If you’re thinking of picking up a racquet and taking up tennis, expect a lot of health and fitness benefits. However, tennis is very demanding on the body, and there are common tennis injuries. To get the best from your game, get advice from a physio for a strength and conditioning plan off the court.
With the French Open round the corner followed by the grass court season during the summer our lower limb specialist physio Alex, previously a full time physio for GB tennis player James Ward, wants to talk about some of the differences that tennis court surfaces have in terms of stresses on the body and also how the players’ training changes to accommodate them.
Tennis is played on three main types of surface: clay, grass and hard:
Clay is the slowest of all surfaces. The ball bounces much higher and the points are much longer so the number of shots per rally increases quite dramatically. As you may all be aware, the slide is a skill that players develop playing on clay. It allows them to reach balls which on other surfaces would not have been possible. These qualities of clay have the following performance and training effects:
As the points tend to be longer, there is an added cardiovascular element to the match. Tennis mostly draws on the anaerobic system which is shorter intervals, but playing on clay taps into the aerobic a little more. This means that any CV training can be tweaked prior to the clay court season to prepare for this, and also training itself on court will consist of longer points to add that endurance element.
Due to the slide element of clay, players often find themselves in lengthened lunge type positions. This requires a different type of strength, flexibility and stability than the other surfaces. It requires 'strength in length' where the muscle is under tension for longer, and works eccentrically for longer. In preparation for this players will use slide boards and slide pads to replicate this. There is also a slight shift to more flexibility work particularly around the hips area. The knee patellar tendons are exposed to more loading due to the slide so gym exercises are tailored to heavier loading of this.
Grass is the surface with the least grip. The ball bounces lower and is faster. Points are shorter and players rely much more on their serve as a weapon. The biggest challenge on grass is footwork. As there is little grip, it makes it very hard to change direction. With this in mind, players tend to use shorter steps, especially when moving laterally, keeping the feet closer together as this will stabilise the body and allow for greater push off ability.
Grass, like clay, does also have a slide element to it, but it is not as prolonged as the clay, and is a lot less secure. You often see players on the grass slipping and this can lead to over stretching injuries. In training it is imperative to work hard on footwork, short quick steps to keep everything tight. There will also be a focus on hip mobility especially into squat position due to the low bounce so exercises in the gym will replicate this. The advantage of grass is that it is softer so the pressure on the joints is less.
Hardcourt is what we would say is the most stable surface and offers the best grip. The advantage of the hard is that the bounce is very true and more consistent than certainly the grass.
The main disadvantage of the hard court is the pressure on the joints. There is greater impact vertically through the body as it has little shock absorption. This can lead to joints feeling stiffer and more worked during training or playing on hard. It's important that the muscles are trained suitably to cope with the added load so they can protect the joint. The pressure can translate all the way up the body so areas like the back can be prone to stiffness due to the impact from the floor. Even more so than before, it’s important to look after joint health by ensuring good mobility programmes and also necessary strength work for the whole kinetic chain right from the feet up to the neck.
So as we can see, the different surfaces pose different challenges for players. The overall training doesn't hugely differ, but there are some subtle changes made in types of exercises, focus of exercises to prepare as well as possible fro the varying pressures and load on the body.
Want to talk about your tennis game with Alex? Call us on 02030 12 12 22 for an appointment.
Words by Alex Manos.
Over the last six months or so there has been quite extensive media interest in Andy Murray's hip injury. It has been quite well known for a couple of years that Andy suffered from hip issues which at times was very evident to see during his matches, yet still he was able to compete at the highest level and win the games’ biggest prizes.
Andy first underwent surgery back in January 2018, an arthroscopy which is more commonly known as 'keyhole surgery'. This minimally invasive surgery is designed to repair any damage to the hip joint, maybe repair the labrum (a cup like cartilage structure which helps stabilise the hip joint) and more often than not, some bone is shaved off from the ball (of the ball and socket) to allow for more clearance and less impingement of the joint. Whilst Andy managed to get back to paying he was still suffering with pain and couldn't get back to the level he was competing at before. This lead to a second operation earlier this year, a more extensive type of surgery which involved placing a metal cap on top of the ball and a metal surface on the socket side of the joint. The hope is that this will allow Andy to return to tennis, but perhaps more importantly lead a more comfortable life where normal activities of daily living are manageable.
Tennis is an extremely dynamic sport, involving lots of twisting and turning. As the distances are relatively small, but the changes in direction are often sharp and repetitive, this places a lot more stress on the joints than it does on the muscles compared to say a larger area sport, like football. Combined with predominantly hard surfaces, this increase the impact forces through a joint.
The hip joint is by nature a stable joint and, being a ball and socket joint, allows it to cope with such levels of rotation but it also has its limits. Having worked in professional tennis, I know first-hand how much the hips are used. They are often a source of stiffness in tennis players as they recruit so much muscle energy to stop and start, the muscles around the hip get tight and this then stiffens up the joint. There is also a lot of repeated bending forward/lunging, and this means a lot of pressure on the front of the hip joint. If there was already a congenital deformity of the hip which caused impingement, this would easily aggravate it, but equally there is the opinion that that this repetitive nature can also lead to the changes. Even just the action of serving which is performed thousands of times a season is extremely load bearing for the hip. Tennis players do take preventive measures to allow for joint protection by having strict strength and conditioning programmes, as well as having mobility and flexibility routines.
It was definitely the last hope for Andy to try and return to top level tennis. Having been privileged enough to spend time with him during my time working with James Ward, it's no surprise to say that he is one of the most dedicated professionals I have met and he has a great team around him to give him the best possible chance. The jury is out and it could go either way but I know that everyone who follows tennis and sport around the world will be hoping to see him compete again at the major events.
Good luck Andy!
If you’re experiencing hip pain call us on 02030 12 12 22 to book an appointment with one of our hip specialists: Paul Martin or Alex Manos.
Words by Alex Manos.
Has Wimbledon fortnight inspired you to pick up a racquet? Read our Physio Alex's advice on equipment, fitness and avoiding the most common tennis injuries:
It's vitally important that the racket you use is set up correctly for you. This means ensuring the grip size is appropriate, the weight and style of the racket suits your level and style of play and perhaps, most importantly, the string settings are correct.
Even small adjustments can make a big difference to your game and prevent injuries, mainly to the wrist and elbow and also help overcome existing injuries. It's well worth going to a specialised tennis shop for advice on this.
Tennis is mainly an aerobic sport in that it is made up of short bursts of energy with rest but repeated often. If you are thinking of improving your fitness levels for tennis, training should replicate this. For example, you could do interval sessions on the bike (as opposed to pedalling continuously for 20 minutes or so). Mixing shorter intense bursts (15 secs up to even 1 minute) with rest would be more beneficial. You could also do the same on treadmills or outside running - short sprint type interval training rather than long moderately paced runs.
Circuits or what is commonly known as HIT (High Intensity Training) is a great way to work the entire body from a strength pint of view and also gaining cardiovascular benefits to give you a better engine during long matches!
Focusing on lower limb stability exercises, with lunges being one of the best exercises is really important in being strong on court and allow for sharp, multidirectional changes of direction. A lot of force goes through the legs so having strong, balanced legs with good ability to safely change direction will help prevent injuries.
Unlike sports like football or rugby which are played on bigger pitches, tennis is contained to smaller areas so muscular injuries are less common as people don't often reach maximal sprint pace for prolonged distances. So, tennis places more load on the joints and tendons than other sports due to the quick short change of direction and also the fact that it's mainly played on hard surfaces. Here are four common tennis injuries.
Lower back pain - it's quite common for tennis players to suffer with painful lower backs. Serving in particular places high loads on the lower back and can compress the joints. The combined forces of quick extension and then rapid rotation and flexion can stress the joints. To try and prevent this it helps to have good mobility in your hips and lumbar spine together with a strong core. Focusing on core exercises which incorporate rotation, almost mimicking certain phases of the serve can really help reduce the risk of injury.
Shoulder injures - rotator cuff strains/pain. The rotator cuff is a group of muscles which surround the shoulder joint to provide stability and strength to the shoulder. It's by nature not a very stable joint as it is so mobile so when it is placed through high loads during ground strokes and more so in serving, it can lead to strains and/or inflammation of these structures. Working on the control and stability of these muscles by doing overall shoulder strength training but in particular lots of lighter rotational work will help prevent injuries.
Tennis elbow - or as its known clinically as Lateral Epicondylalgia is not exclusive to tennis but is prevalent, especially amongst amateur or club players. As stated above, equipment is key and so is technique on shots. The forearm muscles which moves the wrist and elbow are small and not particularly strong. They are prone to being overstretched whilst under stress (particularly on backhand). Having good technique and also good strength in the wrist and shoulder can reduce the load on these delicate muscles.
Patellar tendon/achilles tendon pain - as mentioned above, due to the start / stop nature of the sport, these joints and associated tendons take quite a beating! As with trying to prevent most tendon injuries around the body, keeping strong and conditioned in the bigger muscle groups will protect the joints and tendons. If you think of the joints as the area which will take the most force during movements, and the muscle system as the braking mechanism for this, the stronger and more efficient those brakes are to slow down the forces, the less load will be placed on those tendons and joints.
If you have tendon pain already during tennis its important to seek professional advice. Patients often come to us with several months' history of tendon pain as it can be painful but often can be 'played through', and it's true, often with the correct advice and exercises you can continue to play but it needs to be properly assessed first.
If you think you may have an injury related to tennis or want some advice on any of the above or anything else please feel fee to contact us or book in with one of our physiotherapists. Enjoy the tennis season and the strawberries and cream (but not too much cream!...)
Words by Alex Manos.
