What are the most common injuries at the Australian Open?

Injury trends at the Australian Open have been fairly consistent over the last few years. The majority of treatments tend to involve blister care and medical treatments. Aside from those, the top areas for acute injury during the Open are: the lumbar spine, ankle and neck in the men’s game and the lumbar spine, thigh (note all those thigh wraps on the girls) and abdomen in the women’s game.

In the past, there has not been much focus on abdominal strains within the tennis literature. However, clinically we have noticed a marked increase in the incidence of rectus abdominus muscle strains on the non-dominant side in tennis players. This is most often felt during the service action, especially on impact and is attributed to the repetitive action of the serve involving trunk flexion and rotation. It is normally located at the level or below umbilicus. Strains of the oblique muscles are less common.

The rectus abdominus is strap like in appearance and is commonly known as the “6 pack” muscle. Its primary function is to flex the trunk.

The most common injuries at the Australian Open

In the late cocking phase of the service motion, correct biomechanics requires rotation and extension of the trunk to enable the player to get into a shoulder over shoulder position. The rectus abdominus works eccentrically to get into the stretched position before the explosive “stretch shorten” cycle which enhances the contraction phase of the muscle that pulls the trunk forward. Trunk flexion is a major driver of the somersault action, which (builds angular momentum and) contributes to 20 percent of the racquet head speed at impact.

Quite often players can continue to play through this injury, although their serve accuracy and speed can diminish depending on the severity of injury. Clinically, a high rate of recurrence has been noted amongst players who have not completed an appropriate rehabilitation program after their strain has settled down.

Why does this happen to some players and not others?

There are many external and internal factors that contribute to any injury. In strokes requiring significant power there are many body segments involved. There may even be a compromise elsewhere in the kinetic chain (tight hip flexors or anterior shoulder structures or reduced trunk rotation) leading the player to extend more to get into the appropriate position. Fatigue, muscle imbalance and poor technique could also contribute, as could external factors such as windy conditions or a change in racquet.

References

• Biomechanics and Tennis, Elliott, B., 2006, British Journal of Sports Medicine, 40; 392–396
• Biomechanical Issues of Abdominal and Groin Injuries in Tennis, Knudson, D., 2007, Medical Science in Tennis; 12 (2); 9–11
• Abdominal Wall Injuries: Rectus Abdominus Strains, Oblique Strains, Rectus Sheath Haematoma, 2006, Johnson, R., Current Sports Medicine Reports; (5); 99–103