Tennis Recovery
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TENNIS RECOVERY A Comprehensive Review of the Research Editors: Mark S. Kovacs, PhD Todd S. Ellenbecker, DPT W. Ben Kibler, MD A United States Tennis Association Sport Science Committee Project TENNIS RECOVERY A Comprehensive Review of the Literature A United States Tennis Association Sport Science Committee Project Editors: Mark S. Kovacs, PhD Todd S. Ellenbecker, DPT W. Ben Kibler, MD Introduction In the last two decades, physical training and competitive opportunities have increased dramatically in junior, collegiate and professional tennis. This arose due to a multitude of factors, but much of it has stemmed from an increase in knowledge and understanding of scientifically based training programs focused on improving performance. As this focus on performance has increased, the area of recovery has received relatively limited focus. Recovery is a multi-faceted paradigm focusing on recovery from training—session to session, day to day and week to week. Recovery is also vitally important during training as well as in competition between matches and between days during multi-day tournaments. As more information is needed in the area of tennis specific recovery, the Sport Science Committee of the United States Tennis Association (USTA) sponsored an extensive evidence-based review of the available literature related to eight distinct areas of tennis-specific recovery. These eight areas are: • Nutritional Aspects of Tennis Recovery • Heat and Hydration Aspects of Tennis Recovery • Psychological Aspects of Tennis Recovery • Recovery Aspects of Young Tennis Players • Physiological Aspects of Tennis Recovery • Musculoskeletal Injuries/ Orthopedics Aspects of Tennis Injury • General Medical Aspects of Recovery • Coaching Specific Aspects of Recovery As the mission of the USTA Sport Science Department is “to produce, evaluate and disseminate sport science and sports medicine information relevant to tennis,” this project was a priority to help bridge the gap between the current scientific literature covering recovery in tennis and how this information may be applied practically to coaches, players and parents. The major objective of this project was to gain a greater understanding of the information currently available and provide some guidance on how tennis players should be recovering from training and competition with a specific focus on reducing the likelihood of injury as well as improving performance, health and safety. The original goal of this project was to analyze the data that is available in the hope of illuminating potential answers to some of the following frequently asked questions by coaches, parents, tournament directors and players: • How many matches is it appropriate to schedule in a given day for a junior (18 years old or younger) player? (Players are grouped into 12&under, 14&under, 16&under and 18&under age groups.) • How much time should be allowed between individual matches to allow for adequate recovery - to achieve high level performance while also reducing the risk of injury? • How many weeks in a row should players compete in tournaments (often times traveling to play in these events) before taking a break? • How much time should be allowed between training sessions? • What guidelines should players follow to properly refuel the body after a match/ practice to allow for recovery? The USTA strives to base all recommendations on existing evidence-based literature, yet the literature on recovery, particularly as it relates to tennis, is somewhat limited. Recognizing we cannot answer most of these questions definitively, this project aimed to provide the “most current state of knowledge” to the tennis community using information from many areas of sport science and from other sports arenas as well. We were very fortunate to have each chapter written by leading experts in their respective fields and the information provided does showcase what is presently available, but it equally highlights many areas that are in need of further research. The hope is that this information will be used by clinicians, researchers and coaches to improve the recovery components of the competitive tennis player, with the understanding that much of the recovery literature on tennis has yet to be investigated. More research both in lab settings as well as on the court, during training and live tournaments needs to be evaluated before definitive guidelines can be made. Sincerely, Mark Kovacs, PhD Todd S. Ellenbecker, DPT W. Ben Kibler, MD Table of Contents 1. Coaching Perspectives of Tennis Recovery p. 1-65 Angela Calder, BA, BApplSci, MA (Hons) 2. The Physiological Basis of Recovery: p. 66-129 Special Considerations in Tennis William J. Kraemer, Ph.D., CSCS, FNSCA, FACSM Shawn D. Flanagan, BA, Gwendolyn A. Thomas, MA, CSCS 3. Musculoskeletal Aspects of Recovery for Tennis p. 130-167 W. Ben Kibler, MD Aaron Sciascia, MS, ATC Todd S. Ellenbecker, DPT, MS, SCS, OCS, CSCS 4. Heat and Hydration Recovery in Tennis p. 168-209 Mark Kovacs, PhD, CSCS 5. Psychological Aspects of Recovery in Tennis p. 210-281 Kristen Dieffenbach, PhD, CC AASP 6. Nutritional Recovery for Tennis p. 282-328 Susie Parker-Simmons, MS, RD, 7. Tennis Recovery – Medical Issues p. 329-349 Margot Putukian, MD, FACSM 8. Recovery and the Young Tennis Athlete p. 350-386 Ellen Rome, MD, MPH Gordon Blackburn, PhD USTA Recovery Project I Authors The USTA Sport Science Committee, would like to thank each expert author for agreeing to write these thoroughly researched chapters in each author’s area of specialty. They have all contributed to enhance the knowledge in the area of tennis- specific recovery and their contribution is greatly appreciated. Coaching Perspectives of Tennis Recovery Angela Calder, BA, BApplSci, MA (Hons) Lecturer in Coaching Science School of Health and Sport Sciences Faculty of Science, Health and Education University of the Sunshine Coast Maroochydore, Qld, Australia The Physiological Basis of Recovery: Special Considerations in Tennis William J. Kraemer, Ph.D., CSCS, FNSCA, FACSM Shawn D. Flanagan, BA, Gwendolyn A. Thomas, MA, CSCS Human Performance Laboratory Department of Kinesiology University of Connecticut, Storrs, Connecticut Musculoskeletal Aspects of Recovery for Tennis W. Ben Kibler, MD Aaron Sciascia, MS, ATC Lexington Clinic Sports Medicine Center Shoulder Center of Kentucky Todd S. Ellenbecker, DPT, MS, SCS, OCS, CSCS Clinic Director Physiotherapy Associates Scottsdale Sports Clinic, Scottsdale Arizona National Director of Clinical Research, Physiotherapy Associates Director of Sports Medicine – ATP Tour USTA Recovery Project II Heat and Hydration Recovery in Tennis Mark Kovacs, PhD, CSCS Senior Manager, Strength and Conditioning / Sport Science United States Tennis Association Psychological Aspects of Recovery in Tennis Kristen Dieffenbach, PhD, CC AASP College of Physical Activity and Sport Sciences, Department of Coaching and Teaching Studies, West Virginia University Nutritional Recovery for Tennis Susie Parker-Simmons, MS, RD Sport Dietitian United States Olympic Committee Colorado Springs, Colorado Tennis Recovery – Medical Issues Margot Putukian, MD, FACSM Director of Athletic Medicine, Princeton University Associate Clinical Professor, UMDNJ-RWJMS, Dept of Family Practice Past-President, American Medical Society for Sports Medicine Recovery and the Young Tennis Athlete Ellen Rome, MD, MPH Head, Section of Adolescent Medicine Cleveland Clinic Gordon Blackburn, PhD Department of Cardiovascular Medicine Cleveland Clinic USTA Recovery Project III Reviewers The USTA Sport Science Committee, would like to acknowledge the following individuals for their time, expertise and effort reviewing these manuscripts during the peer-review process. Mitchel Alpert, MD Director oF Pediatric Cardiology, Jersey Shore University Medical Center, New Jersey Clinical Assistant ProFessor, University oF Medicine and Dentistry of New Jersey-The Robert Wood Johnson Medical Center, New Jersey Jessica Battaglia, MS, ATC Coordinator, Coaching Education and Sport Science, United States Tennis Association George C. Branche III, MD Orthopaedic Surgeon, Anderson Clinic Legg Mason Classic Tournament Physician T. Jeff Chandler, EdD, CSCS Chair, Health, Physical Education, Recreation, Jacksonville State University Editor-in-Chief, Strength and Conditioning Journal Miguel Crespo, PhD Research Development OFFicer, International Tennis Federation David Dines, MD Chairman, Department oF Orthopaedic Surgery, Long Island Jewish Medical Center of the Albert Einstein College of Medicine. Associate Clinical ProFessor, Hospital for Special Surgery United States Davis Cup Team Physician Dan Gould, PhD Director, Institute For the Study oF Youth Sports, Michigan State University ProFessor, Department oF Kinesiology, Michigan State University Brian Hainline, MD ChieF Medical OFFicer, United States Tennis Association ChieF oF Neurology and Integrative Pain Medicine, ProHEALTH Care Associates USTA Recovery Project IV Satoshi Ochi, MA, CSCS Strength and Conditioning Coach, United States Tennis Association Anne Pankhurst, BSc Manager, Coaching Education, United States Tennis Association Sally Parsonage, PhD, RN Nutrition Division Head, IMG Academies International Performance Institute David Ramos, MA Coordinator, Coaching Education and Sport Science, United States Tennis Association Scott Reiwald, PhD, CSCS PerFormance Technologist, United States Olympic Committee E. Paul Roetert, PhD Managing Director, Coaching Education and Sport Science, United States Tennis