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The Best Warm-Up for Tennis Players

2/6/2017

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Warm-ups are important for a few reasons: increase tissue temperature and extensibility, increase heart rate to prep the system for intense exercise and prep specific movements that will be performed at higher speeds.  Most often, people do not warm up either for lack of time or lack of knowing where to start!  If you have a particular area of pain or tightness, you may want to spend more time there.  Otherwise, moving through movements of the whole body is ideal. 
For each of the exercises below, I will use the width of the court, going back and forth between exercises.

Try this simple yet comprehensive workout:
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    Jog Forward 50% max effort (width of tennis court)
    Slowly back pedal (back to starting line)
    Jog Forward 60% max effort
    Slowly back pedal
    Run forward 75% max effort
    Side shuffle 
    Run forward 75% max effort
    Side shuffle (facing opposite way from last time)

 Inchworms- moving slowly and deliberately; keep the legs as straight as possible for a good         hamstring and calf stretch.  Once walked out to the plank position, do a push up (can drop to     knees if needed) then walk feet to hands.  
Toy Soldiers- standing upright, hands out stretched in front; kick opposite foot to opposite     hand; alternate feet and move forward with each repetition. 
Walk on toes- just like it sounds, walk on tippy-toes with small steps.

​Walk on heels- walking on heels, taking small steps. 
World’s Greatest Stretch- a great warm up tool because it hits three areas that need attention     for tennis players- hips, hamstrings and back!  Go through ten reps of each movement then     switch legs.
3-way lunge- also addresses multiple areas, particularly glutes, hamstrings, quads and adductors.  Perform 6 reps in each direction per leg.

Leg swings- hold on to something stable at your side; swing leg forward and backward, letting gravity carry it back down.  Also, swing to right and left.  Preform 10 repetitions each direction.

Arm swings- open arms wide then swing across the front, one arm over the other until your fingers contact your back, swing back to front and cross over the opposite way. Also, swing arms up overhead and then back down past the hips. Again, allow gravity to do the movement, no forcing the range of motion! Perform 10 reps in each direction.  
After this warm-up you should notice that your muscles feel warm, heart rate is up, breathing has increased and you are ready to increase the intensity of your movement.  A proper warm up may decrease the likelihood of an injury and will get you ready to perform more quickly! ​
Good luck this tennis season!  If you missed the first parts of this 4-part series, be sure to check those out.  At Athletes’ Potential we help tennis players resolve pain, improve performance and prevent injury.  Like what you’ve read?  Give us a call!​

Thanks,

    Dr. Jackie, PT, DPT
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Dominating the Court: Feet First

2/6/2017

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Building a solid foundation is important for any structure.  Therefore, maintaining healthy, mobile and strong feet is a foundation that athletes cannot ignore. This becomes particularly important for athletes who require agility—moving laterally, side to side, sprinting, shuffling.  The problem is, we rarely focus on our feet, unless they already hurt!

I challenge you to add at least one foot mobilization or exercise into your daily routine.  Your tennis game will thank you.

Ankle mobility - The ability of your ankle to dorsiflex fully (toes up) is ideal for proper biomechanics during running and cutting.  Without proper length in your Achilles, injuries and tendonitis are more likely. The first step is to check your ankle mobility.  The wall test is our favorite.  
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Place your foot a hand width from a wall (in a lunge position), with the foot in that position drive your knee toward the wall making sure that your heel stays down.  Can it touch the wall?  Due to the structure of the calf musculature, you may find that you lack mobility more when your knee is straight.  Be sure to check out your dorsiflexion side-to-side by using a yoga strap or dog leash.  If you seem to be lacking range of motion here, try these two mobility exercises:
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Foot mobility and strength - The foot is very complex with 26 bones and 33 joints. It is important that the joints maintain the ability to glide on one another so that our feet can conform to uneven surfaces and absorb shock as we run and jump.  Years spent in hard dress shoes, high heels and flip flops can take a toll on our feet.  So when we lace up the tennis shoes and play a hard 2 hour match, the feet were not prepared!  Simply being able to separate the movements of the big toe from the little toes can improve your foot mobility, strength and control.  
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 My favorite set of exercises is Toe Yoga (video below).  Try these out, you might be surprised how tough it is!
The great toe - The big toe (or great toe) may seem trivial to some but is essential for function of the foot.  More specifically, the importance of great toe extension.  Without mobility here, the natural mechanism of the foot is interrupted.  This can lead to pain on the outside of the foot, pain of the other metatarsals (top of the foot) and recurrent plantar fascia pain.  If your great toe isn’t so great and is lacking some range of motion, try these out:
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As you add these to your daily routine, remember that there is no quick fix but you are taking the right steps!  If you have knee or hip or back pain, you still need to start at the foundation.  The biomechanics of the foot drives the whole system.  Try these out for a few weeks and notice the change.  You won’t be disappointed!

Thanks for reading,
​

    Dr. Jackie, PT, DPT, OCS, CSC
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Dominating the Court: Adding Power, Improving Your Backhand

2/6/2017

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Your hip and spinal rotation are the power house of each stroke.  The winding-up and subsequent uncoiling of the kinetic chain allows tennis players to add velocity to their stroke.  Without the ability to fully rotate the spine side-to-side, much of the torque will be dispersed down to the hips and knees or up through the shoulder and elbows.  So if you have nagging aches and pains in those areas, your lack of rotation could be the issue.  Let’s check out the amount of hip and thoracic rotation that you have side-to-side. 

Hips
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When checking internal rotation, sit on a table or box so that your feet are not in contact with the ground. Internal rotation is the motion when your foot moves outward from your body when your hips and knees are bent.  We like to see 40-45 degrees, as in the picture below.  Be sure that as you rotate your hip, you don’t bring your booty off the table and lean to make it go further!  Limited here?  Try out the mobility exercise for internal rotation.  Always retest your rotation afterward so you know if the mobilization is valuable!
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External rotation would be the opposite, so as if you were crossing one leg over the other the ankle resting on the thigh of the other leg.  If this is tough, your external rotation may be limited.  This is less common but still possible! The best mobility piece for this is the Lateral Hip Release (video below).  Try it out!  Remember, test- mobility- retest. 
If you sit a lot throughout the day or just generally have tight hip flexors, this could impede your ability to extend your hips fully.  My favorite go-to for this is the Couch Stretch (video below).  Most people would benefit from spending 2 minutes in this stretch daily.  It will undoubtedly add power to your strokes and serves!
Thoracic Spine
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The thoracic spine is specifically important for rotation due to the structure of the vertebra.  If there is limited rotation in the T spine, we will tend to look for more rotation form the lumbar spine and hips.  The way the lumbar vertebra are stacked on each other, rotation is very limited; thus, repeated rotation with a tight T spine can lead to low back and hip pain.
I would not be shocked to see that most tennis players will have a greater amount of rotation or more ease of rotation to their forehand side (so left rotation in right handed athlete).  This is a structural change that can happen over time as muscle for rotation in one direction are recruited more frequently that muscles for rotation the opposite way.  But what about the backhand?  If you feel that you lose a lot of power with the backhand stroke, it could be due to a rotation restriction.
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Take a look at your spinal rotation mobility to each side.  Laying on your side, knees up at 90 degrees, rotate your back to the floor so that your arms make a T.  The top knee should stay stacked on the bottom and both shoulder should touch the floor.  If this is challenging, we modify this just a bit to an exercise working on spinal rotation throughout the whole movement:  The Windmill (video below).  With this variation, you can use breathing to gain a bit more range and get the shoulder closer to the floor.  If you get stuck with your arm overhead and you are unable to touch the hand to the floor, then pause there, take a deep breath and on the exhale gently push into a bit more rotation.
To incorporate hip extension and thoracic rotation, I suggest adding scorpions (video below) to your mobility routine.  They will also hit the shoulder with a nice stretch across the front.  If you’re short on time- hit a set of 10 to each side before grabbing the racquet!
Notice that although we are adding power to your stroke, there were no strengthening specific exercises. The first step is to chip away at long standing range of motion deficits you have may have.  Having proper hip range and spinal rotation will allow you to unleash your potential from the power house of the body.  Once range of motion has been addressed, other areas to explore are strength and control.  However, skipping the mobility piece will only allow you to layer on strength in the shortened range of motion.  To be resilient, mobilize then strengthen!

Thanks for reading,
​

    Dr. Jackie, PT, DPT, OCS, CSC
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Dominating the Court: Kick Shoulder and Elbow Pain For Good

2/1/2017

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The elbow is affected so often by tennis that it was named after the sport!  Tennis elbow, or lateral epicondylalgia, is pain at the outside part of the elbow.  Its sibling, golfer’s elbow, is pain at the inside of the elbow.  Despite the names, tennis players are susceptible to both.
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Many times, the treatment will focus solely on the elbow.  Decreasing inflammation, resting the muscles that insert at the painful area and strengthening can all be helpful, but what is the root of the issue?  Something that can be overlooked is shoulder dysfunction causing pain down the kinetic chain. Check out the picture of the athlete serving below.  The arm acts as a whip-- drawing the hand back and then unraveling with force the whips the elbow forward so the hand and racquet will follow.  If the shoulder lacks the proper stability in these end ranges and with quick change of direction, the elbow takes the force.
We want our shoulders to be strong through the stroke but it starts with being strong as stabilizers.  An easy go-to for shoulder stability are carry variations.  Farmer's carry (see video below) and overhead carry are great places to start, then you can try a waiter’s carry.  This moves the weight out front so that there is more stress to the shoulder musculature.  If you try this variation with a kettlebell and hold it bottoms-up (see picture below video) it will be more challenging and work on grip strength!  As you get tired, your elbow will tend to drift outward and down, so walk while stabilizing the bell only as long as you are able to keep the correct form.
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Movement must be added to make it effective for the tennis player.  The control of the arm to accelerate and then quickly decelerate comes from the posterior rotator cuff.  Those muscles at the back of the shoulder put the brakes on the arm; without control here, again the elbow suffers but you may also feel pain in the back of the shoulder. 
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A very effective protocol is banded rotator cuff strengthening in multiple different angles.  My two favorite are the WY Negative and the Snow Angels:
The WY negative strengthens the external rotators, demands stabilization overhead with arms straight and requires posterior cuff control as your lower slowly.  No other banded exercise that I have seen is as effective and comprehensive for the tennis athlete.  The best band tension to use for this exercise is 3-7#, so much lighter than you might imagine!  Around 10-20 repetitions at a time is a great goal, although you may need a break or two when you first start.
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Another great shoulder stability exercise is the Snow Angel.  Again, with the light band and perform 10 repetitions at a time.  This exercises forces you to pull back on the band and sustain tension while moving overhead and back down. Try it out!
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The subscapularis is one of the rotator cuff muscles that tends to be largely ignored but can be a culprit in shoulder pain with overhead athletes. When it is tight, it will limit external rotation, or the ability to bring your arm back to serve.  It can cause pain at the back of the shoulder and sometimes that back of the wrist!  The easiest way to get pressure and a stretch on the muscle is with a lacrosse ball.  Check out the Subscap Smash (see video below).  This is a great mobilization to add your warm ups or workout routine during tennis season.
The big picture here is that elbow pain is often a secondary symptom due to a primary cause at the shoulder.  Direct trauma and inflammation to the elbow itself are possible but ensuring a strong foundation at your shoulder will protect the elbow joint over the long run.  Try out these mobility pieces for a week or two and note any change that you have in your performance or symptoms.  If you continue to have shoulder or elbow pain, reach out to us at Athletes’ Potential.  We would love to get you back on the court pain-free!

Thanks for reading,
​

    Dr. Jackie, PT, DPT

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