When physiology becomes pathology: the role of magnetic resonance imaging in evaluating bone marrow oedema in the humerus in elite tennis players with an upper limb pain syndrome.
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Upper limb stresses are well recognised in tennis, and the normal physiological responses of the humerus to externally applied forces are well defined. Changes to both the microscopic and macroscopic bony architecture are often not apparent on plain radiographs in the early stages of a stress reaction. Bone scintigraphy is more sensitive, but not very specific to subtle changes, as is computer aided tomography. Magnetic resonance imaging (MRI) scans are now used to assess many musculoskeletal injuries, and may allow earlier recognition of changes. This study reports on eight high level tennis players (seven professionals, one highly ranked amateur), who all presented during the course of the 2002 Australian Open and its lead up events. All had an upper limb pain syndrome centred around the elbow. Each underwent an MRI scan. A group of asymptomatic players also had scans of the same area to serve as controls. All symptomatic patients had various levels of bone marrow oedema in their distal humerus, some with periosteal reactions, although most without. No scans revealed a cortical breach. The management of these reactions is problematic in players on an international circuit, as review is sporadic and not always coordinated. The timetabling of international tournaments means it is difficult for top players to obtain adequate rest to avoid injury. Awareness of this early overuse reaction needs to be raised to allow preventive and therapeutic options to be considered to reduce the incidence of this humeral stress response producing an upper limb pain syndrome. (+info)
Common femoral artery injury secondary to tennis ball strike.
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Tennis is a popular, safe sport that exposes amateur or professional players to minimal risk of injury. Most of this risk is related to musculoskeletal injuries, and vascular trauma is extremely rare. We present a case of a 68-year-old man in whom intermittent claudication developed after his right groin was struck by a tennis ball. The patient sought medical evaluation 2 months after the accident, and a subtotal occlusion of his right common femoral artery was disclosed by angiography and treated by endarterectomy. (+info)
Injury risk from popular childhood physical activities: results from an Australian primary school cohort.
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BACKGROUND: Children engage in various physical activities that pose different injury risks. However, the lack of adequate data on exposure has meant that these risks have not been quantified or compared in young children aged 5-12 years. OBJECTIVES: To measure exposure to popular activities among Australian primary school children and to quantify the associated injury risks. METHOD: The Childhood Injury Prevention Study prospectively followed up a cohort of randomly selected Australian primary and preschool children aged 5-12 years. Time (min) engaged in various physical activities was measured using a parent-completed 7-day diary. All injuries over 12 months were reported to the study. All data on exposure and injuries were coded using the International classification of external causes of injury. Injury rates per 1000 h of exposure were calculated for the most popular activities. RESULTS: Complete diaries and data on injuries were available for 744 children. Over 12 months, 314 injuries relating to physical activity outside of school were reported. The highest injury risks per exposure time occurred for tackle-style football (2.18/1000 h), wheeled activities (1.72/1000 h) and tennis (1.19/1000 h). Overall, boys were injured more often than girls; however, the differences were non-significant or reversed for some activities including soccer, trampolining and team ball sports. CONCLUSION: Although the overall injury rate was low in this prospective cohort, the safety of some popular childhood activities can be improved so that the benefits may be enjoyed with fewer negative consequences. (+info)
Activity patterns, blood lactate concentrations and ratings of perceived exertion during a professional singles tennis tournament.
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OBJECTIVE: To examine the game characteristics and physiological (ie, blood lactate concentration) and perceptual (ie, rating of perceived exertion, RPE) responses during actual tennis competition in professional performers. METHODS: Eight trained and internationally ranked (Association of Tennis Professionals rankings) male tennis players were studied during singles matches (best of three sets) played on an outdoor clay court surface during a professional, invitational tournament. Blood lactate concentrations (n = 53) and RPE (n = 113) were determined at selected change-overs during the game. The variables describing the characteristics of the matches, (a) duration of rallies (DRs); (b) rest time (RT); (c) effective playing time (EPT); and (d) shots per rally (SR), were determined from video recordings. RESULTS: The mean (SD) values for the match-play activity variables were DR 7.5 (7.3) s, RT 16.2 (5.2) s, EPT 21.5 (4.9%), SR 2.7 (2.2) shots. Average blood lactate concentration and RPE values were 3.8 (2.0) mmol/l and 13 (2). Blood lactate concentrations and RPE values were significantly higher (p<0.01) in service games than in receiving games. Both blood lactate concentration and RPE values were significantly correlated with SR and DR (r = 0.80 to 0.28; p<0.001). CONCLUSIONS: Blood lactate concentrations and RPE were found to be influenced by the characteristics of the match and the playing situation (ie, serving or returning). These specific situations might be used to alter the overload training stimulus during tennis on-court practice. (+info)
An integrated physiological and performance profile of professional tennis.
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OBJECTIVE: To describe the physiological responses to tournament tennis in relation to prevailing environmental conditions, match notation, and skills that underpin performance. DESIGN: 14 male professional tennis players (mean (SD) age, 21.4 (2.6) years; height, 183.0 (6.9) cm; body mass, 79.2 (6.4) kg) were studied while contesting international tennis tournaments. Environmental conditions, match notation, physiological (core temperature, hydration status, heart rate, blood variables), and performance indices (serve kinematics, serve velocity, error rates) were recorded. RESULTS: Hard and clay court tournaments elicited similar peak core temperature (38.9 (0.3) v 38.5 (0.6) degrees C) and average heart rate (152 (15) v 146 (19) beats/min) but different body mass deficit (1.05 (0.49) v 0.32 (0.56)%, p<0.05). Average pre-match urine specific gravity was 1.022 (0.004). Time between points was longer during hard court matches (25.1 (4.3) v 17.2 (3.3) s, p<0.05). Qualitative analysis of first and second serves revealed inverse relations between the position of the tossing arm at ball release and the position of the ball toss and progressive match time (respectively, r = -0.74 and r = -0.73, p<0.05) and incurred body mass deficit (r = 0.73 and r = 0.73, p<0.05). CONCLUSIONS: Participants began matches in a poor state of hydration, and experienced moderate thermoregulatory strain and dehydration during competition. These adverse physiological conditions may compromise performance and influence notational analyses. (+info)
Sclerosing therapy and eccentric training in flexor carpi radialis tendinopathy in a tennis player.
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BACKGROUND: Tendinopathy of the flexor carpi ulnaris tendon is a rare entity. Recent research revealed the role of a neurovascular ingrowth at the point of pain in various tendinopathic locations, such as at the Achilles and patellar tendon, in plantar fasciitis as well as in supraspinatus and tennis elbow tendinopathy. However, beyond the elbow no such neovascularisation has been reported to date. METHODS: We present a 35-year old tennis player suffering tremendous pain (visual analogue scale (VAS) rating of 9/10) at the flexor carpi ulnaris tendon with adjacent calcification in close proximity to the pisiform bone. The patient was assessed with power Doppler and laser Doppler quantification of neovascularisation at the point of pain. RESULTS: Power Doppler and laser Doppler quantification of neovascularisation at the point of pain identified higher capillary blood flow at three points over the painful vs the non-painful tendon (146/240/232rU vs 93/74/70rU at the non-affected side). Sclerosing therapy using polidocanol under power and laser Doppler guidance was initiated, with immediate decrease of capillary blood flow by 25% with resolution of the neovascularisation in power Doppler. Immediately following sclerosing, the patient's reported pain level on the VAS was reduced from 9/10 to 4/10. Following a short period of rest, eccentric training of the forearm muscle was initiated over 12 weeks with functional complete recovery and complete resolution of wrist pain. CONCLUSION: Sclerosing therapy using polidocanol under power- and laser-Doppler guidance can decrease capillary blood flow by 25% with resolution of the neovascularisation. Subsequent eccentric training of the forearm muscle over 12 weeks can result in complete resolution of wrist pain. (+info)
Health benefits of tennis.
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The aim of the study was to explore the role of tennis in the promotion of health and prevention of disease. The focus was on risk factors and diseases related to a sedentary lifestyle, including low fitness levels, obesity, hyperlipidaemia, hypertension, diabetes mellitus, cardiovascular disease, and osteoporosis. A literature search was undertaken to retrieve relevant articles. Structured computer searches of PubMed, Embase, and CINAHL were undertaken, along with hand searching of key journals and reference lists to locate relevant studies published up to March 2007. These had to be cohort studies (of either cross sectional or longitudinal design), case-control studies, or experimental studies. Twenty four studies were identified that dealt with physical fitness of tennis players, including 17 on intensity of play and 16 on maximum oxygen uptake; 17 investigated the relation between tennis and (risk factors for) cardiovascular disease; and 22 examined the effect of tennis on bone health. People who choose to play tennis appear to have significant health benefits, including improved aerobic fitness, a lower body fat percentage, a more favourable lipid profile, reduced risk for developing cardiovascular disease, and improved bone health. (+info)
Shoulder joint loading in the high performance flat and kick tennis serves.
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OBJECTIVE: To quantify and compare the full body kinematics and shoulder joint kinetics during the high-performance tennis flat (FS) and kick serves (KS). METHODS: A 12-camera 250 Hz, Vicon motion analysis system recorded the three-dimensional FS and KS of 12 high-performance male players. A total of 22 paired Student's t tests, with an accompanying partial Bonferroni correction (p<0.01), determined statistically significant differences between the variables of interest in both serves. RESULTS: Higher peak horizontal, vertical and absolute racquet velocities were developed during the FS, while higher lateral velocities characterised the KS. Similar shoulder joint kinematics and kinetics punctuated both serves, but with some variation in trunk and lower limb mechanics. CONCLUSIONS: Similar shoulder joint kinetics assisted the development of varying three-dimensional racquet velocities in the FS and KS. The comparable shoulder joint loading conditions point to the repetitive, long-term performance of either serve as relevant in shoulder joint injury pathologies. (+info)