So you want to play tennis and not get injured doing it. Sounds simple enough, but research shows that for every thousand hours of the sport, up to 3 injuries occur.

You’ll get to a thousand hours in less than four years if you play a few sets each week.

Researchers are beginning to figure out how you can prevent these problems. But we still have a ways to go.

Kei Nishikori, who lost the U.S. Open final yesterday, is a case in point, according to Sports Illustrated:

His injury woes started with a right-elbow issue that required surgery and sidelined him for all but three months in 2009 and most of the first three months of 2010. He’s also struggled with back, knee, abdominal and toe injuries. In May, Nishikori led Nadal by a set and a break in the Madrid Open final before eventually retiring with back pain.

Of course, Nadal himself has struggled with injury, including a wrist problem so serious it kept him out of the U.S. Open this year.

52 Sportsmetrics Exercises That Might Help

So what can you do to reduce your risk? One of the most interesting answers comes from Sportsmetrics Tennis, a program directed by Cincinnati orthopedic surgeon Frank Noyes. Noyes and his colleagues have developed a whole series of exercise programs for various sports.

Their starting point was preventing anterior cruciate ligament (ACL) injuries in teenage girls, but Noyes believes the same principles apply to people of other ages and genders. Research in soccer suggests that what protects the ACL will prevent injuries to other body parts. As I reported last week, injuries below the waist are even more common in tennis than injuries above the waist. And the Sportsmetrics Program also includes lots of above-the-waist training as well.

It’s an elaborate program with 52 different exercises carried out in 18 one-and-half-hour sessions over six weeks, so I can’t fully describe it here. (You can read the details in a book Noyes and Sportsmetric research director Sue Barber-Westin put together, ACL Injuries in the Female Athlete starting on page 339. And Sportsmetrics has a slightly scaled-down version for adult amateurs.)

It includes “dynamic warm-up, plyometric and jump training, strength training (lower extremity, upper extremity, core), tennis-specific drills, and flexibility.”

One of the exercises I found interesting is “Shadow Swing Baseline, Forehand and Backhand.”

The athlete starts in the middle of the baseline,
with the arms crossed so that the left hand is
holding the right shoulder and the right hand is
holding the left shoulder. The athlete runs to the
singles sideline of their forehand and swings the torso and shoulders in a complete forehand
motion that goes from the backswing
to the follow-through. The athlete then runs back
to the starting position. When going toward the
deuce side, the left shoulder faces the court, then
the chest becomes parallel to the baseline. The
swing is finished with the right shoulder facing
forward to accelerate the crossover recovery step.

Other Tennis Injury Prevention Resources

Does Sportsmetrics Tennis work? Noyes, Barber-Westin and the tennis pro Alex Hermeto published results of a very small trial in 2010.

The subjects improved 10 to 76 percent in various measurements of strength, agility and endurance. For example they improved 15 percent in the “single-leg triple crossover hop” as seen in this video by Carpet Cues:
https://www.youtube.com/watch?v=q62jKC3nwa0
High scores on this test correlate with good knee function.

It’s reasonable to believe that these exercises reduce the risk of injury in tennis — just as similar exercises work in soccer — but apparently no one has done that research.

What else can help? I’m grateful to “Chas Tennis” over on the Talk Tennis forum for a couple of suggestions.

First there’s this interesting video from Todd Ellenbecker about shoulder injuries. He offers some strengthening exercises which seem reasonable — even if there’s no actual evidence to show that they work.

Ellenbecker is chairman of the U.S. Tennis Association’s Sports Science Committee, which has a list of references about tennis injury on its website, including his books.

Chas also recommended looking into the work of Duane Knudson. For example, Knudson wrote pamphlet on tennis elbow, and a whole book on tennis biomechanics.

Chas also recommends the books From Breakpoint to Advantage and Complete Tennis Conditioning (of which Ellenbecker is a co-author).

Have you read any of these books? Like them or hate them? Let me know. And if you have any other good resources to recommend, please add them to the comments on this page. I’d love to make this list more complete.