By Jane Jarosz
WebMD Live Events Transcript

Most people know about tennis elbow (lateral epicondylitis), a devastating injury to the muscles and tendons on the outside of the elbow. However, did you know that there's a lot that one can do to avoid it?

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

Moderator: Welcome to WebMD Live's Sports and Fitness Auditorium. Today we are discussing prevention of and recovery from tennis injuries with Jane Jarosz, PT.

Greetings, Ms. Jarosz!

Jarosz: Hello.

Moderator: Well, let's begin with a little background information. What are the most common tennis related injuries?

Jarosz: Probably the shoulder and elbow tend to be the most common, due to overuse, because it's a very repetitive sport. Probably the lower back and the knees would be next in line.

Moderator: Is there any way to prevent these injuries?

Jarosz: Several ways. Equipment is one factor to look at. Physical conditioning and preparation, and proper instruction, and good technique.

Moderator: Well, let's begin with equipment.

Jarosz: From an upper extremity standpoint, the first thing to look at is the racquet itself. Racquet material can vary tremendously, from graphite to the more high tech material of carbon and titanium. As you move from graphite to carbon and titanium, the racquet stiffness increases. As you increase stiffness, you'll typically have more power, but potentially at the expense of control. Probably the next thing to look at in a racquet is the racquet head size. There's typically the mid-sized and the over-sized racquet. These are most common today. If someone has an elbow injury, we'll typically recommend on oversized racquet to increase the sweet spot. Probably a third thing to look at is the grip size. Commonly I'll recommend anthropometric. Basically you measure from the second palm line in your hand to the tip of your fourth finger. That gives you your true grip size. As far as the racquet width is concerned, there are two types, standard and wide body. The wide body is wider and increases stiffness of the racquet, therefore increasing power, but again, potentially at the expense of control. Proper shoe wear is important. There are a lot of brands of tennis shoes specifically made for tennis out there. It can be important to make sure you have good cushioning to absorb the shock from the stopping and starting motions in tennis. That will help prevent the overuse knee injury. In addition, good support on the inner and outer side of the shoe is important to support the foot during the side to side motions while playing. That's about it, as far as equipment.

Moderator: Is the court a factor in injury prevention?

Jarosz: Basically there are two types of surfaces most people play on, that is a hard court or a clay court. The clay courts tend to be a lot more forgiving because they are softer, and the player will tend to glide on the court, and the forces to the joints of the body, especially the legs and the back, significantly decrease on the clay courts. The ball often moves much slower on a clay court because, again, the forces of the ball are absorbed more readily. Therefore, the pace of the ball tends to be a little bit slower on a clay court.

Moderator: What should a player look for in a court?

Jarosz: Probably the first thing important is to check out the people that run the facility, as far as if they have a certified tennis pro on staff, do they have involvement with the US Tennis Association? Are there leagues available either within the club or that play other clubs in the area? What's important to that player? Competition? Or more for the social aspect? Or a combination of the two? A club should really offer both of those types of situations.

Moderator: What are the most effective stretches for tennis?

Jarosz: There basically is about ten good different types of stretches to do prior to playing. The US Tennis Association has a card with all the stretches on a sheet that's available if you contact the USTA directly. That would be Key Biscayne, Florida. But stretching for the calves, the hip muscles, the quadriceps, the hamstrings, the shoulder rotator cuff, the forearm of the elbow -- these are the highlighted areas to stretch. It's good to stretch before and after you play both as a warm up and a cool down.

Moderator: Do warm-up and cool-down exercises help to prevent injury?

Jarosz: Yes. Stretching is just one aspect of the warm up and cool down. Also do some active exercises, especially for warming up. I term that as dynamics. That can include jogging around the court, doing some side shuffling - just to mimic the motions of playing, going thru the strokes without hitting the ball, per se, are all good dynamic type warmup exercises.

Moderator: How can one prevent shin splints? And what exactly are they?

Jarosz: Shin splints are an inflammation of the tissue in the lower leg. It's a very common overuse injury. It's typically seen in a lot of runners. It's seen in tennis players on more of an occasional basis. Good ways to prevent them are with a lot of calf stretches and Achilles tendon stretches. Proper shoe wear is very important. Make sure you don't play with old shoes. A softer surface such as a clay court will help tremendously to decrease the forces to that injured area.

Moderator: Here's a question regarding training. What should one focus on? Ball control? Sprints? Endurance?

Jarosz: As far as physical training, tennis is an anaerobic sport. Therefore, from a cardiovascular standpoint, you focus more on short bursts of sprints, with a longer rest time. If you think about playing a game or a set, a point probably last maybe ten seconds. So you want to mimic that same situation when training from a cardiovascular standpoint. In addressing strength training, you probably should focus more on endurance, which would be high repetition and lower weight, since tennis is a repetitive motion sport.

Moderator: How can one find a good coach? Are there organizations that accredit coaches?

Jarosz: Yes, there are organizations which accredit coaches. There is a certification process. The most widely known certification association is the United States Professional Tennis Association. There also is a United States Professional Registry Association. I would look for someone who has this type of certification, because they have gone through specific testing in order to become certified. I would ask a coach what their background is. How long they've been in the field? Were they a player themselves? Maybe ask them for references, too, of other players they've coached. I would also observe the coach working with a group of players or even a private lesson to see what his or her style is like.

Moderator: What do the pro's have -- besides training and experience -- that the average tennis player does not?

Jarosz: They have extensive knowledge from a technical standpoint. They have an understanding of the mechanics of the sport. They also have knowledge in the areas of marketing, management, and things like that, in terms of running a club and not just specifically teaching tennis. They must have organizational skills, and they also have a lot of contacts in the field in terms of developing programs for player, league, social events, etc.

Moderator: Children are very prone to fall when playing tennis. What can a parent do to help prevent this?

Jarosz: If a player is falling, potentially an area to address would be balance and court awareness, so balance drills such as single leg balance, eyes open, eyes closed, balancing on a mini tramp or a pillow even is good. Balancing with a racquet in your hand, and balancing on one leg and going through the ground stroke motion. Also doing some coordination drills -- some side shuffles, some running forward, running backward, some crossover or grapevine type activities. Even some hand-eye coordination exercises are good -- bouncing and catching a tennis ball in a standing position, or catching one you have to move to or run to to catch would be a higher level exercise or activity.

Moderator: Are sports drinks better than water? How much should one drink?

Jarosz: Technically water is the best drink to have while you're actively playing, because it's easily absorbed into the body system. The sports drinks are high in carbohydrates, which gives the players more energy, particularly during long matches or in the hot summer heat. But I always recommend players to -- if they want to use a sports drink, to try it prior to using it in a match. Make sure that their stomach does not get upset. If a player wants to use a sports drink while playing, I don't discourage it, but I often recommend that they water it down. Most importantly, after a match the sports drinks are very good because they help replenish the nutrients lost while playing.

Moderator: Any hot weather tips?

Jarosz: As far as heat is concerned, drink often, even if it's just sips between changeovers, it's important. Wearing light colored clothing is also good. Between changeovers, getting in the shade to cool down is important.

Moderator: Well, our time is about up. Do you have any final comments?

Jarosz: When I work with tennis players from a teaching standpoint, I'll focus a lot on footwork. The reason I do that is because if you think of the body as a linked chain, the feet are the first link in the chain. So if you're not properly set to hit your shot, another link in that chain has to compensate. Oftentimes that causes increased stress to that area, and can eventually lead to injury. The shoulder and the elbow are the later links in the chain. That's why they are often the main areas of tennis injury. Thank you for all the questions.

Moderator: Good night all! Our guest has been Jane Jarosz, PT.

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