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Tennis Injuries of the Hip and Thigh

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Tennis Medicine

Abstract

Injuries to the hip and thigh in the elite tennis player are common and deserve great attention from both an injury prevention and rehabilitation standpoint. The modern game of tennis imparts repetitive stresses to the hip complex through multidirectional repetitive movement patterns required for successful elite-level performance. An average point in tennis requires 4.2 directional changes and requires maximal level exertion and sprinting speeds over short- to mid-range distances [1]. Pluim et al. [2] published a review of epidemiological studies in tennis players. Their review found 10 of 13 epidemiological studies reporting a greater number of lower extremity injuries than in the upper extremity. Four of six of the studies comparing acute versus chronic injuries reported greater incidence of acute injuries in the lower extremity in tennis players. Additionally injuries to the trunk and core accounted for a range of 5–25% of all tennis injuries. This chapter will show the interplay and kinetic chain dependence of evaluation and treatment of hip injuries indicating the need for core stability evaluation and treatment technique utilization in the management of hip and thigh injuries.

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References

  1. Kovacs M, Roetert EP, Ellenbecker TS. Complete conditioning for Tennis. Champaign, IL: Human Kinetics Publishing; 2017.

    Google Scholar 

  2. Pluim BM, Staal JB, Windler GE, Jayanthi N. Tennis injuries: occurrence aetiology, and prevention. BR J Sports Med. 2006;40:415–23.

    Article  CAS  Google Scholar 

  3. Ellenbecker TS, Dines DD, Renstrom P, Windler GE. Injury and illness data from the ATP World Tour 2012 to 2016: a five year analysis. Unpublished Data, 2017

    Google Scholar 

  4. Maquirrian J, Baglione R. Epidemiology of tennis injuries: an eight year review of Davis Cup retirements. Eur J Sport Sci. 2016;16:266–70.

    Article  Google Scholar 

  5. Ellenbecker TS, Ellenbecker GA, Roetert EP, Silva R, Keuter G, Sperling F. Descriptive profile of hip rotation range motion in elite tennis players and professional baseball pitchers. Am J Sports Med. 2007;35(8):1371–6.

    Article  Google Scholar 

  6. Draovitch P, Edelstein J, Kelly BT. The layer concept; utilization in determining the pain generators, pathology and how structure determines treatment. Curr Rev Musculoskelet Med. 2012;5(1):1–8.

    Article  Google Scholar 

  7. Sueki DG, Cleland AJ, Wainner RS. A regional interdependence model of musculoskeletal dysfunction: research, mechanisms and clinical implications. J Man Manip Ther. 2013;21(2):90–102.

    Article  Google Scholar 

  8. Erhard R, Bowling R. The recognition and management of the pelvic component in low back and sciatic pain. Bulletin of Orthopedic Section-APTA, 1977

    Google Scholar 

  9. Robb AJ, Fleisig G, Wilk K. Passive ranges of motion of the hips and their relationship with pitching biomechanics and ball velocity in professional baseball players. Am J Sports Med. 2010;38:2487–93.

    Article  Google Scholar 

  10. Ellera-Gomes JL, de Castro JV, Becker R. Decreased hip range of motion and non-contact injuries of the anterior cruciate ligament. Arthroscopy. 2008;24(9):1034–7.

    Article  Google Scholar 

  11. Vad VB, Bhat AL, Basari D. Low back pain in professional golfers. Am J Sports Med. 2004;32(2):494–7.

    Article  Google Scholar 

  12. Bedi A, Warren RF, Oh YK, Wojtys EM, Oltean HN, Kelly BT. Restriction of hip internal rotation is associated with an increased risk of ACL injuries in NFL combine athletes: a clinical and biomechanical study. Orthop J Sports Med. 2013;1(4 suppl) https://doi.org/10.1177/2325967113S00062.

  13. Bedi A, Dolan M, Leunig M, Kelly BT. Static and dynamic mechanical causes of hip pain. Arthroscopy. 2011;27(2):235–51.

    Article  Google Scholar 

  14. Larson CM, Pierce BR, Giveans MR. Treatment of athletes with symptomatic intra-articular hip pathology and athletic pubalgia/sports hernia: a case series. Arthroscopy. 2011a;27(6):768–75.

    Article  Google Scholar 

  15. Larson CM, et al. Making a case for anterior inferior iliac spine/subspine hip impingement: three representative case reports and proposed concept. Arthroscopy. 2011b;27(12):1732–7.

    Article  Google Scholar 

  16. Tibor LM, Sekiya J. Differential diagnosis of pain around the hip joint. Arthroscopy. 2008;24(12):1407–21.

    Article  Google Scholar 

  17. Kelly BT, Larson CM. Femoroacetabular impingement: pathoanatomy, clinical evaluation and arthroscopic treatment strategies. In Sports hip injuries; diagnosis and management. SLACK. 2015. p. 27–8.

    Google Scholar 

  18. Narveson J, et al. Management of a patient with acute acetabular labral tear and femoral acetabular impingement with intra-articular steroid injection and a neuromotor training program. J Orthop Sports Phys Ther. 2016;46(11):965–76.

    Article  Google Scholar 

  19. Lee D, et al. The pelvic girdle. Churchill Livingstone: Elsevier; 2011.

    Google Scholar 

  20. Page P, Frank C, Lardner R. Assessment and treatment of muscle imbalance: The Janda approach. Champaign, IL: Human Kinetics Publishing; 2010.

    Google Scholar 

  21. Wainner RS, Whitmann JM, Cleland JA, Flynn TW. Regional interdependence: a musculoskeletal examination model whose time has come. JOSPT. 2007;37(11):658–60.

    Article  Google Scholar 

  22. Sizer P, Cook C. Coupling behavior of the thoracic spine: a systematic review of the literature. J Manipulative Physiol Ther. 2007;30(5):390–9.

    Article  Google Scholar 

  23. Kibler WB. Biomechanical analysis of the shoulder during tennis activities. Clin Sports Med. 1995;14(1):79–85.

    CAS  Google Scholar 

  24. Hjelm N, et al. Injury risk factors in junior tennis players: a prospective 2-year study. Scand J Med Sci Sports. 2012;22:40–8.

    Article  CAS  Google Scholar 

  25. Kibler WB. The 4000-watt tennis player: power development for tennis. Med Sci Tennis. 2009;14(1):5–8.

    Google Scholar 

  26. Kibler WB, Chandler TJ. Range of motion in junior tennis players participating in an injury risk modification program. J Sci Med Sport. 2003;6(1):51–62.

    Article  CAS  Google Scholar 

  27. Azevedo D, et al. Pelvic rotation in femoroacetabular impingement is decreased compared to other symptomatic hip conditions. J Orthop Sports Phys Ther. 2016;46(11):957–64.

    Article  Google Scholar 

  28. Kemp J, et al. Patients with chondrolabral pathology have bilateral functional impairments 12 to 24 months after unilateral hip arthroscopy: a cross-sectional study. J Orthop Sports Phys Ther. 2016;46(11):947–56.

    Article  Google Scholar 

  29. Coghill RC, Sang CN, Maisog JM, Ladrola NJ. Pain intensity processing within the human brain: a bilateral, distributed mechanism. J Neurophysiol. 1999;82(4):1934–43.

    Article  CAS  Google Scholar 

  30. Pelletier R, et al. Is neuroplasticity in the central nervous system the missing link to our understanding of chronic musculoskeletal disorders? BMC Musculoskelet Disord. 2015;16:25.

    Article  Google Scholar 

  31. Myers T. Anatomy trains: myofascial meridians for manual and movement therapists. Churchill Livingstone: Elsevier; 2009.

    Google Scholar 

  32. Hoogenboom B, Voight M, Cook G, Gill L. Using rolling to develop neuromuscular control and coordination of the core and extremities of athletes. N Am J Sports Phys Ther. 2009;4(2):70–82.

    PubMed  PubMed Central  Google Scholar 

  33. Landlinger J, Stoggl T, Lindinger S, Wagner H, Muller E. Differences in ball speed and accuracy of tennis groundstrokes between elite and high performance players. Eur J Sport Sci. 2012;12(4):301–8.

    Article  Google Scholar 

  34. Roetert E, et al. Tennis anatomy. Champaign, IL: Human Kinetics Publishing; 2011.

    Google Scholar 

  35. Kovacs M. Tennis training: enhancing on-court peformance. USRSA, 2007.

    Google Scholar 

  36. Garret WE. Muscle strain injuries. Am J Sports Med. 1996;24:S2–8.

    Article  Google Scholar 

  37. Anderson. Hip and groin pain in athletes. Am J Sports Med. 2001;29(4):521–33.

    Article  CAS  Google Scholar 

  38. Meyers WC, Foley DP, Garrett WE, Lohnes JH, Mandlebaum BR. Management of severe lower abdominal or inguinal pain in high-performance athletes. Am J Sports Med. 2000;28:2–8.

    Article  CAS  Google Scholar 

  39. Meyers WC, McKechnie A, Philippon MJ, Horner MA, Zoga AC, Devon ON. Experience with “sports hernia” spanning two decades. Ann Surg. 2008;248:656–65.

    PubMed  Google Scholar 

  40. Weir A, Brukner P, Delahunt E, Ekstrand J, Griffin D, Khan K, et al. Doha agreement meeting on terminology and definitions in groin pain in athletes. Br J Sports Med. 2015;49(12):768–74.

    Article  Google Scholar 

  41. Levangie P, et al. Joint structure and function: a comprehensive analysis. VitalSource eBook. 5th ed. Philadelphia: F. A. Davis; 2011.

    Google Scholar 

  42. Neptune RR. Muscle coordination and function during cutting movements. Med Sci Sports Exerc. 1999;31(2):294–302.

    Article  CAS  Google Scholar 

  43. Tyler T, et al. The effectiveness of a preseason exercise program to prevent adductor muscle strains in professional hockey players. Am J Sports Med. 2002;30(5):680–3.

    Article  Google Scholar 

  44. Caudill P, Nyland J, Smith C, Yerasimides J, Lach J. Sports hernias: a systematic literature review. Br J Sports Med. 2008;42:954–64.

    Article  CAS  Google Scholar 

  45. Verrall GM. Hip joint range of motion reduction in sports-related chronic groin injury diagnosed as pubic bone stress injury. J Sci Med Sport. 2000;8(1):77–84.

    Article  Google Scholar 

  46. Fleisig G, Nicolls R, Elliot B, Escamilla R. Kinematics used by world class tennis players to produce high-velocity serves. Sports Biomech. 2003;2(1):51–64.

    Article  Google Scholar 

  47. Chow JW. Lower trunk muscle activity during the tennis serve. J Sci Med Sport. 2003;6(4):512–8.

    Article  CAS  Google Scholar 

  48. Neuschwander TB, Benke MT, Gerhardt MB. Anatomic description of the origin of the proximal hamstring. Arthroscopy. 2015;31(8):1518–21.

    Article  Google Scholar 

  49. Lempainen L, Johansson K, Banke IJ, Ranne J, Mäkelä K, Sarimo J, et al. Expert opinion: diagnosis and treatment of proximal hamstring tendinopathy. Muscles Ligaments Tendons J. 2015;5(1):23–8.

    PubMed  PubMed Central  Google Scholar 

  50. Sherry MA, Best TM. A comparison of 2 rehabilitation programs in the treatment of acute hamstring strains. J Orthop Sports Phys Ther. 2004;34(3):116–25.

    Article  Google Scholar 

  51. Mica L, Schwaller A, Stoupis C, Penka I, Vomela J, Vollenweider A. Avulsion of the hamstring muscle group: a follow up of 6 adult non-athletes with early operative treatment: a brief report. World J Surg. 2009;33(8):1605–10.

    Article  Google Scholar 

  52. Klingele KE, Sallay PI. Surgical repair of complete proximal hamstring tendon rupture. Am J Sports Med. 2002;30(5):742–7.

    Article  Google Scholar 

  53. Sallay PI, Ballard G, Hamersly S, Schrader M. Subjective and functional outcomes following surgical repair of complete ruptures of the proximal hamstring complex. Orthopedics. 2008;31(11):1092.

    Article  Google Scholar 

  54. Cohen SR, Rangavajjula A, Vyas A, Bradley JP. Functional results and outcomes after repair of proximal hamstring avulsions. Am J Sports Med. 2012;40(9):2092–8.

    Article  Google Scholar 

  55. Williams BS, Cohen SP. Greater trochanteric pain syndrome: a review of anatomy, diagnosis and treatment. Anesth Analg. 2009;108(5):1662–70.

    Article  Google Scholar 

  56. Strauss EJ, Nho SJ, Kelly BT. Greater trochanteric pain syndrome. Sports Med Arthrosc. 2010;18(2):113–9.

    Article  Google Scholar 

  57. Pfirrmann CW, Chung CB, Theumann NH, Trudell DJ, Resnick D. Greater trochanter of the hip: attachment of the abductor mechanism and a complex of three bursae—MR imaging and MR bursography in cadavers and MR imaging in asymptomatic volunteers. Radiology. 2001;221(2):469–77.

    Article  CAS  Google Scholar 

  58. Hestroni I, Larson CM, Dela Torre K, Zbdea RM, Magennis E, Kelly BT. Anteriro inferior iliac spine deformity as an extra-articular source for hip impingement: a series of 10 patients treated with arthroscopic decompression. Arthroscopy. 2012;28(11):1644–53.

    Article  Google Scholar 

  59. Vleeming A, Schuenke M, Masi A, Danneeis L, Willard F. The sacroiliac joint: an overview of its anatomy, function and potential clinical implications. J Anat. 2012;221(6):537–67.

    Article  CAS  Google Scholar 

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Félix, I., Draovitch, P., Ellenbecker, T.S., Dines, J. (2018). Tennis Injuries of the Hip and Thigh. In: Di Giacomo, G., Ellenbecker, T., Kibler, W. (eds) Tennis Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-71498-1_25

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  • DOI: https://doi.org/10.1007/978-3-319-71498-1_25

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