Special Considerations for Female AthletesSome female athletes face complex issues regarding nutrition and health. 18 In training,many young female athletes have relative weakness in the knees, which tend to go inward(sometimes referred to as knee valgus position) when they lower the body or jump. Oftendue to weak hip stabilizers, hamstrings and landing, this effect (knee valgus) is oftenconnected to ACL injuries among female athletes. About 75% to 90% of ACL injuries areamong females. In rigorous movement, the ACL moves and may get pinched, which canrupture or tear the ACL. Research shows that neuromuscular training can help reduce ACLinjuries. 19 Essentially, that means when doing jump plyometrics, it is recommended to trainwith good form and to gradually build strength and complexity over time, especially withfemale athletes.PTR Practical On Court Applications for Sport Science 24
The Most Common <strong>Tennis</strong> Injuries and PreventionDr. Pluim and co-workers 20 conducted a comprehensive study of all research literature ontennis injuries from 1966-2006. They found great variance in the studies due to lack ofmethodology, meaning the studies had different conclusions since they were not consistentwith each other. Problems that typically arise include defining injury severity in terms of timelost, requiring treatment or hospital admission, or costs per injury. On extremes, some studiesinclude blisters and sunburns as injuries, while others only include acute injuries requiringemergency hospital visits. Several studies investigating gender found no significantdifferences between men and women, although some studies indicate there may be amarginally higher rate of injury among men. Some studies found that there is little effect of skilllevel on injuries. That is, a higher level player might be as likely to get injured as a novice whomight be under less stress (e.g., slower balls, slower movement), but is less trained and,therefore, might get hurt despite lower stressors.Most injuries in tennis are microtraumas, often overuse injuries. Microtraumatic injuries aremore common in the upper body and extremities. Acute macrotrauma (i.e., sudden injuriesinvolving a single force) usually occurs in the lower body. A typical macrotrauma might be asprained ankle. Common upper body injuries include lateral epicondylitis (i.e., tennis elbow),medial epicondylitis (golfer’s elbow), rotator cuff tendinitis, muscle strains and stress factures.Among young players, growth plate injuries may also occur.In a review, Kibler and Safran 21 reported that among junior players, the most common area ofinjuries involve lower extremities (39% to 59%), followed by upper extremities (20% to 45%),and finally central core (i.e., head and torso) at 11% to 30%. Studies were fairly consistent inthat order. The two most common lower extremity injuries are the ankle and thigh. In theupper body, shoulder injuries are most frequent, followed by elbow injuries. That order forjunior players is probably reversed for older players given the higher number of one-handedbackhands among adults. Pluim et al reported the most common injury was tennis elbow withan incidence rate of 9% to 35% and prevalence rate of 14% to 41%, depending on the study.Keep in mind, however, that review was from 1966-2006, which includes many years theone-handed backhand was the predominant technique.In addition, juniors might put more stress on the shoulder due to too early learning of kickserves, poor use of legs for upward acceleration, and overuse of the back. Overextending theshoulder and weak shoulder stabilizer muscles can contribute to shoulder injuries, such asimpingement or rotator injuries. It is very important that teaching professionals ensure theirplayers learn the appropriate biomechanics of efficient strokes from a very early age. This notonly helps improve performance, it also reduces the likelihood of injuries.PTR Practical On Court Applications for Sport Science 25