The demands that
are placed on young competitive tennis players can result in
various forms of injury. The concept of rehabilitation is often
over looked when dealing with developing athletes because of
their incredible ability to heal quickly and adapt to the increasing
demands placed upon them. The fact remains that these young
athletes can also suffer from overuse injuries as a result of
the repeated overhead strokes unique to the sport. The overloading
of soft tissues, especially when the athlete is still growing,
can lead to a number of problems. It should be noted that the
onset of injury can start many months or even years before the
symptoms appear.
Regardless of age,
one of the weakest links limiting tennis players involves the
shoulder joint. This joint is referred to as a “ball and
socket” that is able to move in many different directions
allowing such motions as a tennis serve to occur. The requirements
on the surrounding muscles and ligaments to control the motion
at the shoulder and still produce the necessary force and power
wanted in a competitive serve are quite high. In developing
tennis players, there is often an imbalance between stability
and strength of the shoulder muscles. This can result in unfavorable
changes with the positioning of the entire shoulder girdle and
upper limb, thus predisposing the athlete to injury. The most
common musculoskeletal problems associated with the upper extremity
in young tennis players include:
• forward displacement of
the shoulder joint (head of the humerus/upper arm bone; shoulder
blade) can result in constant irritation and swelling of muscle
attachments (tendons) which can cause severe pain and discomfort
• decreased range of motion of the shoulder and arm can
prevent a fluid overhead service motion in turn causing the athlete
to compensate with altered biomechanics; either towards the body
(internal rotation) limiting the follow through, or instability
of the shoulder with the arm moving away from the body (external
rotation) limiting the cocking phase of a serve
• the above two problems
can occur secondary to a pre-existing weakness of the rotator
cuff muscles which hold the head of the upper arm bone into the
joint capsule, or weakness of the muscles that stabilize the shoulder
blade against the rib cage
• poor posture: head forward
and a rounded upper back can lead to degeneration of the joints
in the spine, neck and back pain
• weak grip strength of
the forearm muscles can decrease the athletes ability to control
racquet speed, generate power or absorb vibration from the tennis
ball
The most effective rehabilitation
will focus on correcting the root of the problem and not just
alleviating the symptoms. After pain and swelling are under control,
treatment should include a relevant stretching and strengthening
protocol. Considering the musculoskeletal problems listed above,
appropriate treatment goals would include:
• stretching out tight structures
in the back of the shoulder (posterior capsule of the joint) to
allow for proper alignment and greater range of motion in the
joint
• strength training to improve
endurance of the rotator cuff muscles which are responsible for
maintaining stability and proper alignment of the shoulder joint;
and increasing power, the amount of force the surrounding muscles
can generate during a tennis serve
• sport-specific exercises
incorporating various skills required during a tennis match, with
progressions at a pace that is appropriate for each individual
athlete
Recognition of the common musculoskeletal
problems that young competitive tennis players are faced with
is a key step in the prevention of serious injury and the promotion
of a long and successful tennis career. Club Physio Plus is working
in conjunction with the Ontario Racquet Club Tennis Academy to
develop a strategy that focuses on monitoring and maximizing the
pre- and post-season functional status of their elite amateur
tennis players.
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