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Air pollution – the unseen risk to a player’s health and performance
By Oliver Statham, CTPS
The rise in air pollution is currently attributed to 2 million premature deaths each year, ranking it the 13th leading cause of death worldwide.1 Children and elite athletes are particularly susceptible to the negative effects of air pollution and so it is vital to educate them on the importance of preventative approaches to minimize associated risk factors, so as to maximize performance on court and live healthier lives. This article will briefly discuss 1) the composition of air pollution and how various components affect health and performance, 2) why children and elite athletes are particularly vulnerable to such effects, and 3) preventative strategies to deal with highly polluted areas.
Introduction to air pollution
Air pollution comes in the form of particles or gases, and is produced directly from a source or indirectly formed in the atmosphere. The level of air pollution can vary dramatically from country to country (figure 1). The World health Organization (WHO) air quality guidelines for acceptable exposure to particular pollutants are listed in Table 1.
Click below for the entire article.
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Workload Management and Recommendations for Tennis
Monitoring and understanding players’ workloads have become essentials for tennis performance specialists, strength and conditioning professionals, tennis coaches and others that treat, train and rehab tennis athletes. The USTA produced a very thorough monitoring for tennis booklet that is a great resource for iTPA members. They have provided some good explanation of the topic, some real world examples and how to easily and accurately perform basic monitoring for tennis.
Below is a short excerpt from the booklet.
“An appropriately managed workload will promote optimum progress and improvement in competitive tennis and physical development. Using the parameters of rating of perceived exertion (RPE) and duration (time in minutes), monitoring workload may be simplified, but requires consistency to show benefit. To easily accomplish this, track the time of activity and Rating of Perceived Exertion (RPE) on court and during physical training. RPE is measured using a 1-10 scale (Table 1) to assess how hard you are working. To be effective, you must be honest about how you feel. Use the scale to measure your own exertion; don’t compare exertion levels with others. If it is appropriately applied, RPE accurately represent your effort. A simple workload may be calculated: RPE x duration (minutes) For an example, if you have an average practice (RPE 5) for 60min, your workload is 5 x 60 = 300. Session Workload: Total for each session (practice). Daily Workload: The total for your entire day. For example, a day with multiple sessions can be measured by adding each session workload. For example, 1x tennis session (90min at RPE 6) plus 1x fitness session (45min at RPE 8), the daily workload will be (90 x 6) + (45 x 8) = 900.”
The link to the full workload booklet is below:
http://www.playerdevelopment.usta.com/Strength_Conditioning/
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Sleep for Overall Performance
Patrick Aubone, CTPS & Dr. Mark Kovacs, CTPS, MTPS
Sleep is the one time of the day where the body is able to rest and recover. It has important biological functions regarding physiological process, learning, memory, and cognition. (Halson 2014) Over the years, the medical community has recommended 7-9 hours per night. Research has shown that sleeping less than 6 hours per night for 4 consecutive nights impairs cognitive performance, mood, and immune function.
In a 2012 study on Olympic athletes, researches compared their sleep quality to that of non-athletes. The results showed that there were significant differences between the athletes and non-athletes. There was a significant effect of gender on time awake with female being awake an average of 12 minutes longer than males. Athletes showed poorer markers of sleep quality than a non-athlete of the same gender and age. The researchers concluded that the quality of sleep was significantly poorer in athletes than in non-athletes.
The effects of not sleeping are very present when an individual participates in a sporting event. Their reaction time is slower. The body doesn’t have the same energy and he or she might even miss shots that they would not usually miss. In a study on the performance effects of sleep deprivation researchers found that 36 hours of no sleep resulted in a significant decrease in isokinetic performance. 64 hours of sleep deprivation significantly reduced vertical jump performance and isokinetic knee extension strength. Isometric strength and 40 meter sprint performance were unaffected. (Halson 2014) Clearly research points to sleep being an essential part of performance not just for athletic purposes but also for business as well.
So, what exactly are the performance deficits from lack of sleep? Alertness and cognitive performance decreases. It is estimated that the consequences of sleep deprivation cost billions of dollars worldwide per year due to accidents, reduced efficiency and productivity. Pain often interferes with sleep. Research suggests the possibility that sleep deprivation may cause or modulate acute and chronic pain. (Halson 2014) Most importantly, immune system function may be compromised. Evidence is mounting that sleep deprivation can have detrimental effects on immune function. Increasing sleep can help improve immune response.
Napping has shown to have a positive influence on performance. Following a 30 minute nap, researchers observed increased alertness and sleepiness was decreased when compared to a group that did not take naps. Cognitively naps help improve performance on tasks following a night of sleep deprivation.
3 Takeaways:
- A lack of sleep clearly deprives one of being at their best at work and on the court.
- Cognitively and physically performance decreases under sleep deprivation and consecutive nights of sleeping less than 6 hours.
- Even the body is affected. Research shows that the immune system can be compromised for a lack of sleep.
Here is an interesting article on Sleep/wake behaviours of elite athletes from individual and team sports http://www.tandfonline.com/doi/full/10.1080/17461391.2014.932016 and this is an important piece on how to use nutritional interventions to help you increase your quantity and quality of sleep. Sleep in Elite Athletes and Nutritional Interventions to Enhance Sleep
https://link.springer.com/content/pdf/10.1007%2Fs40279-014-0147-0.pdf
Sources:
https://www.ncbi.nlm.nih.gov/pubmed/22329779/
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The Best High Performance Tennis Academies In Europe…Reflections On A Coaches Tour Of Europe
This article has been adapted from Kovacs Institute, but we thought iTPA members would find it useful.
Over the last two years the Kovacs Institute has been fortunate to evaluate nearly two dozen of the top junior development tennis training environments. In 2022 it was going to major academies, training centers and visiting with top coaches in Florida. In 2023 it was evaluating the top training environments in Spain, France and Italy. The 2023 trip included nearly 20 top junior development coaches who work daily developing young talent from 6-18 years of age. The main goals of the tour were:
- To learn from some of the best tennis coaches, tennis teachers and academies across the spectrum of elite level junior tennis development.
- To better understand the level of the best junior players in the world at the various stages along the junior development pathway.
- Look for commonalities among the best coaches and why they have been successful for multiple decades.
Click the pdf link below for the full article!
Posture, Injuries & The Tennis Athlete
By Patrick Aubone & Dr. Mark Kovacs, CTPS, MTPS
Posture has been a hot topic over the last few years. Individuals spend so much time sitting at work looking at their computers, on their phone or reading that they do not realize their shoulders are slumped and their backs are rounded. Some postural problems can be harmful and affect quality of life negatively. Overweight and obesity as well as low level of physical activity and a sedentary lifestyle have a significant impact on the posture of many children (Wyszynska 2016).
Poor posture begins in childhood. Excessive body mass in obese or overweight children may cause a decrease in the stability and the need to seek postural mechanisms of adaptations. Researchers stated this leads to internal rotation of the hip joint along with the initiation of valgus knees and flat feet. The higher the children’s body mass index the more likely they will grow into these problems. Another problem for children is the amount of time spent sitting down at school and at home. In a study involving school children ages 11-13 researchers concluded that maintaining a sitting position for a long time results in advanced asymmetries of the truck and scoliosis. This causes a decrease in the lumbar lordosis and kyphosis of a child’s entire spine (Drza 2015).
Physical activity has an impact on the posture and physical development of young adolescents.
Posture development all depends on the sport he or she takes part in. Asymmetries in the frontal and horizontal planes as well as spinal curvature can all be seen in adolescent athletes (Grabara 2015). Asymmetric sports may contribute to the development of asymmetric posture. It is believed that athletes with posture deviations may be more susceptible to injuries. A study on the relationship between posture and sports injuries in footballers showed that back injuries were associated with poor symmetry of shoulders, scapulae abduction and back symmetry (Watson 1995). It is important to note that although sport asymmetries may have a disadvantageous effect on posture, it is very important to emphasize the positive aspect of physical activity and how mild asymmetries and adaptation is part of being a high level athlete in most sports.
In tennis it is important to use corrective exercises to correct some notable effects of the sport. Be aware of your position when sitting on the computer or when looking down at your phone. Our body fatigues and we have bad tendencies of slouching and sliding down in chairs to become more comfortable. Reset every couple minutes to maintain a straight back. Here is one great example of an exercise that can help posture of the upper body and core – http://itpa-tennis.org/itpa-blog/prone-scapula-retraction-exercise-for-tennis-players
Takeaways:
- Shoulder exercises focusing on external shoulder rotation are important not just for shoulder health but for postural balance.
- Chest-Back exercise ration should be 1:2 or 1:3. This will help position the shoulders back and balance make sure that the posture and stabilization muscles of the upper back are developed appropriately.
- When looking at your phone, raise it up to eye level instead of slumping over. Work on pulling your chin into your body to help with the upper cervical position.
- Reset your sitting position at least twice an hour to preserve postural health
Sources:
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Prevalence of Musculoskeletal Conditions in Tennis-Teaching Professionals
There has been minimal literature already published on the incidence and prevalence of tennis players injuries. It is reported that previous studies have been conducted on the injury prevalence of tennis teaching professionals however this was prior to an ITF consensus being established. Tennis Teaching Professionals (TTP) spend the same, if not more time on a court than professional tennis players thus is it has been reported in prior literature that TTP’s are indeed at risk of overuse injuries due to the nature of their occupation.
Prior to the International Tennis Federation’s (ITF) consensus to create consistency in future studies there was no previous agreement as to what constituted as an injury, therefore a lot of the results of literature published on the topic of musculoskeletal injuries in tennis players have varied in consistency. Moreover, the methodologies of collecting and analysing data as well as sample populations used have led to a consensus being arranged. Since the consensus statement, this study by Colberg et al, 2016 was the first epidemiological study of its kind that has followed ITF guidelines investigating the occupational risk of injuries in TTP’s. To date, only one previous study on collegiate tennis players has followed the ITF guidelines.
The ITF guidelines now state that an injury is constituted as any physical or psychological complaint that results from a tennis match or tennis training irrespective of the need for medical treatment.
The objective of this particular study was to investigate and determine (based on ITF guidelines) the relationship between occupational activities of tennis teaching professionals and injury risk. Tennis Teaching Professionals (TTP) spend the same, if not more time on a court than professional tennis players. Previous literature prior to the ITF consensus states that TTP’s are at risk of overuse injuries due to the nature of their occupation.
The means of data collection involved in this study was through a survey distributed to the entire USPTA membership base, both male and female aged 21 and above who reside in the USA. A total of 1176 TTP’s took part (8.7% of all 13,500 members). The outcomes measured in this study were prevalence of current injuries and the prevalence of body parts injured. The questionnaire was designed to ask participants to discuss their most severe injury by answering questions on the location, type of injury, cause and severity; as measured on the Visual Analogue Scale (VAS). This data was then analysed with variables taken into consideration to make results generalisable to the entire USPTA population.
The results indicated that most TTP’s in this study reported teaching 5 to 7 days in a typical week for longer than 2 hours a day. It was also shown that male TTP’s worked more than female TTP’s in a week and that those certified as “elite” TTP’s taught more often in a typical week than those without the elite certification within the USPTA.
Interestingly, results showed an injury prevalence of 42%. Specifically, lower extremity injuries were found to be the most prevalent and were also 1.2 times more likely than upper extremities. Upper and lower extremity injuries were more prevalent than trunk injuries and the most common injury location was the shoulder (17%).
In particular, the knee ligament, shoulder muscles, elbow tendons, shoulder joints and ligaments were shown to be the most injured anatomically. Overuse and teaching too much were participants responses to why the injuries occurred, followed by a sudden movement or change of direction . The mean severity of injury was 3.5 on the VAS scale out of a possible 0-10. Most injuries were found to occur on the dominant side whereas Upper Extremity injuries were found to be more common on dominant side than on non-dominant side in lower extremity injuries.
Existing literature states that a prevalence of 21.5% to 52.9% the current study found the prevalence as 42%. There is a clear difference in the previous pooled literature on this subject and this study. Furthermore, previous literature states that lower body injuries are 2.1 times more prevalent whereas this study states that lower extremity injuries are 1.2 times more frequent than Upper Extremity injuries. However, this study does show that there is evidence that TTP’s were more likely to sustain Upper Extremity injuries than tennis players and it is speculated by the authors that this could be because of the high volumes of repetitive hitting.
In this study muscular and tendon injuries were found to be the most common structure to be insulted. According to the authors, the only previous evidence of this type is on professional players which reported muscle cramps and tendon strains as the most common musculoskeletal condition reported.
It is stated by the authors that overuse injuries due to a lack of rest is the most common contributing factor in this population. This was consistent with the only previous literature study to use the recent ITF guidelines which investigated injuries to collegiate tennis players.
The majority of coaches in this study were coaching for 2 hours or more a day therefore this risk is correlated with their profession. Most coaches are self employed and therefore it is speculated that the need to make money could be a contributing factor for a number of overuse type injuries. Nevertheless, it is proposed by the authors that limiting the time of teaching past the point of fatigue would be more reasonable thus tailoring to the coaches individual condition.
There is room for further research in this area as there has not been much prior to this using the new ITF guidelines as well as this study having limitations. For example, this study’s survey could be biased towards a more injured population as a non-injured population might not be motivated to complete a survey on current injuries in the first instance. Also, there is danger that a health care professional may not have made the diagnosis of the TTP’s injury and so this may not be essentially accurate information as far as the individuals interpretation of that injury. in future studies the ITF guidelines definition of injury needs to be enforced to make sure true cases and data are reported.
This study provides useful data to healthcare professionals and tennis teaching professionals on the prevalence of musculoskeletal conditions related to this occupation as well as offering a foundation for future research in other professional bodies and populations using the ITF guidelines. This information can be used to strengthen weak muscles, joints and ligaments as well as create discussion on the relationship between occupation and injury.
Bjorn Blythe provided the critical review and summary of these research studies.
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A Biomechanical Analysis of Abdominal Injury in tennis serves; A Case Report. (Tubez et al, 2010).
The serve is arguably the most important stroke in tennis. Not only does one have more time to execute this stroke than any other stroke but one also has two attempts to get it in. Having said that, it is equally important to use correct technique in this stroke so as to ensure efficiency and quality in movement (not to mention avoid injury).
In a study by Tubez et al, 2015 titled “A Biomechanical Analysis of Abdominal Injury in Tennis Serves; A Case Report”, the focus was on an ATP professionally ranked tennis player who had sustained an injury after serving. The goal of the study was to understand if the injury sustained could be explained by the players incorrect serving technique.
Previous studies in this area have shown that abdominal muscle disorder could be a source of potential risk for local injury in tennis (Natis et al 2012: Sanchis- Moyis et al, 2010) but it has not yet been shown that a specific serve kinematic could cause an injury to the abdominal muscles during this stroke. The aim of this study was to prove that a flaw in technique could cause an abdominal injury by way of comparing a biomechanical evaluation of the player to that of a control group.
The injured player was compared to five other professional tennis players of similar attributes in a series of measurements to examine possible differences.
Measurements consisted of a) 25 serves into the “T area” of the court
b) a 3D measurement of players movement patterns during the service motion. c) measuring maximal external rotation of the shoulder joint as well as maximal rotation of the pelvis and trunk using 3D kinematic evaluation.
d) measuring players maximal ground reaction force and impulsion using two force plates.
e) measuring passive joint mobilisation of the main joints and muscle flexibility, as well as measuring the isokinetic force generated by the hamstrings and quadriceps.
The study found that injured player had the best serving performance in racket speed compared to the mean of the group which could be significant because there is a correlation between racket velocity at impact and ball speed (Gordan and Dapnena, 2006).
The author also states that leg extension is a key parameter in the search for efficiency in the tennis serve and therefore rapid leg extension contributes to serve speed. In relation to this the injured player had a lower leg drive impulsion result. However, this was not due to a deficit of strength as isokinetic results showed better muscle quality in the injured player than that of the mean of the group.
Results showed that ankle plantar flexion bi-laterally was lower for the player than the group. Also, when leaving the force plates the player was shown to have more knee flexion bi-laterally than the control group and therefore incomplete knee extension when leaving the force plate. The author thus hypothesises that this lack of energy generation must therefore be recovered by other movements in the kinetic chain in order to obtain the best result of serve velocity.
Additionally, an anterior pelvic tilt was measured as higher for the injured player than those in the control group, which is of significance because this causes increased lumbar lordosis leading to tension on the hamstrings which the author reasons as an explanation for the players incomplete leg drive.
A maximal forward shoulder velocity was shown to be higher for the player than in the group during serve indicating a higher energy generation between pelvis and shoulder for this player highlighting a compensation between pelvis and shoulder. The author reasons that the abdominals are then working harder to transfer energy from the pelvic girdle to the shoulder girdle.
Results also showed a larger external rotation for the player than in control group which is significant in the cocking phase of the service motion as the player takes his racket back. The authors states that this action could also add increased lumbar lordosis in addition to the abdominal eccentric tension. That author hypothesises that the players lack of leg drive leads to various compensations including abdominal workload and larger external shoulder rotation.
The eccentric contraction of non-dominant rectus abdominus followed by a concentric contraction during the cocking phase of the service motion is then hypothesised as related to the injury mechanism. The anterior pelvic tilt also develops an abdominal pre-stretch during the eccentric phase of serve followed by a concentric phase of the abdominal contraction. In a previous study by Maquiriian et al, 2007 it is stated that this rapid muscle request during the start of trunk flexion can lead to tear, as could be the case here.
Regarding this study, the author admits that overuse could be one reason for injury as well as imperfect technique.The injured player was shown to have a deficit of energy transfer due to an uncompleted leg drive and a specific pelvis kinematic which led the author to propose that the player compensated. The author states that the injured player may have compensated by way of a larger abdominus contraction. These specificities could be a retrospective explanation of medical history concerning the players abdominal muscles as well as the players risk for future injury.
What must not be overlooked was that the injured players serve was faster than those in the control group despite the deficiencies outlined in the results of testing. However, as stated results indicate that the specific technique of serve has been compensated for by the injured players lack of ROM, lack of ankle plantar flexion, lack of knee extension, increased anterior pelvic tilt and increased external rotation in the shoulder.
Some practical applications can be offered in the management of players through a 3D analysis thanks to this study such as measuring ankle ROM, GHJ ROM and Knee ROM. Also, this study shows that when training athletes to prevent injury during the serve it is important to work on ROM and ensure that the kinetic chain is firing optimally.
Bjorn Blythe provided the critical review and summary of these research studies.
Knowing The Ranking Pathway To Professional Tennis
By Mark Kovacs, PhD, CTPS, MTPS
If you work with high level juniors, collegiate players or young transitional professional players this article will be valuable. If the goal of these players is to make it to the Top 100 on the ATP or WTA tours they will need to progress through a few stages of development. Below is some real-world data that can help all iTPA professionals when working with these individuals.
Making it in professional tennis is usually discussed in the terms of making it inside the Top 100 in either the ATP or WTA rankings. This is a lofty goal and most professional tennis players do not actually make it inside the Top 100. Although many very good tennis players never make this ranking milestone, (and it is certainly a very high bar) it is somewhat similar to a player who makes the NBA G-League but never makes the NBA or a minor league baseball player who never makes the Majors. These athletes are some of the best in the world, but never reached the highest pinnacles of their respective sports.
For purposes of discussion, we will focus on individuals that do reach the Top 100 in the ATP and WTA rankings as it is usually the ranking that is used as a definition of success in pro tennis. The main reason is that this is the approximate cutoff for direct entry into the four Grand Slam (main draw) tournaments and also provides direct acceptance into many of the higher level professional tournaments. If an athlete can keep the ranking inside the Top 100 that usually means they can earn a good living playing tennis.
Over the past decade I have directed a number of research studies looking at what it takes for players to make the Top 100 ranking both from a qualitative and quantitative perspective. These studies have included data collection and analysis of thousands of hours of information with over one million data points. The original quantitative analysis was performed back in 2014 and it had very specific goals of determining what the best players did to achieve a Top 10, Top 25, Top 50 and Top 100 ranking. This included analysis all tournament results, matches played, rankings earned in junior tournaments, ITF events and pro events. This included looking at which athletes were on certain pathways and which players were not on certain pathways. Predictive analytics was used to help explain which athletes were tracking to certain ranking goals. This information has been used for many different purposes whether from a federation, coaching, agent, or player perspective when determining whether to go straight to professional tennis or to attend and compete at the collegiate level.
Although many variables exist in determining whether a player will achieve a certain tennis ranking, the data obtained from these studies highlight the rather consistent pathway that most players take to a Top 10 ranking. The Top 100 ranking has more variability, but it also provides a very consistent range that players fit in during their junior careers. Although every player has a different path to the Top, the data consistently shows that we really do not have major outliers in our sport. It requires a long journey and hitting a series of measurable benchmarks throughout the junior career, transition pro career and professional career.
Below are some of the major highlights of this data. This is a very small example of some of the data and provides a nice summary of certain aspects for both male and female tennis players.
If you prefer to watch and listen to a discussion of some of the major findings, please see this webinar that Dr. Mark Kovacs did.
Listen here to a 60 minute webinar on this topic where I discuss the data on the Functional Tennis Webinar
How Many Matches Do Players Play At The ITF Junior Level
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iTPA Professional Tennis Performance and Physical Preparation Expert Group
Here was our November meeting where over 50 Top physical trainers, CTPS professionals and top experts who train professional tennis players discussed the unique aspects of 2020 and also the preparation for the 2021 Australian Open and 2021 season.
Jez Green – Physical Preparation Coach for Andy Murray and Currently Alex Zverev
Satoshi Ochi – Head Strength & Conditioning Coach for the United States Tennis Association
Gabriel Echeverria – Physical Preparation Coach for Tennis Australia
Dozens of other top coaches working with professional players
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WTFC 2018 Presentation Video: Gil Reyes
This presentation video from the 2018 ITPA World Tennis Fitness Conference features Gil Reyes. Continue reading