www.tennismedicine.org MAY 2019 INSIDE THE STMS STMS Adductor How To Get Dirty Member Spotlight Strains and Enjoy it! With Deb Skinstad Understanding Injury Risk & Transitioning from hard Performance Enhancement courts to clay www.tennismedicine.org The clay court season is in full swing! Wow, and what a real treat it’s been already. One of the highlights for me was watching in the photographs and an accompanying Editor’s Nadal and Fognini’s semi-final battle in Monte- video - stretching routines and exercises Carlo. And, to finish off this incredible run on - sums up an excellent take home message Corner clay, Fognini went onto win the Monte-Carlo with practical significance and ramifications event in fine form, beating Lajovic in two sets. for tennis players. Secondly, in our ‘Coaching with Deborah Skinstad The Monte-Carlo win is Fognini’s first ever Corner’, we are introduced to an international Master’s 1000 title. tennis coach Norman McMarthy, from Cape Town, South Africa. Norman gives our readers Beside the viewing excitement, the an inside scoop on clay court tennis and the commentary for clay court tennis is riveting transition from hard court tennis to clay court as well. Phrases and words like ‘perfecting the tennis – specifically targeting our competitive clay court craft’, ‘marathon’, ‘style’, ‘skill’, and junior players. Norman’s article is entitled: ‘long cross-court rallies’, to name a few. For How to get dirty and enjoy it! Transitioning the viewer, spectator and fan, these images from hard courts to clay’. Thirdly, we have and narration paint a vivid picture of grit, some great material, as always, from the endurance and athleticism that clay court professional tennis tour, namely the WTA with tennis – the slowest grand slam surface – is their ‘Physically Speaking’ articles. We have renowned for. included one fantastic article this month for your reading pleasure. The theme for our May issue, as we head toward the second Grand Slam of the year, Finally, our content this month is rich with all the French Open, is clay court tennis and clay things pertinent to clay court tennis at the court tennis players – specifically focusing moment. We trust the information presented on those players who transition from other will assist you in your pursuit of broadening surfaces to clay. It’s with great pleasure your skill-set and knowledge within tennis that I introduce to you our contributors this medicine and sport science related fields. month. Up first, in our ‘Ask the Expert’ section, Happy reading - Here’s to a great clay court we consult a Physiotherapist, namely, Alex season! Cascone. The topic presented: “Adductor Strains: Understanding Injury Risk and Performance Enhancement”. Alex does a great job in condensing a complex topic and Yours in tennis, making it practically applicable to our broad Deb Skinstad, MA readership. Moreover, the visual cues depicted (PhD Sport Science candidate). www.tennismedicine.org Inside the STMS Member STMS Spotlight with Board of Directors Deb Skinstad Picture: Some of our Postgraduate sport scientists and I (tennis ball in hand) on graduation day. Stellenbosch University, 2018 Neeru Jayanthi, MD President Giovani Di Como, MD 1. Occupation/Certification(s) and of itself is fascinating to me, specifically Vice-President from an exercise physiology perspective. I am an early career academic in the In light of this, recovery from injury and the Walt Taylor, MD Department of Sport Science, Faculty of advancement of medical health science in this Treasurer Medicine and Health Sciences (FMHS) at regard is quite remarkable. Current topics of Stellenbosch University, South Africa. In this interest is over-use injury in the developing Deborah Skinstad, MA capacity, I have three major roles, namely: player / athlete and how this differs from the Newsletter Editor in chief lecturing, research and social impact. I adult tennis player. Given that children are currently lecture across a wide spectrum of categorized as a special populations group, Michael Griesser, MD classes within the discipline of sport science, there is tremendous scope for more studies Journal Chief Editor including teaching tennis to our student body in the area of paediatric tennis medicine and Richard Gayle, MD & Karen Jordan DPT as well as coaching. My research focus is the return to play in this group. Education Committee Co-Chairs human condition of the developing athlete (tennis players), youth sport and exploring 5. How do you think we can improve the Caroline Martin, PhD drop out and attrition in junior tennis players. field of tennis medicine? Research Committee, Chair 2. How long have you been involved in I am encouraged by the openness and Paul Caldwell, MD tennis and in what ways? willingness of the medical faculty and broader Website Committee, Chair profession to collaborate on multidisciplinary I’ve been a multi-sport athlete since childhood. topics. I encourage and support such Melissa Baudo, DPT My first sporting love is tennis. I started research, specifically those that advocate (and Social Media, Chair playing tennis at around 5 years old – this love are open to) mixed methods research designs Mark Kovacs, PhD and all around passion for the game landed me – quantitative and qualitative strategies to Tennis Committee, Chair a one way ticket to Tulsa, Oklahoma where I provide depth of understanding on the ‘people’ played four years of collegiate tennis. Playing (tennis players) under investigation. From Todd Ellenbecker, DPT & Elaine Brady tennis opened avenues to coach the sport and this standpoint, much can be understood to PT Membership Committee, Co-Chairs then study the sport. I guess, one could say, I help make informed decisions regarding best have gone 360 in tennis. I still play, still coach / practice in the field of tennis medicine. Miguel Crespo, MD teach and now research within this scope full- International Tennis Federation (ITF) time. Pretty amazing vocation, right?! 6. Why did you join the STMS and how Kathleen Stroia, MS, PT, ATC 3. What is your current role in tennis or are you involved? Women’s Tennis Association (WTA ) tennis medicine? Gary Windler, MD The STMS is a great platform to be involved Association of Tennis Professionals (AT P) My current role in tennis is three-fold: in. Personally, I find my involvement coaching, research and playing recreationally. extremely rewarding and mutually beneficial as it provides me with several learning 4. What do you find most interesting opportunities – learning from the experts and about tennis medicine? the best in the tennis medicine industry is incredible. Great question. I think at this point, and My role in STMS is serving as the newsletter in a nutshell, it is how resilient the human editor. I’m still learning and growing in this new body and human condition is. The body in venture but thoroughly enjoying it. www.tennismedicine.org Ask a Physio Understanding Injury Risk & Performance Enhancement Alex Cascone, PT, DPT, CPTS Abductor Injury Mitigation: player to retrieve balls hit at a wide angle and also to preserve better positioning on the court to prepare for the next shot. Additionally, Lower extremity injuries are common among all levels and ages open stance ground strokes are also more prevalent in the modern of tennis players. In fact, some reports suggest as much as 67% of game of tennis. In both cases, the groin musculature undergoes all tennis injuries are lower extremity related (1). More specifically, extreme eccentric muscle actions (muscle lengthening under tension) adductor (groin) strains are listed as one of the most frequent injuries to decelerate and control lateral momentum. Once the slide or open in elite junior tennis players (2,3). Adductor strains occur during stance ground stroke is completed, the player typically incorporates a movements involving quick acceleration or rapid change of direction cross over recovery step via concentric adductor muscle action. These when paired with extreme hip abduction, such as split type movements movements require adequate hip mobility, adductor flexibility and in which the leg moves away from the body, or also large hip external muscle function, where impairments in any one domain may increase rotation moments. Combined injury of the hamstrings and hip adductor risk of adductor strains. muscles - the semimembranosus, and adductor magnus and longus respectively - has been observed during a split type movement in sports such as tennis (4). These movements happen most frequently Intrinsic Risk Factors: on surfaces with less friction such as clay. Increased prevalence of adductor strains is often anecdotally associate with increased sliding A prospective study conducted by Tyler et al examined whether hip side-to-side during play. muscle strength and flexibility play a role in the incidence of adductor strains in NHL players (5). The authors measured preseason hip flexion, However, regardless of surface type, split type movements have become abduction and adduction strength in 47 players as well as adductor more prevalent in the modern game of tennis. This maneuver allows the flexibility before two consecutive seasons. At the end of the second www.tennismedicine.org season, 11 adductor strains were reported in 8 players (indicating bilateral strains in some cases). Players who sustained an adductor strain were identified with 18% less preseason hip adduction strength compared with uninjured players. Also, adductor/abductor muscle ratios were significantly different as uninjured