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Back injuries in skilled tennis players start at their serves. (One-Leg Standing Test).

LAKE BUENA VISTA, FLA. -Every game of tennis starts with a serve--and so do most tennis injuries.

Back injuries--not arm or shoulder injuries--are the most common complaints among skilled tennis players, Dr. Edward G. McFarland said at the annual meeting of the American Medical Society of Sports Medicine.

Tennis-related back injury may be due to hyperflexion or lack of flexibility in the hips. A skilled player hits the tennis ball forcefully by using momentum that is transferred through the legs, hips, and back. A less skillful player has poor transfer of force and compensates by using the arm alone to increase serve velocity. This action is likely to result in arm and shoulder pain, explained Dr. McFarland of Johns Hopkins University, Baltimore.

In patients with shoulder problems, a one-leg standing test can reveal problems with legs and hips, and a hitch in shoulder motion can indicate scapular dyskinesia. Signs of tennis shoulder include drooping of the shoulder and minor winging of the scapula.

For tennis elbow, or epicondylitis, Dr. McFarland recommends a smaller racket handle, although support for this advice is anecdotal.

Variables that have not been shown to alter tennis injury patterns include string tension, type of racket material, and tennis ball size. The grip, serving style (foot back vs. foot up), and shoe style have not been shown to have any significant effect for good or ill.

Physical therapy is effective for most of injured tennis players. Surgery is needed only in cases of severe rotator cuff pathology or instability, Dr. McFarland said.
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Author:Splete, Heidi
Publication:Internal Medicine News
Article Type:Brief Article
Geographic Code:1USA
Date:Aug 15, 2002
Words:255
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