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Ask the Lab: Wrist Stress and Shoulder Strengthening

PLEASE NOTE: The medical opinions in USTA.com's Ask the High Performance Lab are responses intended for the average player. Please consult with your primary physician before beginning any new exercise program.

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From Paul S., Worthington, Minnesota: Is there more stress on the wrist using the open stance forehand compared to the closed stance forehand, or is it equal?


Rafael Nadal
Dr. Bahamonde: Paul, the amount of wrist stress is more related to the type of grip and/or the type of forehand technique, a single unit or a multi-segment forehand. The research studies on the open stance tend to show non-significant advantages on ball or racket velocity over the traditional square stance. 

In 2003 we conducted a study to investigate the upper extremity joint loading between the open and square stance tennis forehand and we found that the open stance did not generate greater loadings in the upper extremity joints than the square stance (Bahamonde & Knudson (2003), Kinetics of upper extremity in the open and square stance forehand. Journal of Science and Medicine in Sports, 6(1): 99-101. The wrist loadings were small for both stances but our subjects used a standard eastern forehand grip. It is very likely that type of grip will strongly affect wrist stresses.

Bruce Elliott and his co-workers from the University of Western Australia have shown the type of grip affects how much of the racket velocity is generated by the hand segment (Elliot et al, (1997)), The influence of grip position on upper limb contributions to racket head velocity in the tennis forehand, Journal of Applied Biomechanics, 3: 182-196. It is very possible that players who rely on excessive wrist motion during the forehand stroke will generate greater loadings or stresses at the wrist, which could lead to overuse injuries in the joint — this has not been documented in the biomechanics literature.

From Albert S., San Diego, California: Please suggest and if possible send some graphics on how to exercise and strengthen the shoulder and rotator cuff muscles.

Jelena Jankovic
Dr. Kovacs: Albert, thank you for your great question. The tennis player’s shoulder is a complex area with many different structures that go into making the shoulder strong, flexible and able to withstand the rigors of competitive tennis. The rotator cuff is a group of four muscles that play an important role in shoulder movement and stability.

The four muscles of the rotator cuff are the Suprispinatus, Infraspinatus, Teres Minor and Subscapularis. Although the rotator cuff muscles receive a lot of attention with respect to the shoulder, there are other muscles that play an important role in optimum shoulder function. These other important muscles are the rhomboids (which are muscles of the upper back) as well as the major visual muscle of the shoulder which are the deltoid group.

The deltoid group is one muscle, but it has three distinct parts (sometimes referred to as heads); the anterior (front portion), the lateral (middle portion) and the posterior (or rear portion). The strengthening of the shoulder region will not only help to prevent shoulder injuries, but can also increase the power that you could generate into your strokes. It would also be recommended that you seek the advice of either a strength and conditioning specialist, physical therapist and/or an athletic trainer with specific experience working with tennis athletes. These experts can assess your specific strengths and weaknesses and then tailor a specific injury prevention and performance improvement program for you.

About the Authors:

Mark Kovacs
Mark Kovacs, PhD, CSCS, is the USTA Manager of Sport Science and is a tennis researcher, certified strength and conditioning specialist and certified tennis professional. He was a former tennis All-American and NCAA champion. The USTA Sport Science department is responsible for testing, training and tracking top junior and professional tennis players as well as producing, evaluating and disseminating sport science and sport medicine information relevant to tennis.

Rafael Bahamonde
Rafael Bahamonde, PhD, FACSM, received his Ph.D. in Human Performance with a sport biomechanics major and a minor in human anatomy from Indiana University, Bloomington. Dr. Bahamonde's research interests are in sport biomechanics with emphasis on tennis techniques and injury prevention and gait analysis.  He is currently a Professor of Physical Education at Indiana University – Indianapolis, associate researcher for National Institute for Fitness in Sports, member for performance enhancement team for U.S. Diving, and a Fellow of the American College of Sports Medicine.

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