The list of tennis players who have withdrawn from tournaments in recent weeks, from the Mutua Madrid Open to the Italian Internationals, in view of the Paris slam, Roland-Garros (Sinner, Alcaraz and Medvedev have withdrawn, while Nadal and Berrettini return with great caution from physical problems), raises the issue of a greater number of injuries among professionals who play a lot and on different playing surfaces. “Although the injuries seen in tennis are common to other sports, its ongoing nature throughout the year, combined with the different surfaces on which it is played, the equipment used and the biomechanics, leads to a unique spectrum of injuries. In In general, acute injuries occur more frequently and tend to affect the lower limbs more often, while chronic injuries tend to affect the upper limbs more frequently.” Andrea Bernetti, vice president of the Italian Society of Physical and Rehabilitative Medicine (Simfer), explains this to Adnkronos Salute. From a treatment point of view, “most injuries can generally be managed through conservative approaches that include rehabilitation intervention strategies to be evaluated on a case-by-case basis – he observes – The ‘return to play’ phase and the prevention of relapses are then fundamental “.
“The explanations behind the injuries of elite athletes are always difficult to provide without knowing the specific case in detail and it is therefore not correct to generalize – specifies Bernetti – However, based on literature data, we can partly underline two elements as plausible factors of risk. First of all, a central role is played by the hours of play and the number of matches played. In particular, recent scientific research has shown an incidence of injuries between 0.04 and 3 per 1,000 hours of play. continues the physiatrist – using data on minutes played in all Association of Tennis Professionals (ATP) and Women’s Tennis Association (WTA) professional tennis events between 2011 and 2016, they found injury rates of 201.7 per 10,000 gaming exposures for women and 148.6 for men. Additionally, they noted significant differences in the distribution of injuries between men and women, with the shoulder, foot, wrist and knee being the most common injury sites. among women, while knee, ankle and thigh injuries were most common among men.”
“A further interesting data – remarks Bernetti – comes from a Dutch study conducted on over 3,500 amateur tennis players of the Royal Netherlands Lawn Tennis Association, which demonstrated how a higher rate of overload injuries was observed in players who played on more surfaces than to players who played mainly on one surface. This change between playing surfaces – warns the expert – could be a risk factor for injuries even among elite players and can at least partly explain the increased incidence of injuries. to the transition from the period of play on a surface to the immediately following one. Naturally these are general data, each injury must be assessed and treated in a personalized way by analyzing every single peculiar characteristic of the athlete”.
“From a therapeutic point of view, the precise details of individual injuries should be known. Generally speaking, we can think about two aspects – suggests Bernetti – prevention on the one hand and therapy in case of injury on the other. Elite tennis players they are followed by complete staff with high-level professionals who approach both these aspects with very high preparation. In fact, the elements to consider are many, well beyond mere athletic preparation, and range for example from the evaluation of the biomechanics of the athletic gesture to sports equipment. , passing through the nutritional and psychological aspects, just to name a few.”
In the context of the evaluation of movement and athletic gesture, “technological devices are increasingly used, such as inertial sensors and video analysis systems, which allow the movement to be objectified and to understand what and how to correct if appropriate. From the point From a treatment perspective – observes the physiatrist – the majority of injuries can generally be managed through conservative approaches that include rehabilitation intervention strategies to be evaluated on a case-by-case basis. The ‘return to play’ phase and the prevention of relapses are then fundamental. therefore in some cases it is necessary to intervene by also providing for a change in the type of game and shots”.
“Technology naturally also supports the treatment phase – highlights the expert – through the use of latest generation instrumental physical therapies and instruments to increase strength or proprioception also through biofeedback tools. Where appropriate, then, Infiltrative treatments can be envisaged under ultrasound guidance using for example hyaluronic acid or Platelet rich plasma (Prp) unscientifically called ‘platelet jelly’. Each case – concludes Bernetti – must however be evaluated and managed in a highly personalized way.” .
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