University of Tennessee, Knoxville TRACE: Tennessee Research and Creative Exchange Masters Theses Graduate School 8-2014 Effects of Different Approach Directions and Sizes of Selected Tennis Forehand Strokes on Knee Biomechanics Louise Barbara Beggs University of Tennessee - Knoxville, [email protected] Follow this and additional works at: https://trace.tennessee.edu/utk_gradthes Part of the Biomechanics Commons Recommended Citation Beggs, Louise Barbara, "Effects of Different Approach Directions and Sizes of Selected Tennis Forehand Strokes on Knee Biomechanics. " Master's Thesis, University of Tennessee, 2014. https://trace.tennessee.edu/utk_gradthes/2791 This Thesis is brought to you for free and open access by the Graduate School at TRACE: Tennessee Research and Creative Exchange. It has been accepted for inclusion in Masters Theses by an authorized administrator of TRACE: Tennessee Research and Creative Exchange. For more information, please contact [email protected]. To the Graduate Council: I am submitting herewith a thesis written by Louise Barbara Beggs entitled "Effects of Different Approach Directions and Sizes of Selected Tennis Forehand Strokes on Knee Biomechanics." I have examined the final electronic copy of this thesis for form and content and recommend that it be accepted in partial fulfillment of the equirr ements for the degree of Master of Science, with a major in Kinesiology. Songning Zhang, Major Professor We have read this thesis and recommend its acceptance: David R. Bassett Jr., Eugene C. Fitzhugh Accepted for the Council: Carolyn R. Hodges Vice Provost and Dean of the Graduate School (Original signatures are on file with official studentecor r ds.) Effects of Different Approach Directions and Sizes of Selected Tennis Forehand Strokes on Knee Biomechanics A Thesis Presented for the Master of Science Degree The University of Tennessee, Knoxville Louise Barbara Beggs August 2014 Copyright © 2014 by Louise Beggs All rights reserved. ii ACKNOWLEDGEMENT I would like to thank my advisor, Dr Songning Zhang, for his guidance, support and expert advice and opinion throughout the process. I would like to thank my committee members, Dr Eugene Fitzhugh and Dr David Bassett Jr. for their advice and help on the project. I would also like to thank my parents, Barbara and Robert Beggs, and my siblings, Deborah Cairnduff and Graeme Beggs for their continued and unfailing support throughout the last two years in gaining my Masters Degree. Thank you to my peers in the biomechanics and kinesiology department, and my friends outside of the University for their support. Thank you to all of the participants who volunteered to be part of the study. iii ABSTRACT Tennis is a global sport and knee injuries are prevalent, ranging from acute to chronic and minor, to severe. Different directional movements and speeds involved in tennis may lead to a higher chance of injury due to changing loading rates at the knee. This study investigates effects of diagonal and lateral forehand strokes with step or lunge on kinematics and kinetics of the knee on the dominant leg during simulated tennis play. Ten National Tennis Ranking Program (NTRP) players level 4.0 upwards were recruited for the study. A motion analysis system was used to obtain three-dimensional joint kinematics, and force platform to collect ground reaction force (GRF) data. Players performed five trials in four conditions, lateral step, lateral lunge, diagonal step, and diagonal lunge, using a forehand stroke for all four conditions. A two-way repeated measures ANOVA was used, with post-hoc comparisons, with significance set at 0.05 a priori. The results from the study show that there were no significant differences of peak knee extension moment, peak knee abduction moment between the diagonal and lateral forehand shots, either with a step or lunge, or peak abduction moment between approach size in both directions. However, there was a significant difference in knee extension moments depending on approach size in the lateral and diagonal direction, with the lunge approach in each direction being significantly higher than the step. Further study may be required to determine what approach steps and direction movements are more appropriate for players of a standard below NTRP level 4.0, and for a knee OA population. Keywords: Knee, Tennis, Knee Osteoarthritis, Knee extensor moment, knee abduction moment iv TABLE OF CONTENTS CHAPTER ONE INTRODUCTION ............................................................................................... 1 STATEMENT OF THE PROBLEM ......................................................................................... 3 HYPOTHESES ........................................................................................................................... 4 LIMITATIONS ........................................................................................................................... 4 DELIMITATIONS ..................................................................................................................... 5 CHAPTER TWO LITERATURE REVIEW ................................................................................. 6 Epidemiology of Knee Injuries in Tennis ................................................................................. 6 Gender Differences for Knee Injuries ....................................................................................... 9 Knee injuries in Tennis ............................................................................................................. 10 Biomechanics of Knee during Tennis Related Movements ................................................... 11 Injury Risk and Biomechanics during High Impact Activities .............................................. 19 Effects of Playing Surface on Biomechanical Responses ...................................................... 20 Summary ................................................................................................................................... 21 CHAPTER THREE METHODS ................................................................................................... 23 Participants ................................................................................................................................ 23 Instrumentation ......................................................................................................................... 23 Professional Coaches Survey ................................................................................................... 24 Experimental Protocol .............................................................................................................. 24 Data Processing and Statistical Analysis................................................................................. 25 CHAPTER FOUR EFFECTS OF DIFFERENT APPROACH DIRECTIONS AND SIZES OF SELECTED TENNIS FOREHAND STROKES ON KNEE BIOMECHANICS ............................................................................................................................ 27 ABSTRACT .............................................................................................................................. 27 METHODS................................................................................................................................ 31 RESULTS .................................................................................................................................. 34 DISCUSSION ........................................................................................................................... 40 REFERENCE LIST ......................................................................................................................... 46 APPENDICES ................................................................................................................................... 50 APPENDIX A .................................................................................................................................... 51 APPENDIX B .................................................................................................................................... 54 APPENDIX C .................................................................................................................................... 55 APPENDIX D .................................................................................................................................... 57 v APPENDIX E .................................................................................................................................... 59 APPENDIX F .................................................................................................................................... 60 VITA ................................................................................................................................................... 70 vi LIST OF TABLES Table 1 Peak GRF and knee kinematic and kinetic variables: Mean ± STD ............................ 36 Table 2 Ankle kinematic and kinetic variables: Mean ± STD ................................................... 37 Table 3 Individual Subject Characteristics ................................................................................. 61 Table 4 Individual Subject GRF and Ankle Kinetic and Kinematic Variables in Lateral Step: Mean STD ....................................................................................................................................