CONDITIONING, FITNESS & HEALTH page 2 of 3

Most papers are based on a collection of highly selected cases which represent the more intractable end of the tennis elbow spectrum and their reported results have been inconsistent. Tennis elbow is largely a self limiting condition. The prime aim of treatment should be based on Hippocrates' first tenet of medicine first do no harm. Therapy should start with the simple and conservative before progressing to the more complex and invasive therapies. It should be acceptable to the patient, cost effective and where invasive therapy is recommended, the potential benefits should clearly outweigh the risks. The principles of therapy for tennis elbow are to relieve pain, microbleeding and inflammation, promote healing, rehabilitate the injured arm and try to prevent recurrence. The most effective modalities of treatment are found to be cryotherapy in the acute stage then nonsteroidal anti inflammatory drugs and heat in its various modalities including ultrasound. This is combined with rest which is best defined as the absence of painful activity. Injection of a depot preparation of cortisone is effective although patient reports are not as flattering as those of doctors. There is no advantage and in fact considerable disadvantage in using more than 2 such injections. Therapies such as acupuncture and chiropractic have not been evaluated. Nevertheless they cause no harm, may result in good and should be tried before resorting to more invasive therapy. Rehabilitation should run parallel to treatment.

*Kelley, J.D., et al. "Electromyographic and cinematographic analysis of elbow function in tennis players with lateral epicondylitis." American Journal of Sports Medicine 22.3 (1994): 359 63.

Lateral epicondylitis occurs frequently in tennis players and appears to be caused by tears in the extensor aponeurosis. The purpose of this study was to compare the electromyographic activities of 5 muscles in players with lateral epicondylitis with those of injury free players during the single handed backhand tennis stroke. Finewire electrodes were placed into the extensor digitorum communis, extensor carpi radialis longus and brevis, pronator teres, and flexor carpi radialis muscles in competitive tennis players; 8 players had lateral epicondylitis and 14 had normal upper extremities. The backhand stroke then was recorded on high speed film and synchronized with the electromyographic signal. The injured players had significantly greater activity for the wrist extensors and pronator teres muscles during ball impact and early follow through. This activity increase may have been caused by the abnormal mechanics evident on film, including a "leading elbow," wrist extension and an open racquet face near the time of ball impact, and ball contact in the lower half of the strings. These mechanics not only result in a lower level of play but also leave the wrist extensors and the pronator teres muscles vulnerable to injury. This is the first study that documents increased activity in muscles that have been previously injured.

*Kibler, W.B., and Jeff Chandler. "The effect of conditioning on performance parameters injuries in elite youth tennis players." USTA Research Grant, 1990. Information available from Drs. Kibler and Chandler, Univ. of Kentucky, Lexington, KY 40506

The authors studied the physiological changes in addition to monitoring injuries that occur in elite youth tennis players in order to determine the fitness levels for injury prevention and performance enhancement.

*Kibler, W.B., C. McQueen, and T. Uhl. "Fitness evaluations and fitness findings in competitive junior tennis players." Clinics in Sports Medicine 7.2 (1988):403 16.

Elite tennis players, as well as a large number of active recreational players, are involved in a sport that applies high repetitive loads that can create tension overload situations in certain key anatomic areas of the body and add to possible overload situations in other areas of the body. This results in patterns of inflexibility and weakness that can be demonstrated on a tennis specific musculoskeletal exam, and that can be correlated with areas of increased injury occurrence. These players report conditioning programs that are, for the most part, inadequate to confer total conditioning of all the muscular parameters important in playing tennis. All of these factors, in addition to the frequency and type of playing, contribute to the occurrence of the overload injuries noted. These aspects need to be addressed in a preventative program for injury reduction. We do not believe that major changes in the way that tennis is played should be implemented until the effects of a proper preventative conditioning program are evaluated. The "ideal" conditioning program has not yet been found. While the exact composition of the program is in doubt, our studies allow us to recommend flexibility, strength, and endurance training for all athletes playing tennis at frequent intervals. This program should be guided by the findings on the preparticipation exam.

*Knudson, Duane V. "Factors affecting force loading on the hand in the tennis forehand." Journal of Sports Medicine and Physical Fitness 31.4 (1991):527 31.

The effect of preimpact hand forces and impact location on the postimpact force loading on the hand in the tennis forehand drive was examined. Force sensing resistors and strain gauges were mounted on a midsized tennis racket. Three dimensional cinematography was used to reconstruct the motion of the ball, racket, and upper extremity of two varsity tennis players. One subject performed fifteen strokes using his normal grip while another performed sixteen, eight with a normal grip and eight with a significantly firmer grip. Postimpact peak forces on the hand were significantly (p less than 0.01) related to force at the base of the index finger in preparation for impact and the distance the ball impacted from the longitudinal axis of the racket. Impact location and preimpact force on the hand were found to account for 66% of the variability of postimpact peak force loading in the tennis forehand drive, and are important factors related to force loading in the tennis forehand. Smaller grip forces and rackets minimizing the effect of off center impacts should be considered as intervention to reduce the risk of tennis elbow.

*Kraemer, William J. "The effects of periodized vs. non-periodized resistance training on biomechanical and physiological variables in tennis." USTA Research Grant, 1990. Information available from Dr. William Kraemer, Penn State Univ, University Park, PA 16802

The author conducted research to determine if physiological and biomechanical differences exist between periodized and non-periodized resistance training programs over an entire scholastic year. This project resulted in the publication of Strength training for tennis: a practical guide to strength training by the USTA in 1993. Kramer, A.M., and D.V. Knudson. "Grip strength and fatigue in junior college tennis players." Perceptual and Motor Skills 75.2 (1992):363 66.

Change in grip strength over 30 trials was documented in two samples of junior college tennis players to assess possible fatigue. Eight men and eight women performed 30 maximum grip strength tests with 25 sec. rests between trials. Significant positive correlations (.38 and .53 for men and women) were observed between grip strength and trials. In practical terms, grip strength did not change over 30 trials in these tennis players. The data suggested that the repetitive gripping patterns used by these players in tennis play resulted in consistent maximum grip strengths across 30 trials.

*Leach, R.E., and A. Abramowitz. "The senior tennis player." Clinics in Sports Medicine 10.2 (1991):283 90.

Mature athletes playing tennis can sustain both acute and chronic injuries. A number of the injuries are related to a gradual loss of flexibility and strength. Much of this is reversible with properly directed conditioning and rehabilitative programs.

*Lehman, R.C. "Shoulder pain in the competitive tennis player." Clinics in Sports Medicine 7.2 (1988):309 27.

Shoulder pain in the elite tennis player is of the overuse variety and is usually attributable to impingement symptoms. Nonoperative approaches favor the quickest return to competitive tennis, and when surgery is necessary, arthroscopic procedures are preferred.

*Lehman, R.C. "Surface and equipment variables in tennis injuries." Clinics in Sports Medicine 7.2 (1988):229 32.

Alterations in equipment can reduce the incidence and severity of overuse injuries in the competitive tennis player. Changes in racquet variables, court surface, footwear, and string tension play an important part in treatment of both upper and lower extremity injuries. Adequate time for rehabilitation is needed to prevent reinjury when returning to competition.

*Love, Page. "Nutrition assessment of junior elite tennis players: body composition measurements, energy needs estimation, and dietary intake evaluation." USTA Research Grant, 1991.

Information available from Dr. Page Love, c/o USTA, 7310 Crandon Blvd., Key Biscayne, FL 33149.

The author attempted to develop body composition norms for junior tennis players. The study proposed specific nutrition education guidelines junior tennis players can use to meet their optimal nutritional status for competitive tennis play.

*Luethi, Simon Markus. A biomechanical analysis of short-term pain and injuries in tennis. PhD Diss. Univ. of Calgary, 1983. Available from Univ. of Calgary, Calgary, Canada T2N 1N4

*Malec, Luzanna A. Anaerobic and aerobic capacity of selected Southern California female collegiate skilled and unskilled tennis players. MS Thesis. California State Univ., Fullerton, 1982. Ann Arbor: UMI, 1982. Order No. 1318573.

The anaerobic and aerobic capacity of ten skilled and ten unskilled collegiate female tennis players were compared in this study. Open circuit method of gas analysis during a graded exercise test, and the Margaria-Kalamen Power Test were used to measure the various physiological parameters.

*Marks, M.R., S.S. Haas, and S.W. Wiesel. "Low back pain in the competitive tennis player." Clinics in Sports Medicine 7.2 (1988):277 87.

The etiologies of low back pain and the biomechanics and pathology of the lumbar spine as they relate to tennis stroke mechanics have been reviewed, and a treatment protocol has been presented. A recent survey of the Men's Professional Tennis Tour is the only article found that discusses low back pain in tennis players; the orthopaedic and sports medicine literature is otherwise devoid of any relevant studies. Because this one survey indicates that 38 per cent of 143 tennis players missed at least one tournament because of low back problems, it seems obvious that an epidemiologic study on low back pain in racquet sports is vital to a more thorough understanding of the problem.

*McCann, P.D., and L.U. Bigliani. "Shoulder pain in tennis players." Sports Medicine 17.1 (1994):53 64.

Shoulder pain is a common complaint amongst tennis players. The anatomy of the shoulder girdle is complex and defining the exact pathology that accounts for shoulder pain in tennis players can be difficult. Impingement syndrome and glenohumeral instability are the 2 most common causes of shoulder pain in tennis players. Tennis players with impingement syndrome typically present with pain, especially during overhead strokes and serves. The impingement test helps to confirm the diagnosis. Treatment focuses on restoring any motion and strength deficits and anterior acromioplasty with repair of rotator cuff tears for patients who do not respond to nonoperative care. Tennis players with instability present with pain and a sensation of shoulder 'slipping'. Treatment emphasises rotator cuff and scapular muscle strengthening and surgical stabilisation of the capsulo labral complex for patients who fail a rehabilitation programme. Prevention of injury in tennis players depends on maintaining flexibility, strength and synchrony among the glenohumeral and scapular muscles.

*McElgun, T.M., and R.G. Cavaliere. "Sequential bilateral rupture of the plantar fascia in a tennis player. Journal of the American Podiatric Medical Association 84.3 (1994): 137 41.

*Mero, A., L. Jaakkola, and P.V. Komi. "Neuromuscular, metabolic and hormonal profiles of young tennis players and untrained boys." Journal of Sports Sciences 7.2 (1989):95 100.

This study compared the neuromuscular, metabolic and hormonal profiles of trained prepubescent tennis players and an untrained group. The boys in the experimental group (n = 9; mean age +/ S.D. = 11.4 +/ 0.5 years) had participated in tennis training for 2.3 +/ 1.0 years and the boys in the control group (n = 9; mean age +/ S.D. = 10.9 +/ 0.4 years) were normal active volunteers. The tennis players were found to be physically more active than the controls when the comparison was made for either 1 year (4.9 +/ 1.8 vs 2.6 +/ 2.5 times per week; P less than 0.05) or for 1 week (3.4 +/ 1.2 vs 0.4 +/ 0.5 times; P less than 0.001) preceding the tests. Choice reaction time was significantly (P less than 0.01) shorter in the experimental group (258 +/ 16 ms) than in the control group (344 +/ 81 ms). Dropping height in the best drop jump was significantly (P less than 0.05) higher in the tennis players (0.46 +/ 0.19 m) than in the control boys (0.27 +/ 0.10 m). The tennis players had significantly lower oxygen consumption at the 'anaerobic threshold' than the controls (P less than 0.05). There were no significant differences between the groups in serum hormone levels. The small differences that existed may have been caused by active participation in sport by the tennis players.

*Mitchell, Joel. "The effect of ingestion of a carbohydrate beverage on performance, energy, and fluid status during a tennis match." USTA Research Grant, 1990. Information available from Dr. Joel Mitchell, Texas Christian Univ., Ft. Worth, TX 76129

The author studied and evaluated whether carbohydrate beverages are more beneficial to tennis players than water for energy, performance, and proper fluid levels.

*Moorman, C.T., III, et al. "So called trigger ankle due to an aberrant flexor hallucis longus muscle in a tennis player: a case report." Journal of Bone and Joint Surgery (American Volume) 74.2 (1992):294 95.

*Morgans, LeLand F., et al. "Heart rate responses during singles and doubles tennis competition." Physician and Sportsmedicine 15.7 (1987): 67-71+.

This study monitored the heart rates of 17 adult male tennis players during singles and doubles competition. Results revealed that subjects playing singles games reached an average of 61 percent of their maximal heart rate. In doubles competition, subjects reached only 33 percent of maximal heart rate.

*Morris, M., et al. "Electromyographic analysis of elbow function in tennis players." American Journal of Sports Medicine 17.2 (1989):241 47.

Muscle activity about the elbow during tennis strokes in nine professional and collegiate level players was studied using indwelling EMG and high speed photography. Eight muscles were evaluated for the serve, forehand, and backhand strokes. The serve was divided into six stages and the ground strokes into four stages. EMG tracings were subjected to analog to digital conversion and a relative measure of quantity was obtained. Analysis of variance and Turkey tests were then done to assess statistical significance (P less than 0.05). The ground strokes showed low activity in all muscles tested during the preparation phase. During the acceleration phase, both the backhand and forehand showed a generalized increase in all muscle activity. Both strokes showed marked activity of the wrist extensors and, in addition, the forehand showed high activity in the brachialis and biceps.

In the follow through phase, there was a generalized decrease in muscle activity. The serve showed low activity in all muscles tested during the wind up phase. The wrist extensors increased their activity in the cooking phase, with marked activity in late cooking. The pronator teres and the triceps showed increased activity in the acceleration phase. Follow through phase showed low muscle activity except for the biceps, which increased in late follow through. In conclusion, the muscles of the elbow help stabilize the elbow as a unit during the ground strokes in these high level players. Power in the serve comes from increased activity in the triceps and pronator teres. The predominant activity of the wrist extensors in all strokes may be one explanation for predisposition to injury.

*Mulherin, W.B. "Treating injuries in tennis." Journal of the Medical Association of Georgia 81.6 (1992):317 21.

*Murakami, Y. "Stress fracture of the metacarpal in an adolescent tennis player." American Journal of Sports Medicine 16.4 (1988):419 20.

*Murphy, R.J. "Heat problems in the tennis player." Clinics in Sports Medicine 7.2 (1988):429 34.

Any athlete, regardless of the sport or exercise, should allow an appropriate period to get in condition before exerting maximal effort. Athletes should be encouraged to observe environmental conditions and sharply curtail or postpone activity if the humidity reaches 95 per cent at any temperature. In addition, athletes should expose as much skin as possible to the air, and remain well hydrated before, during, and after exercise.

*Nirschl, R.P. "Prevention and treatment of elbow and shoulder injuries in the tennis player." Clinics in Sports Medicine 7.2 (1988):289 308.

Tennis injuries are common in both the upper and lower extremities. The most common, and often most difficult, upper extremity injuries are shoulder tendinitis and tennis elbow (lateral and medial). Key considerations in the treatment of tendinitis include an understanding of the injury process and the resultant character and quantity of the pathologic spectrums. Tendon degeneration rather than tendon repair is the primary pathologic entity secondary to intrinsic muscle tendon overload. For best treatment results, the protocols of treatment, both surgical and nonsurgical, must be individualized.

*Noteboom, T., et al. "Tennis elbow: a review." Journal of Orthopaedic and Sports Physical Therapy 19.6 (1994):357 66.

Tennis elbow is a common yet sometimes complex musculoskeletal condition affecting many patients treated by physical therapists. The purpose of this article is to review the anatomy, clinical examination, differential diagnosis, conservative care, and surgical treatment for tennis elbow or lateral epicondylitis. Particular attention is given to determining the precise pathological cause of lateral epicondylitis, with consideration of intrinsic and extrinsic factors associated with this condition. This information should assist health care practitioners who treat patients with this disorder.

*Pinzur, Michael S. "Wrist pain associated with 'fractured' handle weights in a tennis racket." Physician and Sportsmedicine 16.7 (1988): 120-22.

Three case studies of tennis players with vague wrist pain while hitting a tennis ball showed unremarkable physical examination results. X-rays taken of the tennis rackets they used, however, showed fractures in the handle weights. Replacement of the rackets relieved all symptoms.

*Ponton, Dennis. "Nutrient intake of tennis players: recommendations and practices." USTA Research Grant, 1990. Information available from Dr. Dennis Ponton, State Univ. of New York College at Buffalo, Buffalo, NY 14222

The author examined whether tennis-specific nutrient recommendations exist, and, if so, if they correlate with waht competitive tennis players actually follow as a dietary plan.

*Priest, J.D. "The shoulder of the tennis player." Clinics in Sports Medicine 7.2 (1988):387 402.

A depression of the exercised shoulder was found among highly trained tennis players, and in other athletes employing the overhand motion. This deformity is attributed to stretching of the shoulder elevating muscles, and to hypertrophy of the racket holding extremity. Most symptoms in the shoulders studied were in the region of the rotator cuff, and occurred upon strokes requiring abduction. Shoulder dependency causes a relative abduction of the extremity, which may result in impingement of the rotator cuff. Shoulder droop may lead to thoracic outlet syndrome, and, in the athlete, may simulate scoliosis.

*Prochaska, V., L.A. Crosby, and R.P. Murphy. "High radial nerve palsy in a tennis player." Orthopaedic Review 22.1 (1993):90 2.

High radial nerve palsy occurred in a 47 year old athlete following muscular overexertion. Surgical exploration showed a fibrous arch coming from the long head of the triceps and causing entrapment of the radial nerve. Radial nerve entrapment following muscular overexertion has been reported to be caused by fibrous arches coming from the lateral head of the triceps. Fibrous arches can occur from either the lateral or long head of the triceps muscle. The neuropathy that occurs can be irreversible.

*Rettig, A.C., and H.F. Beltz. "Stress fracture in the humerus in an adolescent tennis tournament player." American Journal of Sports Medicine 13.1 (1985):55 58.

*Ryu, R.K., et al. "An electromyographic analysis of shoulder function in tennis players." American Journal of Sports Medicine 16.5 (1988):481 85.

Shoulder injuries in tennis players are common because of the repetitive, high magnitude forces generated around the shoulder during the various tennis strokes. An understanding of the complex sequences of muscle activity in this area may help reduce injury, enhance performance, and assist the rapid rehabilitation of the injured athlete. The supraspinatus, infraspinatus, subscapularis, middle deltoid, pectoralis major, latissimus dorsi, biceps brachii, and serratus anterior muscles were studied in six uninjured male Division II collegiate tennis players using dynamic electromyography (EMG) and synchronized high speed photography. Each subject performed the tennis serve and the forehand and backhand groundstrokes, and each stroke was divided into stages. The tennis serve contains four stages. Three stages characterize the forehand and backhand groundstrokes. Our results indicate that the subscapularis, pectoralis major, and serratus anterior display the greatest activity during the serve and forehand. The middle deltoid, supraspinatus, and infraspinatus are most active in the acceleration and follow through stages of the backhand. The biceps brachii increases its activity during cocking and follow through in the serve with a similar pattern noted in the acceleration and follow through stages of the forehand and backhand. The serratus anterior demonstrates intense activity in the serve and forehand, thus providing a stable platform for the humeral head and assisting in gleno humeral scapulothoracic synchrony. The tennis serve and forehand and backhand groundstrokes are accomplished by complex sequences of muscle activity that incorporate contributions from the lower extremities and trunk into smooth, coordinated patterns.

*Sachs, Michael L. "Injuries, physical factors and psychological characteristics in intercollegiate tennis players: a counseling/prediction model." USTA Research Grant, 1990. Information available from Dr. Michael Sachs, Temple Univ., Philadelphia, PA 19122

The author examined whether a correlation exists between psychological distress and injuries in intercollegiate tennis players.

*Shin, In Sik. The influences of string tension and frame stiffness on racquet and ball motions, and on impact loads at the elbow joint during the tennis backhand drive. PhD Diss. Univ. of Illinois, Urbana-Champaign, 1989. Ann Arbor: UMI, 1990. Order No. 9011021.

The motion of the ball and frame during and just after impact was inferred from the acceleration time change of an accelerometer instrumented impactor pendulum, and the strain time change of the frame during the clamped racket impact. The impulsive loads acting on the elbow joint were estimated by adopting an inverse dynamic analysis (impulse momentum equation) for the racket and forearm during the backhand drive. The stiffness and string tension conditions tested in the experiment were 5450 and 7540 N/m crossed with 178,245, and 311 N, respectively for the two phases of tests. Generally, the impulse of the first acceleration spike was not consistently affected by the string tension and frame stiffness. However, at the slowest impact speed, high string tension and flexible frame significantly reduced the impulse on the ball. This specific result was partly consistent with the impulse measured in actual backhand drive impact where only the tighter string reduced the impulse applied to the ball. Although the mean impulses produced by the stiff frame were larger than those by flexible frame at the tested string tensions, the difference was not significant. The mean linear and angular impulses acting on the elbow joint during backhand drive were 0.804 N $\cdot$ sec and 0.416 N $\cdot$ sec, respectively, with large variability in the measures. The approximated peak impulsive force and moment was 144 N and 78 Nm respectively. The effect of different string tension and frame stiffness on the impulsive loads at the elbow joint during backhand drive was not significant. Recommendations. A lighter impactor would improve the applicability of the impactor pendulum results to actual racket and ball interaction. A set of 3 D impulse momentum equations need to be developed for incorporation into 3 D motion analysis.

*Simpson, K.J., et al. "Factors influencing rearfoot kinematics during a rapid lateral braking movement." Medicine and Science in Sports and Exercise 24.5 (1992):586 94.

Understanding the morphological, movement, and biomechanical characteristics that influence rearfoot motion during lateral movements is necessary for footwear design and for the determination of injury mechanisms. The purpose of this study was to identify factors related to rearfoot kinematics during a lateral braking movement. Seven highly skilled male tennis players performed 24 trials of side shuffle movements at various speeds. A rear view of the right leg performing a braking step onto a force platform was filmed. The neutral O landing style was most commonly demonstrated. Average movement velocity, foot velocity at touchdown, and body mass were variables demonstrating weak or nonsignificant correlations with the rearfoot parameters. Although structural inversion was correlated significantly with the maximum rearfoot angle and velocity (r = 0.52 and 0.69), the results were affected by movement speed and sample size. The biomechanical characteristics displayed the greatest influence on the various rearfoot kinematic parameters. The magnitude of the significant (P less than 0.0001) correlations generally decreased in the following order: maximum horizontal and vertical force gradients, corresponding times to the maximum gradient values, maximum horizontal and vertical forces, and the corresponding times to maximum forces. In conclusion, the gradient associated parameters were the most useful biomechanical parameters for predicting changes in rearfoot kinematics.

*Sinoway, L.I., et al. "Enhanced maximal metabolic vasodilatation in the dominant forearms of tennis players." Journal of Applied Physiology 61.2 (1986):673 78.

In an effort to evaluate potential peripheral adaptations to training, maximal metabolic vasodilation was studied in the dominant and nondominant forearms of six tennis players and six control subjects. Maximal metabolic vasodilation was defined as the peak forearm blood flow measured after release of arterial occlusion, the reactive hyperemic blood flow (RHBF). Two ischemic stimuli were employed in each subject: 5 min of arterial occlusion (RHBF5) and 5 min of arterial occlusion coupled with 1 min of ischemic exercise (RHBF5ex). RHBF and resting forearm blood flows were measured using venous occlusion strain gauge plethysmography (ml X min 1 X 100 ml 1). Resting forearm blood flows were similar in both arms of both groups. RHBF5ex was similar in both arms of our control group (dominant, 40.8 +/ 1.2 vs. nondominant, 40.9 +/ 2.1). However, RHBF5ex was 42% higher in the dominant than in the nondominant forearms of our tennis player population (dominant, 48.7 +/ 4.0 vs. nondominant, 34.4 +/ 3.4; P less than 0.05). This intraindividual difference in peak forearm blood flows was not secondary to improved systemic conditioning since the maximal O2 consumptions in the two study groups were similar (controls, 45.4 +/ 3.9 vs. tennis players, 46.1 +/ 1.7). These findings suggest a primary peripheral cardiovascular adaptation to exercise training in the dominant forearms of the tennis players resulting in a greater maximal vasodilatation.

*Sprigings E., et al. "A three dimensional kinematic method for determining the effectiveness of arm segment rotations in producing racquet head speed. Journal of Biomechanics 27.3 (1994): 245 54.

The contribution that a segment's anatomical rotations make to racquet head speed depends on both the segment's angular velocity and the instantaneous position of the head of the racquet with respect to the segment's axes of rotation. Any analysis of racquet swing technique that does not consider both of these factors simultaneously is, at best, incomplete. With this in mind, a three dimensional kinematic method was developed to determine the effectiveness of the anatomical rotations of the upper arm, forearm, and hand in producing racquet head speed. The method entailed developing a system of vector equations for three dimensional upper limb rotations that used displacement histories of 10 selected landmarks as input. The required three dimensional displacement histories were obtained using three cine cameras and the DLT approach. To test the diagnostic capabilities of the method, a tennis serve was selected for analysis. For the player and serve analyzed, the greatest contribution to racquet head speed at impact was produced by internal rotation of the upper arm (8 m s 1). Forearm pronation, although exhibiting the fastest rotation at impact (24 rad s 1), ranked only fourth in terms of its contribution (4 m s 1) to racquet head speed. To test the performance of the method, a comparison was made between the racquet head speed measured directly from film and the racquet head speed computed by summing all of the individual segment contributions to speed commencing at the start of forward swing and ending at ball contact. The results indicate that the method can successfully determine the individual contributions that the different anatomical rotational velocities of the arm segments make to the measured instantaneous racquet head speed.

*Swank, Ann. "Physiological profile of male senior tennis players: a comparison with age-matched controls." USTA Research Grant, 1993. Information available from Dr. Ann Swank, Univ. of Louisville, Louisville, KY 40292.

The author gathered data for an in-depth description of the male senior tennis player and attempted to identify significant data on the physiological characteristics of such. An analysis of the research statistics was conducted to indicate differences in the male senior tennis player and the controls in reference to strength, flexibility, a healthier lipid profile, and enhanced aerobic capacity.

*Therminarias, A., et al. "Effects of age on heart rate response during a strenuous match of tennis." Journal of Sports Medicine and Physical Fitness 30.4 (1990):389 96.

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