By Neeru Jayanthi, MD, Director Emory Tennis Medicine; Tony Tran, ATC, Emory Tennis Medicine; Lucy Avant, NYU (Pre-Med) Tennis Player, Emory Tennis Medicine intern; and Michelle Mullins, MD, Rothman Institute, Orlando, Florida
What warmup do you do before a league match? If you are like most tennis players, you probably run out on court, stretch your legs, and then ask your teammate how their week has been while you begin hitting. As a sports and tennis medicine physician who has researched and treated injuries extensively for more than 20 years, that warmup is likely not working! One of the biggest challenges in fielding a full lineup is availability due to injury; so, what can we do about this? Most high-level junior, college, and professional tennis players do a dedicated warmup and cool-down program to reduce injury risk, but we found that in researching adult league players (who may be more vulnerable to injury), most do not perform a standard warmup or cool down.
In a cross-sectional study we conducted with more than 500 adult recreational league players in 2003, 52.9 percent of tennis players with an average age of 46.9 years experienced injury in the last year (*Jayanthi et al., 2005) with the elbow and shoulder being the most common locations. Most adult injuries tend to be muscle or tendon such as rotator cuff, tennis elbow (elbow tendinopathy), tennis leg (calf muscle), hamstring injuries, and Achilles tendon (among other) injuries that may actually be preventable. Based on several tennis studies we have done, more than half of adult league tennis players have reported an injury in the last year that has kept them from playing. That means as an adult league tennis player, you have a greater than 50-percent chance of not playing due to injury this year!
The Tennis 10+ is a tennis-specific warmup/cool-down program created and researched by the Emory Tennis Medicine team to reduce injury and optimize performance on court for competitive adult (and high-level) tennis players. The Tennis 10+ was developed using an evidence-based approach, which accounts for known tennis-related injury patterns and best injury prevention exercises. Tennis 10+ has two, main components: the dynamic warmup prior to play and cool down after play. The protocol consists of 10 exercises in total, which take approximately 10 minutes to perform; 6 minutes of “dynamic warmup” prior to play and a 4-minute “cool down” after play. The plus portion of Tennis 10+ contains additional exercises for chronic or recent injury to the common regions of the body that may be prescribed by your healthcare provider. With the aim of increasing compliance, the protocol is straightforward, requires minimal time, and can be performed on court with or without a resistance band and minimal or no equipment.
The USTA recognizes that dynamic warmup and flexibility and strength training is an essential element of any pre-activity and post-activity routine, but no standardized, tennis-specific program had been researched previously. To our knowledge, the Tennis 10+ is the first researched and evidence-based warmup/cool-down program for adult tennis players. Over the 9-month study period of 350 adult tennis players, this warmup and cool down was associated with lower rates of injury and reduced severity of injury (fewer days missed) in adult tennis players who were compliant with the program versus those with low compliance. In fact, the players who were more compliant participated in more hours per week of tennis! The average age of players was around 46 years old from all levels of play, and many reported a prior injury. We recommend you perform our Tennis 10+ warmup before and cool down after every practice and match to stay fit on court and in your lineup!
Don’t forget some basic rules with doing warmups and cool down
- Static stretching is not recommended before you play. “Stretching on cold tissue” may be more detrimental and likely does not reduce injury risk.
- Dynamic warmup (gradual lengthening exercises recreating your tennis movement patterns) is your focus to reduce injury risk before you play.
- Static stretching after playing is more appropriate to lengthen tissue when it is warm.
- Maintaining strength is a key part of injury prevention and treatment.
Exercises you can perform along the width of the court
Total Body Warmup
- Jogging with arm circles & side shuffle with arm swings (1 min.)
- Extend the leg: walking toe touches “Frankenstein” (1 min.)
- Knee tucks with calf raise (1 min.)
- Lunges with rotation forward lunge & side lunge with rotation (1 min.)
- Internal & external rotation, shoulder (1 min.)
- Shadow swings
5 each FH/BH & 10 service motion (1 min.)
Repetitions: 5 forehands and backhands; 10 serves
Short court progression suggested
TENS Cool Down
- Triplanar core stability (1 min.)
Repetitions: 10 leaning back, right, left, and twisting
- Eccentric wrist flexion & extension (1 min.)
- Knee back: Standing quadricep stretch (1 min.)
- Standing calf stretch on wall/fence & hamstring sliders (1 min.)
*Jayanthi, NA, Sallay PI, Hunker P, Przyblski M, “Skill-Level Related Injuries in Recreational Competition Tennis Players, Medicine and Science in Tennis: Vol. 10(1): 12-15, 2005.
