of evidence, 3.

METHODS

A total of 125 female professional tennis players, the majority of whom were ranked in the top 200 World Tennis Association singles rankings, underwent a comprehensive preparticipation physical health status examination. Hip range of motion was assessed using a digital inclinometer and side-to-side differences in rotational parameters calculated, and associations with previous injuries were identified.

RESULTS

A history of an abdominal strain was reported by 10% of players, and there was an association between abdominal strains and the presence of hip flexion contractures (odds ratio, 6.1; P = .006). Hip flexion contractures were bilateral in 85% of those found, affected only the nondominant side in 9%, and affected only the dominant side in 6%. We were unable to identify any specific side-to-side rotational adaptations in the dominant or nondominant hips, and no association between loss of hip range of motion and shoulder, lower back, hip, knee, or ankle injuries was found.

CONCLUSION

We report an association in female professional tennis players between abdominal strains and flexion contractures of the hip with iliopsoas tightness. We did not find evidence of specific hip adaptations in rotational range of motion. If hip flexion contractures are found on clinical examination, a stretching program may be indicated. Further studies are required to assess whether such a program can reduce the risk of abdominal injury.