Below is an audio interview featuring iTPA Certification Commission and renowned orthopedic surgeon Dr. Marc Safran. Dr. Safran is Professor and Associate Director of Sports Medicine at Stanford University. He is a team physician for the Stanford Teams and is the director of the sport medicine fellowship program. Dr. Safran is also the chief orthopedic consultant to the WTA. He has served as the medical director of the San Diego WTA tournament for 13 years and is the medical director of the ATP tournament in San Jose (since 2002), and has been a neutral site physician for several Davis Cup ties.

In this audio clip, Dr. Safran offers tips to parents on ways to keep competitive, young tennis players healthy. A must-listen for parents!

Much of the talk in the sports media in the United States is centering more and more on the potential concussion dangers of football (American football for our international friends), especially at an early age. A recent story in USA Today (May 23rd, 2012) further expounded on those fears, with Tom Brady’s father expressing doubt whether he would let his son Tom Brady play football all over again. "This head thing is frightening for little kids," Brady Sr. said. "I think Kurt Warner is 100% correct. He's there to protect his children, and these other people who are weighing in are not addressing the issue of whether it's safe or not for kids."

According to the article, in a recent study, researchers at the Center for Injury Biomechanics, a joint effort of Virginia Tech and Wake Forest, estimated there are currently 3.5 million USA football players in youth leagues. Furthermore, while youth league players have fewer and lower-magnitude head impacts than high school and college players, high-magnitude hits do occur, and most happen in practice.

While we wish our sports cousin of football the least amount of injuries possible, this is an opportunity for the sport of tennis, and parents/coaches, to promote and speak about the health benefits and lower risk of injuries for young tennis players, when compared to football. Tennis involves no physical contact and the chance of concussion is highly unlikely. Compared to many other sports, tennis has a multitude of benefits from health, fitness to cognition and learning; whereas, many other sports do have possible negatives with respect to injury rates.

With the introduction of 10 and under tennis, the balls are bounce lower, racquets are smaller (more appropriate to a young athlete’s size) and courts smaller. Whether you are for or against the new ITF and USTA rule changes, it’s pretty clear that tennis is a great sport for young athletes to gain athletic skills in a safer environment than other sports. Plus, you get to wear hats over helmets :)

http://www.usatoday.com/sports/football/story/2012-05-16/Parents-weigh-youth-football-risks/55150850/1

Dr. Neeru Jayanthi (Director of the Tennis Medicine program at Loyola University Stritch School of Medicine and member of the ITPA Cerification Commission) provides a great review of some of his research analyzing injury risk in junior tennis players. He discusses information that he and his research team found from a series of studies looking at US Junior tennis players who play competitive sectional and national tournaments. The data provides some unique insights. Some of the areas discussed in this 5 minute video are:

• at what number of matches in a single tournament does the medical withdrawal rate substantially increase?
• does different ages of competition result in different injury rates?
• do males have more medical withdrawals in  junior events than female players?
• at what number of hours of practice/competition per week does injury risk rise for the junior tennis player ?
• does some data exist that links the total number of matches per year with medical withdrawal rates?
• how many 10 year old players report specializing in only tennis compared to older players (i.e. 16 and 18 year olds)

Check out this short education-packed video from one of the best tennis-specific physicians around. Please feel free to comment on this and other ITPA blog posts and please suggest topics that our ITPA experts can answer in the future.

Coach Loren Landow provides his insight in the above audio clip about some similarities and differences between tennis athletes and athletes in other sports, especially with respect to training the young athlete. The ITPA thanks Loren for his support and the work he does developing athletes (especially tennis athletes).

Loren Landow, CSCS, USAW

Coach Landow has trained thousands of athletes in numerous sports to maximize their athletic potential while reducing their risk of injury. He has successfully trained over 400 professional athletes, including 17 NFL All-Pros. Coach Landow has trained the USA U-19 Rugby National Team, over 60 nationally and internationally ranked high school and collegiate tennis players, Olympians and many other athletes in the NHL, MLB, MLS,UFC and NCAA. In addition, Coach Landow serves as a consultant for several professional organizations. Most importantly, Landow is highly sought after for his ability to analyze and correct biomechanics. He is a certified Muscle Activation Techniques Specialist, utilizing soft tissue massage techniques to correct imbalances and enhance muscle regeneration. Through his various innovative methods Coach Landow has made dramatic improvements in an athlete’s speed, power, agility, coordination. In addition, Coach Landow serves on the S.P.E.E.D. advisory counsel, a position reserved for the top performance coaches in the country. Coach Landow is also a national and International presenter and speaker for the leading associations in the performance industry.

Check out Loren Landow at www.lorenlandowperformance.com

Gifted young athletes are under increasing pressure to play only one sport year round. But a Loyola University Health System study of 519 junior tennis players has found that such specialization increases the risk of injury. Researchers who analyzed 3,366 matches in United States Tennis Association junior competition found that players who specialized in only tennis were more likely to withdraw from tournaments for medical reasons, typically injuries.

Also, players who had experienced an injury or tennis-related illness during the past year were 5.4 times more likely to withdraw from a tournament for medical reasons.  "Parents, coaches and players should exercise caution if there is a history of prior injury," said Dr. Neeru Jayanthi, lead author of the study. "And parents should consider enrolling their children in multiple sports."

Jayanthi is medical director of primary care sports medicine and an assistant professor in the departments of Family Medicine and Orthopaedic Surgery and Rehabilitation at Loyola University Chicago Stritch School of Medicine. He also is chairman of the education committee of the International Society for Tennis and Medicine Science and an ITPA Certification Commissioner.

Kids who play more than one sport probably are less likely to develop injuries because they have a chance to rest from the repetitive overuse of the same muscle groups. Also, cross training in other sports such as basketball and soccer uses other large muscle groups "and may enhance their developmental and athletic skills," Jayanthi said.

Players in the study began playing tennis at an average age of 6, began competing at age 9 and began to specialize at age 10. Players practiced a median of 16 to 20 hours per week, and 93 percent said they competed at least 10 months per year.
The study is the latest in a series of studies Jayanthi and colleagues have conducted on injuries in young tennis players. Earlier studies found that:

• Junior players are more likely to withdraw for medical reasons if they play five or more matches in a single tournament. Counting singles matches, doubles matches, consolation matches, etc. a player can compete in as many as 10 matches in a tournament. "The heavy match volume takes its toll as the tournament progresses, and a relatively high number of these young tennis players not only sustain injury but are unable to compete any further," Jayanthi said.
• Boys are more likely to withdraw for medical reasons than girls, and older teenagers are more likely to withdraw than younger adolescents. 
• Medical withdrawal rates are significantly higher in consolation and singles matches. In some cases, players withdraw for medical reasons -- even when they are not hurt -- in order to save their rankings or because they have lost interest in playing in consolation matches.

Take home: This was a very revealing study performed by one of the top tennis doctors in the world and the major take home message is that young athletes need to play multiple sports to develop good overall athletic skills in many different movements and learn to compete under different sport and social environments. However, if the young athlete does have aspirations to play at the highest level at a certain point he or she will need to devote the majority of training time on improving his/her tennis skills (physical, mental, tactical and technical). The question is always at what age should this specialization occur? A general rule of thumb is during or just after puberty. However, individual differences must be understood and a big determining factor is motivation and desire for the sport.