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Employ a progressive rehab program for tennis players

This is an excerpt from Effective Functional Progressions in Sport Rehabilitation by Todd S. Ellenbecker, DPT, Mark DeCarlo, MS, MHA, and Carl DeRosa, PhD.

The following interval return programs provide sport-specific functional progressions for returning to golf, tennis, and baseball. Each has specific instructions for returning based on the demands and activities required for successful performance in that sport. Reviewing the stages, and in many instances working with the person as he or she progress through the stages, is recommended to ensure an optimal result or return to participation. The programs listed here are designed to be given to the injured athlete and provide an overview of the progression of activity that is recommended for this functional return.

Of critical importance is the continued use of functional tests and objective measures to determine proper strength and range of motion before initiating the interval return program. Integration of continued functional exercise progression during the execution of the return programs is also recommended. Each of the programs in this section of the text provides step-by-step progressions of the key aspects of functional performance in these sports. Evaluation of proper sport biomechanics or technique is also of critical importance to decrease loading and ensure optimal progression in these functional return programs.


Key Factors in an Interval Tennis Program

Frequency: Alternate-day performance

Supervision: Emphasis on proper stroke mechanics

Stroke progression: Groundstrokes → volleys → serves → overheads → match play

Impact progression: Low pre-impact ball velocity to higher pre-impact ball velocity

Ball progression: Low compression (foam) to regulation tennis ball

Sequencing: Proper warm-up, interval tennis program, cool-down and cryotherapy

Timing: Supplemental rotator cuff and scapular exercises performed either on rest day after interval tennis program or after execution of interval tennis program on the same day to minimize the effects of overtraining and overload

Interval Tennis Program Guidelines

  • Begin at the stage indicated by your therapist or doctor.
  • Do not progress or continue the program if joint pain is present.
  • Always stretch your shoulder, elbow, and wrist before and after the interval program, and perform a whole-body dynamic warm-up before performing the interval tennis program.
  • Play on alternate days, giving your body a recovery day between sessions.
  • Do not use a wallboard or backboard as it leads to exaggerated muscle contraction without rest between strokes.
  • Ice your injured arm after each stage of the interval tennis program.
  • It is highly recommended to have your stroke mechanics formally evaluated by a USPTA teaching professional.
  • Do not attempt to impart heavy topspin or underspin to your groundstrokes until the later stages of the interval program.
  • Contact your therapist or doctor if you have questions about or problems with the interval program.
  • Do not continue to play if you encounter localized joint pain.

Preliminary Stage

Start with foam-ball impacts, beginning with ball feeds from a partner. Perform 20 to 25 forehands and backhands, assessing initial tolerance to groundstrokes only. Presence of pain or abnormal movement patterns in this stage indicates you are not ready to progress to the actual interval tennis program. Continued rehabilitation would be emphasized.

Interval Tennis Program

Perform each stage ________ times before progressing to the next stage. Do not progress to the next stage if you had pain or excessive fatigue in your previous outing—remain at the previous level until you can perform that part of the program without fatigue or pain.

Stage 1

a. Have a partner feed 20 forehand groundstrokes to you from the net. (Partner must use a slow, looping feed that results in a waist-high ball bounce.)

b. Have a partner feed 20 backhand groundstrokes as in 1a.

c. Rest 5 minutes.

d. Repeat 20 forehand and backhand feeds.

Stage 2

a. Begin as in Stage 1, with a partner feeding 10 forehands and 10 backhands from the net.

b. Rally with a partner from the baseline, hitting controlled groundstrokes until you have hit 50 to 60 strokes. (Alternate between forehand and backhand, allowing 20 to 30 seconds rest after every two or three rallies.)

c. Rest 5 minutes.

d. Repeat 2b.

Stage 3

a. Rally groundstrokes from the baseline for 15 minutes.

b. Rest 5 minutes.

c. Hit 10 forehand and 10 backhand volleys, emphasizing a contact point in front of the body.

d. Rally groundstrokes for 15 minutes from the baseline.

e. Hit 10 forehand and 10 backhand volleys as in 3c.

Pre-Serve Interval

Perform these tasks before Stage 4. Note: This interval can be performed off court and is meant solely to determine readiness for progression into Stage 4 of the interval tennis program.

a. After stretching, with racket in hand, perform serving motion for 10 to 15 repetitions without a ball.

b. Using a foam ball, hit 10 to 15 serves without concern for performance result (focusing only on form, contact point, and the presence or absence of symptoms).

Stage 4

a. Hit 20 minutes of groundstrokes, mixing in volleys using a format of 70% groundstrokes and 30% volleys.

b. Perform 5 to 10 simulated serves without a ball.

c. Perform 5 to 10 serves using a foam ball.

d. Perform 10 to 15 serves using a standard tennis ball at approximately 75% effort.

e. Finish with 5 to 10 minutes of groundstrokes.

Stage 5

a. Hit 30 minutes of groundstrokes, mixing in volleys using a format of 70% groundstrokes and 30% volleys.

b. Perform 5 to 10 serves using a foam ball.

c. Perform 10 to 15 serves using a standard tennis ball at approximately 75% effort.

d. Rest 5 minutes.

e. Perform 10 to 15 additional serves as in 5c.

f. Finish with 15 to 20 minutes of groundstrokes.

Stage 6

a. Repeat Stage 5, increasing the number of serves to 20 to 25 instead of 10 to 15.

b. Before resting between serving sessions, have a partner feed easy, short lobs to attempt a controlled overhead smash.

Stage 7

Before attempting match play, complete steps 1 to 6 without pain or excess fatigue in the upper extremity. Continue to progress the amount of time rallying with groundstrokes and volleys in addition to increasing the number of serves per workout until you can perform 60 to 80 overall serves interspersed throughout a workout. Remember that an average of up to 120 serves can be performed in a tennis match; therefore, be prepared to gradually increase the number of serves in the interval program before engaging in full competitive play.

Learn more about Effective Functional Progressions in Sport Rehabilitation.

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Effective Functional Progressions in Sport Rehabilitation

Effective Functional Progressions in Sport Rehabilitation

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