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Injuries in Junior Competitive Tennis: Demographic Information and Injury Trends in US Competitive Junior Tennis Players

7/14/2014

9 Comments

 
Junior tennis injuries are starting to get more media attention as youth sport injuries have increased over the past decade; it is more common to see surgeries performed on young athletes for overuse injuries. Much of this media attention stems from other sports like baseball and football, but tennis is also one sport where overuse injuries is an area that every coach, parent, tennis performance trainer (TPT) and Certified Tennis Performance Specialist (CTPS) should hold a strong education. Many of these injuries, and even surgeries, used to be only performed on college and adult athletes. Fortunately for tennis, the average young tennis player experiences relatively few severe injuries and is considerably lower than many other sports [1]. However, overuse is a concern in competitive young tennis athletes. Although injury rates and types of injuries are not as well researched as in some other sports (i.e. baseball, soccer, etc.) some interesting data exists that can help us better understand young tennis athletes and the typical issues that they see. Over a multiyear period a major junior national tennis tournament 21% of participants sustained an injury [2]. Over the last few decades research has been inconsistent about where the majority of tennis injuries occur. Earlier research showed that a large percentage of injuries occurred in the lower body [3]. However, more recent research has showed that upper body and core injuries are becoming more prevalent [4]. This is likely due to the change in technique (more open stance movements and greater reliance of upper body in stroke production, the slower surfaces and new technologies in the racket and strings.)

One unique study involved a series of questions on training, technique, competition and other factors that was provided to all participants at the largest junior team tennis event in the US [5]. It was collected at 12 different locations and 861 junior tennis players completed the survey:

- 97% of individuals who completed the study

Gender breakdown:

  • males-43% (356);
  • females-57% (N=476).

Age: 10-17

As the goal of the study was to evaluate injury patterns and trends a clear definition of injury was important. “An event that forces a player to miss 3 or more consecutive days of tennis play, either practice or competition, or that requires medical attention from a trainer, therapist, or doctor.”

Major Findings From This Study

  • For both the 12 and under and 14 and under age group the shoulder was the most often injured area. However for the 16 and under age group the back was the most commonly injured area.
  • Only 51% and 54% (male and female) of respondents use free weights and only 38% and 39% use machines.
  • Only 43% and 58% (male and female use medicine ball during training).
  • 90% and 97% (male and female) use a double-handed backhand
  • 20% and 22% (male and female) use an abbreviated/short service motion
  • 83% of all players predominantly train and play on a hardcourt surface
  • 81% of all injuries in junior tennis players were tennis related
  • 51% of all athletes that reported an injury visited a Physician or Physical Therapist


Below are three charts that provide the breakdown of the location of injuries based on the three different age groups (12 and under; 14 and under; 16 and under).



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When all the data was pooled together the following showcases the most common injury areas in the junior players who participated in this study (male and female combined ages 10-17)

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Summary:

The shoulder and back are two major areas that need a greater focus in training and injury prevention programs. The high prevalence of hardcourt tennis play is something that needs to be taken into account when devising on and off-court training programs. The increase in injuries as athletes’ age through their junior career is also something that should be of major interest to coaches, trainers and administrators. More education is needed to ensure that appropriate understanding of volume and injury prevention programs are implemented to help reduce the likelihood of injuries in junior tennis players. This is something that requires good communication between tennis coaches, certified tennis performance specialists and parents to ensure that the young tennis players develop and optimize performance while limiting the occurrence of injury.

1.         Kibler, W.B. and M. Safran, Tennis Injuries, in Epidemiology of Pediatric Sports Injuries, D. Caine and N. Maffuli, Editors. 2005, Base, Karger. p. 120-137.

2.         Hutchinson, M.R., et al., Injury surveillance at the USTA boys' tennis championships: A 6-yr study. Medicine and Science in Sports and Exercise, 1995. 27(6): p. 826-30.

3.         Reece, L.A., P.A. Fricker, and K.F. Maguire, Injuries to elite young tennis players at the Australian Institute of Sport. Aust J Sci Med Sports, 1986. 18: p. 11-15.

4.         Winge, S., U. Jorgenson, and L. Nielson, Epidemiology of injuries in Danish championship tennis. Int J Sports Med, 1989. 10: p. 368-371.

5.         Kovacs, M.S., et al., Demogrpahic data and injury trends in American national junior tennis players. Journal of Strength & Conditioning Research, 2012. 26(1): p. S62.

9 Comments
John Gugel link
7/15/2014 11:53:26 pm

Good post! A quick glance would indicate that "shoulder" injuries would be number 1 in your summary instead of "back" injuries.

Did I miss something?

Thanks!

Reply
ITPA
7/16/2014 12:20:58 am

Thanks for the post. In the 12s and 14s age group the Shoulder issues were reported in higher numbers, but in the 16s age group the back was reported in higher numbers. Due to the fact that the total number of respondents in the 16s age group was higher, the total number of back issues when combining all ages was higher than the total number of shoulder issues. However, the take-away message should be that both shoulder and back issues are areas to focus training and prevention programs.

Hope this helps explain the data. Thanks for following the iTPA.

Reply
Fred link
11/30/2014 08:42:38 pm

We think that this is a major item in modern tennis, not only because of the injuries but also because of the best development of young players to modern pros.
It is our experience in Dutch tennis that the majority of young players play with much too high stringbed stiffness, often the wrong “modern” strings, and / or racquets which are much too heavy for them. Alle these defects have huge effect on the danger of getting injuries.
And because we think that the modern tennis coach should be the ‘racquet advisor” for his players we organize special symposiums for them.
The intention of the symposium is to inform coaches about the importance of the individual tuning of racquet and string bed and to demonstrate the tools that we developed to do so.
We have the following tools available:
* The string classification system divides the strings in classes for different players based on the elongation figures.
* A string-bed-tester measures the stiffness of the string bed, which is the most important figure for playability, much more important than the type of string.
* The Tension Advisor advises a type of string and the right SBS based on the individual information of the player. The system calculates the right stringing tensions for the advised SBS, when the specs of the racquet are entered.
* The Swing-weight-advisor offers 3 actions:
- It advises the SW of the racquet based on stroke-preparation, age and body size of the player.
- It calculates the SW when the weight of the racquet is entered.
- It calculates the weight that should be added to obtain a certain SW.
* The RS test, which can be used in combination with the stiffness tester, measures the stiffness (RA value) of the racquet.
The Swingweight and Tension advisor are available for everybody, the TA system is online and the SW advisor is an Excel sheet and we are working on the online version.
We think that the coach can be the only good advisor because he is the only one who can judge the player and his technique.
With the advisors, a small scale and a stiffness tester the coach can actually create the right advise “on court” with his smartphone.
Because we have to give the seminar on a big international tournament for children in January we are working on the English version of our lecture.
The lecture and the software tools are available for everybody, free of charge.
If you are interested in more info or the tools just send us an email to [email protected].

Kind regards
Fred Timmer
Stringway

Reply
Thad Hawkes
12/3/2014 05:15:41 am

Is there any data which references the type of ball that these kids used/are using, especially in the 12 under group?

Did they start with yellow ball at an early age?
Did they move from the Red, Orange, Green ball and if so, how did that affect their arms?

Reply
ITPA
12/3/2014 10:57:32 am

Great question. This specific study was collected back over 6 years ago and the vast majority of players grew up playing with regulation equipment during the 10 and under age period. Thanks so much for following the iTPA.

Reply
John Welborn
12/3/2014 05:47:46 am

would love to see the study factoring in Clay courts vs. Hard courts. There was a study done several years ago by Nigg out of University of Calgary and it showed significant reduction for injuries on Clay. Couple that with the player development benefits of clay and get the word out and we could impact the injury problem.

Reply
Marc
12/4/2014 06:03:18 pm

Surprised to see that there was not a higher number of hip injuries. A lot of junior's see the pro's hitting open stance and start to copy this and use this stance a lot of the time.....rather than making stance situation based and stepping in whenever possible. Do other coaches agree with this?

Reply
Marc
12/4/2014 06:31:20 pm

Hi sorry forgot to add that the increase in shoulder injuries could be related to open stance as well. M

Reply
Cindy Persky
2/2/2015 09:10:05 pm

i think for kids who are not home schooled the coaches should encourage kids to spend some time off court for weight and agility training. Especially as they get older.

Reply

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