Improve Tennis Performance with Chiropractic

What you need to know

Playing Surface in Tennis and Chance of Injuries

Tennis is also unique from other sports in that there is a variety of playing surfaces ranging from hard court (acrylic), clay, grass, and artificial grass. Hard court has the highest coefficient of friction and lowest shock absorption, which makes sliding much more difficult, leading to shorter stopping distances and theoretically higher peak loads . From the Davis Cup data, 75% of all injuries occurred on hard courts. Higher ball speeds on hard courts may also lead to higher forces applied on the upper extremities . Conversely, clay is considered a slower surface due to increased shock absorption and loss of ball speed. However, the lower coefficient of friction between the clay surface and the player means that sliding becomes an integral part of playing on clay, which might entail an entirely different set of stresses on the body

Sleep Deprivation in Tennis

Most adults require 7–9 h of sleep per night ; some postulate athletes may need more due to the typical intensive exercise regimen. Inadequate sleep duration in the general population has been associated with a myriad of negative health effects including neurocognitive, metabolic, immunologic and cardiovascular dysfunction . People who are sleep deprived may have impaired brain function that could affect judgment and/or decision-making during athletic performance . From a metabolic standpoint, sleep deprivation has been associated with obesity and diabetes . Sleep-deprived individuals may crave unhealthy foods and show impairments in glucose sensitivity, which may impair glycogen repletion and potentially affect appetite, food intake, and protein synthesis . Impaired sleep also negatively affects growth hormone and cortisol secretion Sleep deprivation increases pro-inflammatory cytokines, which impairs immune system function, impedes muscle recovery and repair from damage, leads to autonomic nervous system imbalance (simulating overtraining symptoms), results in slower/less accurate cognitive performance, and alters pain perception . From an athlete’s standpoint, all these metabolic pathways affected by poor sleep are very important and relevant to athletic performance. The measured physical effects of sleep deprivation include decreased running performance, decreased muscle glycogen concentration and reduced submaximal strength, isokinetic peak torque, minute ventilation, distance covered, sprint times, tennis serve accuracy, and time to exhaustion. Cognitive effects included decreased psychomotor functions, mood, and vigor (a subjective feeling of energy and enthusiasm), and increased reaction time and confusion. Restoration of sleep and sleep extension in athletes improves sprint times , tennis serve accuracy ,. Cognitive performance tasks also improved, ranging from reaction times, psychomotor vigilance tasks, alertness, vigor, and mood Unsurprisingly, improving sleep resulted in decreased fatigue and sleepiness Sleep Recommnedations 1. Don’t go to bed until you are sleepy. If you aren’t sleepy, get out of bed and do something else until you become sleepy. 2. Regular bedtime routines/rituals help you relax and prepare your body for bed (reading, warm bath, etc.). 3. Try to get up at the same time every morning (including weekends and holidays). 4. Try to get a full night’s sleep every night, and avoid naps during day if possible (if you must nap, limit to 1 h and avoid nap after 3 p.m.). 5. Use the bed for sleep and intimacy only; not for any other activities such as TV, computer or phone use, etc. 6. Avoid caffeine if possible (if must use caffeine, avoid after lunch). 7. Avoid alcohol if possible (if must use alcohol, avoid right before bed). 8. Do not smoke cigarettes or use nicotine, ever. 9. Consider avoiding high-intensity exercise right before bed (extremely intense exercise may raise cortisol, which impairs sleep). 10. Make sure bedroom is quiet, as dark as possible, and a little on the cool side rather than warm (similar to a cave). Tips and Tricks with Sleep Other ‘Tips & Tricks’ for Healthy Sleep Hygiene [67] 1. Avoid blue light emitted from screens at least 2 h before bed (smartphones, laptop, monitors). Blue light suppresses melatonin production that is needed to induce sleep. Avoid text messaging, social media, games, app use. 2. Get bright, natural light (the sun) upon awakening (the sun is ideal, but some suggest at least a 10,000 lux lamp if artificial) 3. Don’t hit the snooze button. It does not improve sleep quality. 4. If you have difficulty waking up, some suggest a dawn-simulator alarm clock. 5. If you must use your computer at night, consider installing color-adjusting and blue-light reducing software or wear blue-light blocking glasses. 6. Meditation may be helpful. Brainwave entrainment (e. g., binaural beats) is considered experimental. 7. Higher carbohydrate (namely high glycemic index foods) at night may improve sleep, as well as high protein including tryptophan. High fat intake at night may disrupt sleep. Inadequate total caloric intake during the day may impair sleep at night. 8. Topical magnesium (e. g., salt bath, topical mineral oil) or oral magnesium may help if you are deficient. 9. Melatonin naturally occurring in foods (e. g., tart cherry juice, raspberries, goji berries, walnuts, almonds, tomatoes) may potentially improve sleep, but avoid artificial melatonin supplements. 10. Don’t fall asleep to the TV. Sleep studies show you frequently wake up during the night and have poor quality sleep. 11. Herbal supplements are largely unknown with potential serious side effects, and may be on USADA-prohibited lists or result in positive banned substance test for athletes. 12. Consider reducing your fluid intake before bed so you don’t get up to go to the bathroom (only if you maintain enough hydration during the day). 13. Cooling your body temperature may improve sleep. Some suggest keeping room between 60–70 degrees; however, keep hands and feet warm (socks and gloves may help during winter months). 14. Check your mattress - it may be too old (mattresses typically last a maximum of 9–10 years) and may have allergens. 15. Recovery from exercise should not only focus on muscle recovery. Reducing mental fatigue is just as important for healthy sleep. Reduce external stressors in your life.

Upper limb Injuries in Tennis

Injuries to the shoulder joint are very frequent in professional tennis players, mainly due to the repetitive mechanical overload of the shoulder joint . Shoulder pain was present in 24% of elite tennis players from age 12–19 years, with the prevalence increasing to 50% for senior ex-professional tennis players (over 35 years old) . In throwing sports, alterations in scapular position and motor control have been reported to account 67%–100% of shoulder injuries, including rotator cuff tears, impingement, and glenohumeral instability Alterations in periscapular muscle properties could cause posterior shoulder tightness and further glenohumeral internal rotation deficit (GIRD), which has been defined as one of the most frequent rotational adaptations of the shoulder joint. GIRD has been defined as the loss in degrees of glenohumeral internal rotation of the throwing shoulder compared to the non-throwing shoulder . It is believed that GIRD is one of the risk factors behind a shoulder injury amongst tennis players . Tendinopathy was documented to be the most frequent type of injury to the wrist since tennis players add a lot of spin and speed on their strokes and wrist tendinopathy has been reported to have the highest incident rate of tendon injuries 4.2. Dyskinesia Visible alterations (winging or asymmetry) in the position and the motion of the scapula have been termed scapular dyskinesis , responsible for changes in activation of scapular stabilizing muscles . Burn and colleagues reported that overhead athletes have greater prevalence of developing scapular dyskinesis than non-overhead athletes, found to be present in 61% of overhead athletes.Research highlighted the scapular dyskinesis as a possible variable for shoulder pathology in tennis players. Tennis forehand drive might contribute to scapular dyskinesis, according to research, mainly due to scapulothoracic anterior tilt width and internal rotation observed during the follow-through phase of the forehand motion. Tennis players with scapular dyskinesis were found to have reduced subacromial space, according to a study from Silva and colleagues 3. Shoulder Rotational Properties Limited internal rotation (IR), rather than glenohumeral internal rotation deficit GIRD, was associated with shoulder pain history, duration of tennis practice, and player’s age, after comparing shoulder rotation range between professional tennis players with and without shoulder pain history . Shoulder flexibility and shoulder ROM were found to be limited according to research Common Injuries in the upper limb are : Slap Lesions ( See our sports chiropractic section for more information ) Internal or subacromial impingement Rotator Cuff Tendinopathy/tear Medial and lateral elbow tendinopathy Wrist- Carpal ligmament strain sprains.

Lower Limb Injuries in Tennis

Hip Groin Muscle Strains Knee and thigh Thigh Muscle Strain Quad muscle Dysfunction Knee ligament sprains Meniscus Tear- See our sports chiropractic section for more information Extensor tendinopathy Ankle Ankle sprain and fracture

Incidence of tennis injuries

Cardiovascular and Strength requirements for Tennis

Speed and agility Tennis players need to be exceptional movers in a linear direction, but also in lateral and multidirectional movements. A rather practical research study tested the relation between acceleration, maximum velocity, and agility in soccer players. It appears that these three variables are individual, and each specific quality is independent of the other Strength Strength is required in muscles and joints both for performance (ball velocity) enhancement and to reduce injuries (protection of joints, ligaments, tendons, and so on). Solid contact between the racket and the ball is required for optimum stroke execution, and this is influenced by grip strength. A firm wrist is necessary to prevent the racket head from straying from its intended path under the influence of high angular speeds and torques. A maximum grip strength of 600 N has been reported in elite level tennis players, as well as greater grip endurance compared with non‐players In the tennis serve, it has been shown that the greatest contribution to final speed of the racket head was, in order of importance: upper arm internal rotation, wrist flexion, upper arm horizontal adduction, forearm pronation, and forward movement of the shoulder Maintaining good form requires your chiropractic visits to focus on proper spinal and muscle hygiene that’s why we focus on proper function and posture. Flexibility Physical demands of tennis cause musculoskeletal adaptations that are sometimes positive (increased strength) and sometimes negative (decreased joint ROM and reduced muscular flexibility). These repeated demands to produce force by muscle shortening can cause a cycle of microtrauma to the tight muscle, followed by scar formation, followed by more microtrauma with continued use. These adaptations can become maladaptations, reducing joint ROM, changing biomechanical patterns, and decreasing the efficiency of force production, thus increasing the chance of injury to the muscle Tennis athletes have been shown to have a greater range of internal shoulder motion in their dominant arm than other athletes, but also have smaller range of external shoulder motion. The major reason for this is probably the repetitive service action which increases the internal ROM—a possible performance benefit So make sure you get your ROM examination on your next Chiropractic session at Health Wise Chiropractic

Performance factors related to the different tennis backhand groundstrokes

One-and two-handed backhands require different motor coordination Two-handed backhand strokes rely more on trunk rotation for racquet velocity generation, whereas one-handed backhand strokes rely more on segmental rotations of the upper limb Players using a two-handed backhand should learn early a slice one-handed backhand because of the different co-ordination pattern involved Equipment scaling is a great tool for coaches to learn early proper one-handed backhand strokes Future research related to the interaction between backhand technique, gender and skill level is needed Backhand vs Forehand: In analysing the distribution of the final strokes in a rally as a function of point outcome in elite level tennis players, Research has revealed that forehands are associated with a greater number of points won, while more points are lost with backhands played as the final shot. Interestingly, players have generally been found to serve to an opponent’s backhand more often when under pressure as it is considered the weaker side. Across all forms of competitive play, including professional tennis, backhand strokes are less frequently played than forehand strokes The degree of the shoulder and hip alignment rotation angles at the end of completion of the backswing appears to be affected by several factors such as stroke direction, height of impact, post impact ball velocity and gender. Research reported that the shoulder alignment angle was larger when playing DL than when playing CC for both BH, but that the hip alignment angle was larger only for the 2BH

How different muscles control the body in different tennis movements

Service: A subtle coaching point in maximising power in the serve is the timing of the “leg drive” with the racquet preparation for the drive to the ball. The eccentric stretch and pre‐tensing of the anterior shoulder muscles (particularly the internal rotators) is maximised by a vigorous leg drive which positions the racquet “down behind and away from the lower back” in preparation for the drive to the ball. Groundstrokes: Rotation of the shoulders greater than the hips (creating a separation angle) and the positioning of the upper limb relative to the trunk during the backswing phase of these strokes, place appropriate muscles on stretch. This is why in the backhand a separation angle (one handed ∼30°; two handed ∼20°) is created in the backswing in preparation for the swing to the ball. Volley/service return: The split step, an integral part of preparation for a volley, service return, or groundstroke, places the quadriceps muscle (extensor at the knee joint) on stretch, permitting storage and subsequent release of energy to enhance quick movement in preparation for the subsequent stroke. Serve/groundstrokes Internal rotation of the upper arm at the shoulder Work by my team has primarily been responsible for identifying the important role that internal rotation of the upper arm at the shoulder joint plays in the service) and the forehand strokes Functionally, the internal rotator musculature must accelerate the upper arm in the swing to impact, before the external rotators eccentrically contract to decelerate this rotation during the follow through phase of the action. As the external rotators are much smaller than their internal rotator counterparts, it is essential that specific training is structured to protect the shoulder from injury, as discussed in the sports medicine section below Trunk rotations in the serve The view most commonly held by coaches was that a player rotated the trunk horizontally about a near vertical axis during the forward swing in the service action. Players knew better and have tilted the trunk to rotate more in a shoulder‐over‐shoulder orientation, rather than a simple horizontal rotation of the shoulders. They obviously positioned themselves in this manner to enable internal rotation of the upper arm at the shoulder to play the important role in the service action that we now know it does Lower limb and pelvic drive in groundstrokes Research at the University of Tokyo has provided insight into the role of lower limb drive and pelvic rotation in the forehand and backhand strokes. The importance of internal extensor moments at the back hip was identified in both the above studies. Again the importance of hip (pelvic) rotation has been highlighted in both forehand and backhand strokes Loading Epidemiological data have shown that tennis injuries are primarily caused by overuse. Loading (the rate of force development, peak force, and torque are mechanical factors that collectively are often referred to as “load”) may be applied to the body externally (ground reaction force, vibration) or internally (muscle forces and torques Loading increased with an increase in service speed. That is, irrespective of sex, if a player wishes to develop a more powerful serve they need to modify technique (rotate selected segments more quickly) and prepare the body physically to perform the higher speed movement(s). Those players with more effective knee flexion‐extension during the service action were associated with lower loading at the shoulder and elbow. This finding needs to be further clarified such that the effect of leg drive on loading is assessed; this is currently taking place at the University of Western Australia. There was a trend for players with very abbreviated backswings to record higher force levels at the shoulder. This finding is also currently being tested in a more controlled design The abdominal muscles were more active in the topspin serve than the flat and slice serves during the upward swing of the racquet to impact. These results reinforced the importance of abdominal and low back exercises (core stability) together with the muscles about the shoulder and lower limbs in strength and rehabilitation programmes in tennis Muscle balance One of the possible causes of shoulder injury may be peak strength/torque imbalances in those muscles responsible for acceleration and then deceleration of the upper arm at the shoulder joint For example in the serve you have: external upper arm rotation at the shoulder during the backswing slowed by eccentric contraction of the internal rotators at the shoulder concentric contraction of the shoulder internal rotators, in the drive to the ball, is then slowed by an eccentric contraction of the shoulder external rotators during the follow through

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