Prevention of injury in tennis should concentrate on both the intrinsic needs of two areas: the scapula for flexibility, strength, balance, and endurance, and on the function of the core in relation to its role in extremity function and dysfunction. A thorough pre-rehabilitation exam including the core and the involved extremity is required prior to rehabilitation and/or training. The early focus should be on the deficiencies discovered during the pre rehabilitation exam. These usually include both altered patterns of motion of the hip, trunk, and shoulder and actual weakness or inflexibilities of muscles, which may be seen locally or distantly. Specific inflexibilities and weaknesses may be addressed locally by specific exercises, but motion patterns should be addressed on a global level involving the entire kinetic chain motion. Rehabilitation for extremity injury should start with core emphasis. Rehabilitation should be viewed as a "flow" of exercises that build a base of stability and force generation, and then proceed distally to establish control of the forces while allowing maximal mobility of the distal segment. The core and scapula are the central parts of this flow. Both act as the base of stability for the shoulder with the core being the "engine" of force generation and the scapula existing as the "platform" for the rotator cuff to perform from. Since both are involved in many aspects of overhead athletic activity, they should be evaluated as part of the workup of any upper extremity injury, and should be rehabilitated prior to rehabilitation of the injured extremity. It is also crucial to incorporate periods of rest not only during the training program, but also between practice and competition.
© Copyright 2006 Medicine and Science in Tennis. Alle Rechte vorbehalten.