Tennis’s Injury Epidemic; Lessons to learn for Tennis’ elite

There is another addition to the injury epidemic that has blown up in tennis over the past couple of months, and this time it affects the man of the moment: reigning Wimbledon and Australian Open champion Roger Federer, who has withdrawn from this week’s Cincinnati Masters because of back trouble, which may also throw into doubt his participation at the US Open.

This has sparked the debate once more that players are putting their bodies on the line repeatedly without adequate rest and rehabilitation. The combination of an ever dwindling off season, general overtraining and the increasing exposure to the unforgiving concrete courts, that dominate the circuit in the modern era, are the main causes of players breaking down.

Already during 2017, injuries and illness or other issues have been and/or are already prevalent as can be seen from the following snapshot:

Roger Federer (back injury)
Andy Murray (hip injury)
Novak Djokovic (arm/elbow injury)
Stan Wawrinka (knee injury/surgery)
Marin Cilic (groin injury)
Kei Nishikori (wrist injury)
Juan Martin Del Potro (wrist & recovery)
Bethanie Mattek-Sands (knee injury)
Madison Keys (wrist surgery)
Petra Kvitova (hand/arm injury from attack)
Carla Suarez Navarro (arm injury)
Tommy Robredo (foot surgery)
Nick Kyrgios (leg injury)
Kevin Anderson (hip injury)
Sloane Stephens (foot injury)
Sabine Lisicki (shoulder injury)
Catherine Bellis (hip injury)
John Millman (hip injury)
Maria Sharapova (forearm injury)
Ana Ivanovic (retired)
Serena Williams (pregnant)
Victoria Azarenka (personal problems)
Sara Errani (ban)

With the US Open about to begin on Monday 28 August, it is almost certain that before the final Grand Slam of the year, there will be numerous players who withdraw or cannot play, whilst when the event starts, due to the sweltering conditions or players already carrying injuries, there will be player retirements and withdrawals through exhaustion or injury.

There was much debate at Wimbledon regarding the high number of match retirements. Novak Djokovic was one of ten players to retire from the Men’s Singles competition, with the tournament experiencing an unusually high attrition rate.

A combination of the pressure to satisfy tournament sponsors, appease TV and Media schedules, win prize money and secure ranking points is compelling players to compete too regularly and in turn they are putting themselves at a far greater risk of injury.

Top 10 players must commit to specific WTA tournaments, exclusive of the Grand Slams and the year-end WTA Championships, which include the four Premier Mandatory tournaments, four of the Premier 5’s and at least two 700-level tournaments. A player has the option of skipping one of the Premier 5s annually, but must enter the one skipped in the next year. It is not hard to grasp what a gruelling schedule that becomes in practice for Tennis’ elite.
In addition, further pressure was added as last year was an Olympic year which had to be fitted into the events schedule. None of this takes account of Davis Cup and Fed Cup which also adds to the scheduling.

The lure of money and keeping sponsors happy puts pressure on the majority of players to play 20 or more tournaments in a calendar year.

The system is set up to make money at tournaments; there is a conflict between players being pushed to make it for themselves and for others and having enough time to rest. It’s an important problem which has not been addressed properly.

The common view of Sports orthopaedic and medical specialists is that the surge in injury-related retirements during play is the result in players entering too many tournaments. The problem is not that they play too much; it’s the way the schedule is set up. Players frequently go through long stints, six weeks or more without a break. Often the tournament play, coupled with the rigors of travel and practicing every day can be too much and most players could benefit from some time off.

The ATP and WTA claim that they have addressed the problem. Both have education programmes emphasising the need for planning a schedule and preparation. The ATP provides full-time trainers for which demand has markedly increased, as do the WTA for the women, though there are many more personal trainers on the men’s tour.

There are the added issues that players hit the ball so hard, the rackets have had such an effect and there is now so much “strength in depth” in both the men’s and women’s games. In addition, matches are tougher on the body and there are few easy ones any more. Players are learning about the balance of preparation, prevention and recovery and rehab. The ATP and WTA would argue that stats don’t show there are more injuries than before; it’s that several high-profile players have had injuries. This catches people’s attention.

The WTA stats over the last five years indicate a doubling of on-site withdrawals. More injuries have been caused by changes in the modern game. There is a need to rationalise the calendar better around the Grand Slams, with constant changes of surface, culture and of time zones influence the body a lot more than is realised.

In addition, players are playing a lot more tennis and it’s a 12 – month sport now. The technology is such that they are more prone to injuries and the majority of injuries seem to be over-use problems.

Similarly, the elite junior players from pre-puberty to late teens seem to pick up the same kind of injuries as the elite groups. There are often changes in the dominant shoulders, with a reduced range of movement. There can be an asymmetry problem and postural changes.
That’s a warning for the professional tours if they allow undue pressure on players to compete. It is a difficult dilemma, but if an authority sets up a new system which penalises a player for not turning up, you have to wonder whether it is better.

The pressure to satisfy tournament sponsors, TV and Media schedules, as well as, to win prize money and ranking points is making players compete too much and run a far greater risk of getting injured. Will the time come when the players start taking the administrators to court?

The ATP/WTA need to take responsibility and put players’ health high on the agenda. Otherwise the situation might give way to litigation, as we have seen in football. It might sound farfetched, but you can imagine it happening!

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