March 2020 - Athletic Performance Academy

Todd Ellenbecker- Injury Prevention and Recovery for Tennis

March 19, 2020/in APA Blog /by dazdrake

This blog is a review of the Tennis Files Podcast Episode 39 – Injury Prevention and Recovery

Todd Ellenbecker

Background:

Todd Ellenbecker– Todd is the Vice President of Medical Services for the ATP Tour and a Director of Physiotherapy Associates Scottsdale Sports Clinic in Arizona. He is a certified sports clinical specialist, and orthopaedic clinical specialist by the American Physical Therapy Association

Discussion topics:

TE on why Tennis players get injured

”We can sum that up in basically one characteristic word and that is overuse. Most of the injuries we see in the sport of Tennis are overuse. Tennis players typically get injured because they do the same thing repetitively over and over and over again. We call those injuries overuse injuries and they occur simply because of the repetition that is required to get good and develop skill in the sport of Tennis. And then when you play Tennis successfully, playing tournaments, practicing, training and all the other things that go with it you typically because of that overuse become injured.

Even if you have a biomechanically efficient stroke you can still get injured in those muscles, because too much of a good thing sometimes isn’t a good thing, that’s why players don’t play 60-70 Tournaments a year, that’s why people don’t practice 12 hours a day. There are certain limits to our physical capacity, so there is a very fine balance between developing optimum skill and having the optimal amount of recovery so you don’t fall victim to an injury.

Proper mechanics is likely one of the single most important things to prevent injury

Learning the game with proper mechanics, coupled with proper exercise and development of the musculoskeletal system and neurological system etc all those things help to prevent injury as well as proper equipment. All of those multifactorial things can add up into why someone can have an injury.

TE on three of the most common injuries seen on the Tour today

”Definitely the number one most common injury is the lower back of the spine. There is so much rotational stress that occurs at the lower back and obviously the kinetic chain is how we develop power in Tennis and so we are always funnelling power from the ground up through the legs, through the trunk (or core if you will) and then to the arm and ultimately the ball.

The trunk is that very vital area that funnels a great deal of rotational power through it and so it is often times subject to injury.

The other area of the area of the shoulder. We see many different types of shoulder injury particularly with the rotator cuff tendons.

The third one is foot and ankle injuries because obviously we have got to get to the ball. Tennis is a multi-directionally strenuous sport where we have to cut and move in multi-directions, with friction on the lower body, friction on the skin and problems with the foot and ankle itself because of the overuse.”

TE on the mindset and approach we should take to protect the shoulder

”Years ago recreational players and even some of the lower level elite players would play tennis to get in shape. So the idea is that people didn’t really do a lot of things to get ready for playing tennis. But now the idea is really that you need to get in shape to play tennis.

So the biggest thing that can be done particularly as it relates to the shoulder, is some level of preventative conditioning. Usually this means things like using therabands to strengthen the shoulder, flexibility exercises particularly something called the cross-arm stretch, or a sleeper stretch; just some gentle stretching and some elastic resistance to strengthen the muscles around the shoulder blade and the rotator cuff are important steps that truly every regular Tennis players should be doing to prevent a shoulder injury.”

TE on some the correct approaches to lifting the weight room and the importance of the smaller muscles

”Most tennis players use too much weight, and do some bench press, some military press and some dips, basically all those exercises work the muscles in the front of the body the pecs, the bigger muscles around the shoulder and unfortunately they are muscles that are already strong in a tennis player. They don’t work the small muscles that hold the scapulae in position.

We’re talking about the four rotator cuff muscles. We’re talking about the trapezius which is a scapular stabiliser. We’re talking about the serratus anterior, the rhomboids, some muscles in the upper back. Those are muscles that to optimally contract you actually use very little amount of weight like the bands or a light weight, and you do it repetitively with a high number of repetitions.

Three times 15-20 repetitions to stimulate the smaller muscles so they not only have strength but they also have endurance.”

TE on the optimal time to do some of these shoulder exercises

”Often times from a well intentioned place they will start doing them right before they play, as this is a good way to warm up using the bands on the court. The problem is, if you fatigue your rotator cuff and then try to go on court and play Tennis for 2 hours or even an hour that’s not really sound. That’s like saying you are going to warm-up 10km before you run your marathon. You’d already be tired and it would impact their ability to run a marathon.

So we really want to make sure we are doing the shoulder preventative exercises for the shoulder after you play or on days that you don’t play.

So ideally you need at least 4-5 hours for the muscles to recover before you play, so you could wake up and do them first thing in the morning if you are not due to practice until midday or later. In a perfect world, do the exercises after you play.”

TE on what type of things tend to cause hip pain in Tennis players

”The key is the very strong link to the core. So probably one of the most significant things about Tennis players who have hip pain is we really want to evaluate their lower back and core musculature. Many times if there is any weakness in their core, typically most individuals will say my core is not as strong as it used to be, especially as we age and become less active.

Sometimes players don’t have enough range of motion in the hip and that’s something we can work on getting more flexible particularly with the two joint muscles as we call them, muscles that cross not only the hip but the knee. Muscles like the IT band, the rectus femoris, the iliopsoas, the hamstrings. When they become tight they can affect the movement patterns and can affect ether the hip or the knee joint as well.”

TE on three things Tennis players can do to prevent injuries

The number one thing is to learn how to hit the ball properly- develop the strokes
Make sure that you do preventative type exercises and you get in shape to play Tennis
Recover after Tennis- try foam rolling

TE on advice to prevent shin splints

”Can happen when you transition from one surface to another, for example grass turf to gym floor. More often than not in a sport of tennis, it’s because of either an inadequate shoe wear and they are not changing them enough or it’s improper footwear. or it’s the actual athletes that are having the shin splints have a lot of pronation or flat flattens, and you get this eccentric lengthening or pull on the muscle that goes up and down the inside of the shin.

One of the first things that we try is to put in an orthotic device and/or change the shoe. If the shoes are very good then we usually try the orthotic.

We also need to make sure the calves are stretched regularly as a tight calf can make you pronate more. We also need to apply ice to reduce some of the acute symptoms of the shin splints.”

Author opinion:

The part of the podcast that was most interesting was the advice to do the shoulder preventative exercises for the shoulder after you play or on days that you don’t play. A common part of the APA pre-tennis warm-up utilises a low volume of single set theraband exercises for 10-15 repetitions.

It will be a good moment to review this approach with the sports medicine team to see if there are anything we might want to do differently in view of this recommendation.

Top 5 Take Away Points:

Overuse Injuries– most of the injuries we see in Tennis are overuse
Fix your mechanics– proper mechanics is likely one of the single most important things to reduce risk of injury
Get in shape to play Tennis- don’t play Tennis to get in shape
Importance of preventative conditioning exercises for the shoulders
Importance of having a strong core and loose hips

Want more info on the stuff we have spoken about? Be sure to visit:

Dr. Mark Kovacs- Strength & Conditioning for Tennis

March 12, 2020/in APA Blog /by dazdrake

This blog is a review of the Tennis Files Podcast Episode 33 – S&C For Tennis

Dr. Mark Kovacs

Website

Background:

Dr. Mark Kovacs– Dr. Kovacs is a renowned performance physiologist, researcher, author, speaker and coach with an extensive background training and researching athletes and elite performers. His unique skillset has made him one of the worldwide leading performance experts in the area of optimizing human performance through the application of cutting edge, evidence-based information. He formerly directed the Sport Science, Strength & Conditioning and Coaching Education departments for the United States Tennis Association (USTA)

Discussion topics:

MK on several areas of Tennis fitness that are required

”Overall philosophy of Train hard and recover hard. Like most sports it requires a multitude of physical qualities.

Flexibility
Strength/Power
Agility/Movement
Endurance- to last long matches
Dynamic Balance

These are factors that are important in becoming a PROFICIENT ATHLETE first and foremost, and tennis player second. Unfortunately people are so focused on the tennis side of it, hitting tennis balls that sometimes they don’t develop their physical capabilities well enough. We see that at every level of the game. You may have great strokes but if your physical qualities aren’t optimised and you can’t get to the ball, recover from wide balls and fitness for the long term you can’t compete at your highest level for three or four hours.

So it’s really important to look at yourself as a tennis athlete, and make sure you don’t have major limitations in your physical capabilities. It’s definitely an area that can be worked on, and you can do a really good analysis to understand where you are at today, and what areas you need to work on.”

MK on prioritising the different elements of Tennis Fitness

”Everyone is at a different stage of their tennis development. The thing for most tennis players from a speed, power strength perspective is that a lot of that is based on your strength foundation level. So you need to make sure you are doing some form of strength training. That’s really a foundation for a lot of other physical capabilities.

So strength is one component that needs to be a priority. The other is your endurance. You have got to make sure you can last a match as we know plenty of players who are great in the first set and by the third set they’ve got nothing left in the tank. So strength at one end of the spectrum and endurance at the other.

The third big piece is this flexibility/mobility area where you have got to have the right range of motion. You have got to be able to get into the right positions so you can really utilise the energy appropriately meaning the energy up from the ground through the entire kinetic chain out into the ball. That’s where the great players, the efficient athletes do a great job, and get injured less typically.

Athletes that are less efficient are always using the wrong body parts to create their power, they are adjusting at the last minute to hit the ball and those are the players that typically have more issues in the long-term.”

MK on which areas are typically lacking in the adult amateur tennis athlete

”A lot of what you see as a limitation is a lack of general body strength, not necessarily absolute strength but the ability to repeat that movement (muscular endurance. Meaning that when I ask you to perform a single leg squat many of them struggle to put eight through their hip and lower limbs without collapsing or falling one way or the other.

If the lower limbs and core are not strong and stable then we lose energy and have to recruit other muscles to allow us to make contact with the ball. That’s where we see a lot of the problems stemming from.

We want to make sure we have stability with muscular endurance.

MK on which muscle or muscles groups is an area a tennis player typically under trains

”We used to say it was the core, but now people seem to have a greater understanding of the importance of training the core. So a lot more people are now training the entire core region, still sometimes they are doing it with the wrong exercises but that area at least is more of a focus.

The area that doesn’t get enough attention is the lower limb, the calf all the way down to the ankle. This is really the large major joint and last major muscle groups before ground contact, and we know that everything we can get energy wise into the ball comes from the ground. So if we have a weak link at the lower limb then everything further up the chain is limited.

Ankle range of motion =>stretch it out DAILY
Ankle stability
Ankle force generation capabilities => bodyweight squats are a good exercise

MK on type of strength training most appropriate for Tennis players

”A lot of tennis players structure their training to not necessarily increase their size of the muscles but what they are doing is they are developing general strength, power and muscular endurance and they are not trying to increase size of muscle as an objective. However as you age, you want to increase muscle mass because there is a natural aging effect, where you lose muscle mass as you get older.

Strength foundation – 3×10 (two reps short of a 10 Repetition Maximum- so not going to failure)
Power– 5×3-5 (30-60% 1RM) -the optimisation of training for a tennis player. Less that 6 reps. Light, Fast and Low Reps.
Absolute Strength– 5×3-5 (>85% 1RM) less than 6 reps. Heavy, Slow and Low Reps.
Hypertrophy– 4×6-12
Muscular endurance– 2-3×8-15

MK on different types of Periodisation for Tennis players

Perioridation is simply a form of planning to increase and decrease load throughout a period of time to optimise your training and be prepared for your appropriate competition. The reason Tennis players train is so that they can compete at a higher level so you need to structure your training with:

Heavier weeks
Lighter weeks
Higher volume
Lower volume

We can’t do week after week more and more. At some point you will break down. For some players that might be week two or three of a programme. For others that might be week six or eight. But at some point you keep increasing the workload and increasing the intensity you are going to break down, and a structured periodised programme is designed to avoid that!

Monitor the workload, monitor the rest and then pull back on the training depending on what the numbers are telling you objectively. When you start to see signs of fatigue (and there a lot of different ways to monitor that) you want to start backing off and you want to start reducing volume and reducing intensity. Let them recover for two, three, four days or even a week depending on how bad it is, and then start ramping up the training again. If you don’t do that the body will naturally shut it down itself by getting sick or injured and have to take time off.

One way is the block approach– where you really emphasis one specific component for an extended period of time (two to threes strength foundation, two to three weeks absolute strength, two to three weeks power etc. This is a great way to train and develop those areas, no doubt about it, and for athletes who have a traditional season with a full off-season, a full pre-season that’s how I train them (football players, basketball players).

In many Tennis players, they don’t have that luxury as they are competing once a month, every two weeks, may take two weeks on, three weeks compete etc and that’s their entire year. So for those individuals that are competing year round, we use a tennis specific periodised model, which is a form of non traditional periodisation known as concurrent approach. Meaning we do everything every week. We have a strength day, a muscular endurance/hypertrophy day, a power day.

The way we periodise it is we increase or decrease the volume and intensity in a structured way leading into our major tournaments. So certain events where we know aren’t as important as others, where they are competing just for match practice, they are going to train through that tournament somewhat, and maintain their physical training regime so they can really peak for some of the more important tournaments.

MK on some of the best strengthening exercises for the serve

A lot of times people try to fix their serve technique without knowing what the cause of the problem is. Sometimes it’s purely a technical issue that can be changed just with a cue and some practice. Most of the time there is a PHYSICAL LIMITATION that is the reason why you can’t do certain things on the tennis court.

In general the big areas that athletes need to focus on are the hip range of motion. Most people don’t think of the serve as a hip based exercise but that’s really where a lot of the power comes from. So they have to have good hip stability and range of motion.

The second big area is their back leg strength. If they don’t have good strength and power here that needs to be an area of focus.

Once our lower limb and hip is doing it’s job we can focus further up the chain with the core and shoulder.

MK on how to improve Footwork

”Very. very important area. A lot of people think that taking a lot of little steps is the best way to move, and it’s definitely not. It’s actually the slowest way to move on court. We want to be in the air more than we are on the ground, and what that means is that we want to take less total steps to get from A to B.

The problem is we want to do that as quickly as possible but you have to have the right amount of power to generate into the ground and out. So if you think about Usain Bolt at the Olympics, the reason he wins is because he takes less total steps than all his competition in the 100m dash. If the fastest way to move was to take a lot of little steps, we would see everyone shuffling down the track, and we don’t see that for a reason, because the fastest way to move is to take big steps.

Sometimes we do need to take those smaller adjustment steps but that only occurs if something has gone wrong in your movement to the ball

(meaning you haven’t timed it right, you’ve over ran the ball or mistimed the ball that is coming to you). Great movers always look like they are in the right position.

You with individuals that really struggle with movement you have to ask yourself:

Technique– am I using the most efficient footwork pattern as possible?
Strength/Power– do I have the leg strength and ability to produce the power to move quicker
Flexibility/Balance– concept of stability. Do you have the stability to be able to take these larger steps and absorb what you need to absorb, and take another step without losing your balance or taking too much time to regain your balance?

A good oncourt drill to use that work really well is the T line to S line (in service box) 30-sec cross-overs (run facing the net). This is a great exercise because you have to work on not only your footwork, but your change of direction, acceleration. If you do that for 30-seconds that is about a long a point as most people will play, so you get a little bit of speed endurance. You’re starting to get a little tired in the last 10-seconds.

We also like the Spider 5 ball drill.

Focus on your technique and understand your angles of stopping and starting, which is the art of good movement.

MK on areas of flexibility to focus on

Calves– loosen up that area
Hip mobility– loosen specifically internal rotators (pigeon stretch)
Shoulder mobility– internal rotators eg. sleeper stretch

MK on overall athleticism of a Elite Tennis player

Tennis players aren’t going to win any of those traditional competitions on a specific quality. They won’t have the biggest vertical jumps, and jump 40 inches; they will be in the mid twenties or low thirty inch at best. They won’t get a 4.3 seconds 40Y dash, maybe it’s going to be in the 4.6-4.8 range. They aren’t going to put up 20 reps on the 225lb bench.

However, they are going to do pretty well in all those competitions and when you combine all those scores together their average is going to be higher than a (American) football player, because an American football player is not going to have the endurance of a Tennis player etc. You need to be really good at all those physical attributes to be an elite tennis player.

Author opinion:

At APA we always promote the use of using a range of exercises, that require a mixture of physical capabilities- it’s just the focus and intensity of those exercises that changes at a given point in time.

For this reason APA would agree with the recommendations to use a concurrent approach to Tennis periodisation with a focus on building a strength foundation.

Top 5 Take Away Points:

Total athlete– recognise that Tennis is a sport which requires a multi-variate approach with emphasis on strength, endurance and flexibility
Strength foundation– importance of building relative strength as the foundation of power and speed
Importance of lower limb strength– make sure you focus on strength of lower limb
Importance of hip mobility and back leg strength for serve- rather than focusing on the upper body, make sure you are getting the lower half working efficiently first
Importance of taking big steps- rather than taking lots of little steps remember the fastest way to get from A to B is with big steps.

Want more info on the stuff we have spoken about? Be sure to visit:

Twitter:

@MKovacsPhD

Joel Jamieson: Recovery-Driven Conditioning

March 8, 2020/in APA Blog /by dazdrake

Joel Jamieson– online educator who taches coaches how to write science based conditioning programmes that deliver real world results

Website

Bioforce HRV

Morpheus

Bioforce conditioning certification

What is Conditioning?

The overall mental and physical preparation in order for someone to compete or perform in whatever environment they are trying to compete or perform in, whether that’s the game of life and you’re trying to stay alive and sustain a healthy life or it’s in the octagon and last from bell to bell for 3-5 minutes.

Conditioning- how well they can use their fitness they have to accomplish something

Energy system development– VO2max and Anaerobic threshold
Movement capacity– the energy it takes to perform a movement (efficiency)
Mental performance– control emotion and heart rate without a massive adrenalin dump

Movement capacity- we try to develop fitness and a lot of times that does mean going to high intensity and causing some fatigue to develop fitness qualities, but what we forget is that as we get fatigued our natural inclination is to let our fatigue fall apart.

If the coach is reinforcing that by saying: ‘Go faster, finish, keep going’ etc the problem becomes that they have learned to have poor technique as soon as they get tired, and have bad habits.

In sport as you fatigue, technique is always what wins! So we have to realise that as we develop these different fitness qualities we can’t let that develop hinder our movement and make us have sloppy technique. That doesn’t haven’t to be the case and it’s a very trainable quality!

Need For A Aerobic Base

Nowadays you will hear coaches say it’s all about interval training now. The research is based on time constraints of 4-6 weeks studies so of course if you are trying to improve fitness in that time, ”intensity is just a driver of the acceleration of things” so if I have 4-6 weeks and testing from point A to point B then training harder is going to lead to better results in those time frames.

But if we look at real world development over 6 months or a year then you can’t just do one intensity all the time. There is something to be said for spending time at lower intensities and higher volume training and greater frequency of training having looked at HRV data for many years.

In most sports that have a high aerobic demand there is a tendency to have a distribution annually of about 80% of time at lower intensities and 20% at higher intensities. That seemed to be a distribution that held true across almost any endurance sport in the world.

First 20-30 seconds of maximum effort work is predominantly anaerobic. After that point you will be predominantly aerobic. Because you were so anaerobic for the first 30 seconds, it takes up until to around 60 seconds of maximum intensity to where the total energy comes around to being around aerobic.

Now of course there is a difference between going for 2 minutes versus 2 hours but both events are going to be predominantly aerobic. It’s more just a question of how the aerobic system is functioning from an aerobic power versus aerobic capacity over the event. If you look at the average speed of a 1-mile and a marathon race the speed is not massively different to go one mile or to go 26. The reason for this is once you get to that 1-mile pace it is entirely aerobic, and when it is entirely aerobic it is possible to sustain that for a long time.

Specificity? Why not just practice the event?

Let’s use the classic indoor Concept 2 Rowing challenge.

A typical interval routine might be: 500m x four intervals with 5 minutes rest between intervals, and over time taper that down to rest to 1-minute between.

But why not just practice my 2000m rowing challenge every session and get better at the race?

It comes back to developing fitness qualities which requires a range of intensities. We are trying to develop different components of the aerobic engine, or anaerobic engine depending on the sport. Those happen at different intensities.

Let’s say I’m training for powerlifting, which is 1 repetition maximum of Bench press, Deadlift and Squat. So why don’t I just come in the gym and max out on 10 heavy singles every session and then walk out the gym? Well most people will say, ”A you’re going to blow your joints apart if you try that and B there is something to be said for doing some higher rep work and some different exercises.”

So we look at strength sports and inherently recognise that we can train for that with higher rep work and different exercises so it’s really the same thing if we are talking about the aerobic engine and aerobic sports. Yes the sport might mean rowing 2k for a few minutes, but that doesn’t mean that only doing that is the ultimate way to develop fitness qualities for it, because there are other intensities which will help us develop the overall biological systems and capacities that we need to get better at that specific event.

So one day a week we try and do a very close to competitive scenario session to get that overall brain-body connection used to that distance and pace and feeling so we do use specificity in training. But again, there are reasons and benefits to using other intensities to build the fitness qualities we need to be able to perform at that event.

Competition

The closer you get to the competitive event the more you want to simulate and recreate as many different parts of the event as possible. That’s where the psychological part of the training comes into play. The brain works by familiarity.

UFC fighters- the guys that have been in the Octagon more times are more calm and don’t get the adrenalin dumps than the person who is going in there for the first time.

There is a reason that the home team wins more than the away time as they are more familiar with the environment.

Train Slow Be Slow

There is no way I’m going on an ergometer for 45 minutes but there is some merit in doing longer work at zone 2 or what we know as that steady zone of 120-150 bpm! So can you just chop up your training into say 10 minutes weights circuit, 20 minutes rowing and then a brisk walk home?

General Central component- adaptations to blood vessel network, and heart are general adaptations that will apply to a lot of different types of exercises. An elite cyclist would still likely do well in other endurance events because they have developed these large central adaptations of aerobic fitness that will transfer to other aerobic events.

Specific component- more specific endurance to the sport, specific motion in leg drive in the exact movement of the bike.

The only caveat with doing general training is that you can’t take this idea that heart rate is equivalent no matter what you are doing. A strength circuit will cause a high heart rate but the resistance of strength training is significantly different to going out for a jog, or a row. The resistance drives my blood pressure up which causes different changes in the cardiovascular system.

But yes going out for a run, versus a bike versus a run can be used to get the general central adaptations, recognizing that the further out from an event we can prepare the body by doing different movements and events. The closer we get to the specific event

If that was not the case then bodybuilders and powerlifters would be great endurance athletes and they are not!

Charlie Francis popularised the High-Low System and he was talking about 70-80% of his overall work volume for his sprinters were tempo intervals at 70% of their maximum speed. So the vast majority of their overall running volume was done at low speeds, but 20-30% towards the end was done at their high speeds.

Now did that tempo interval work slow them down? No! Clearly not, they are the fastest guys in the world! So there is something to be said for the fact that the body is going to adapt to what you do, so if all you do ALL THE TIME is run slow then your body will get better at running at those speeds if you’re doing that over a period of time.

But the idea that any submaximal work is going to all of a sudden slow you down just doesn’t hold up. Your body is going to adapt to the BIGGER PICTURE of things as long as you provide your body with that high speed or high intensity stimulus it’s not going to slow down.

Hope you have found this article useful.

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Todd Ellenbecker- Injury Prevention and Recovery for Tennis

Todd Ellenbecker

Background:

Author opinion:

Top 5 Take Away Points:

You may also like from Tennis Files Podcast:

Dr. Mark Kovacs- Strength & Conditioning for Tennis

Dr. Mark Kovacs

Background:

Author opinion:

Top 5 Take Away Points:

You may also like from Tennis Files Podcast:

Joel Jamieson: Recovery-Driven Conditioning

What is Conditioning?

Need For A Aerobic Base

Specificity? Why not just practice the event?

Competition

Train Slow Be Slow

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