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BackgroundDespite reported injury rates of up to 3 per 1000 hours exposure, there are no evidence-based prevention programmes in tennis.PurposeTo evaluate the effectiveness of an e-health prevention programme for reducing tennis injury prevalence.Study designTwo-arm, researcher-blinded randomised controlled trial.MethodsAdult tennis players of all playing levels were randomised in an unsupervised programme lasting 12 weeks (TennisReady group or control group). The primary outcome was the overall injury prevalence over a 16-week period, measured at 2 weekly intervals with the Oslo Sports and Trauma Research Centre questionnaire. Estimates for the primary outcome and associated 95% CIs were obtained using generalised estimating equation models. Secondary outcome scores included prevalence of substantial injuries, overall incidence, adherence and time-loss injuries.ResultsA total of 579 (83%) (TennisReady n=286, control n=293) participants were included in the primary analysis. The mean injury prevalence was 37% (95% CI 33% to 42%) in the TennisReady vs 38% (95% CI 34% to 42%) in the control group (adjusted p-value 0.93). The prevalence of substantial injuries was 11% (95% CI 9% to 14%) in the TennisReady vs 12% (95% CI 9% to 15%) in the control group (p value of 0.79). Analysis of the secondary outcome scores showed no difference between groups. The mean prevalence rates between high (8%) and low (92%) adherent groups were 32% (95% CI 23% to 44%) and 37% (95% CI 33% to 42%), respectively (p value 0.36).ConclusionProviding an unsupervised e-health tennis-specific exercise programme did not reduce the injury rates and should not be implemented.Trial registration numberNTR6443.

This study examined the association and predictive ability of several markers of internal workload on risk of injury in high-performance junior tennis players. Fifteen young, high-level tennis players (9 males, 6 females; age: 17.2 ± 1.1 years; height: 178.5 ± 8.7 cm; mass: 68.1 ± 4.8 kg) participated in this investigation. Data on injury epidemiology and internal workload during training were obtained for one competitive season. The session-rating of perceived exertion (s-RPE) was used to calculate internal workload markers in absolute (acute workload and chronic workload for 2-weeks, 3-weeks and 4-weeks) and relative terms (acute:chronic workload ratios [ACWR] for 2-weeks, 3-weeks and 4-weeks). Associations and diagnostic power for predicting tennis injuries were examined through generalised estimating equations and receiver operating characteristics analyses. During the season, a total of 40 injuries were recorded, corresponding to 3.5 injuries per 1000 h of tennis practice. The acute workload was highly associated with injury incidence (

ObjectiveThe aim of this study was to determine whether there is a difference in the prevalence of tennis injuries between the four most common court surfaces in the Netherlands, including hard court, clay, sand-fill artificial grass and red-sand-fill artificial grass. Natural grass was not included in this study.MethodsThis was a repeated cross-sectional study over 6 months, involving members of the Royal Netherlands Lawn Tennis Association (KNLTB). A monthly questionnaire was sent to a random sample of 20 000 KNLTB members, stratified by their club’s playing surface. The questionnaire included questions on court surface, tennis exposure and physical complaints, using the Oslo Sports Trauma Research Centre questionnaire on health problems.ResultsA total of 3656 (18%) of the 20 000 invited members completed at least one of the monthly questionnaires [mean age 49 years (15)]. A total of 4047 injuries were reported by 1957 respondents. Of these injuries, 3246 (80%) were overuse and 801 (20%) were acute. There were no statistically significant differences in injury prevalence between groups who played primarily on any one of the four court surfaces. However, players who played on multiple surfaces had a higher injury prevalence, particularly of overuse injuries, than those who primarily played on one court surface. Compared with the other court surfaces, there was a higher prevalence of lower limb overuse injuries when playing on hard court.ConclusionThere is no significant difference in the overall prevalence of injury on clay, hard court, sand-fill artificial grass and red-sand-fill artificial grass.

Objectives We compared the utility of four cooling interventions for reducing heat strain during simulated tennis match-play in an environment representative of the peak conditions possible at the Australian Open (45 °C, Design Nine trained males undertook four trials in a climate chamber, each time completing 4 sets of simulated match-play. Methods During ITF-mandated breaks (90-s between odd-numbered games; 120-s between sets), either iced towels (ICE), an electric fan (FANdry), a fan with moisture applied to the skin (FANwet), or ad libitum 10 °C water ingestion only (CON) was administered. Rectal temperature (Tre), mean skin temperature (Tsk), heart rate (HR), thermal sensation (TS), perceived exertion (RPE) and whole body sweating (WBSR) were measured. Results After set 3, Tre was lower in ICE (38.2 ± 0.3 °C) compared to FANdry (38.7 ± 0.5 °C; p = 0.02) and CON (38.5 ± 0.5 °C; p = 0.05), while Tre in FANwet (38.2 ± 0.3 °C) was lower than FANdry (p = 0.05). End-exercise Tre was lower in ICE (38.1 ± 0.3 °C) and FANwet (38.2 ± 0.4 °C) than FANdry (38.9 ± 0.7 °C; p Conclusions Fan use must be used with skin wetting to be effective in hot/dry conditions. This strategy and the currently recommended ICE intervention both reduced Tre by ∼0.5–0.6 °C and Tsk by ∼1.0–1.5 °C while mitigating rises in HR and TS.

Talented athletes use metacognitive skills to improve their performance. Also, it is known that these skills are important for managing one's health. The goal of this study was to identify the relationship between metacognitive skills and overuse injuries in talented tennis players. Metacognitive skills were measured in 73 talented tennis players (45 boys and 28 girls, age 11-14) at the start of the season, using the Self-Regulation of Learning Self-Report Scale. Overuse injuries were monitored for one season using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems. Ordinal regression indicated that moderate or low selfmonitoring skills (compared to high selfmonitoring) (OR 4.555, CI 1.096-18.927, P = 0.037) and exposure time (OR 1.380, CI 1.106-1.721, P = 0.004) were associated with more time loss overuse injuries. A second analysis showed that this was the case in girls (OR 10.757, CI 1.845-62.714, P = 0.008), but not in boys. Linear regression revealed that higher reflection scores and exposure time predicted overuse severity (F(5,58) = 2.921, P = 0.020, R-2 = 0.201). Possibly, selfmonitoring can help players to prevent themselves from time loss overuse injuries. Coaches should be aware that players can differ in selfmonitoring ability and thus in the ability to prevent overuse injuries. The role of reflection needs more research.

Purpose:To determine the relationship between outcomes of the shuttle wheel test (SWT) and peak oxygen uptake (VO2peak) during that test and whether SWT and VO2peak can discriminate between different skill levels of wheelchair tennis players. Methods:Fifteen wheelchair tennis players performed an SWT on a tennis court while VO2 was measured continuously. Outcome measures were VO2peak and achieved stage. Relations between outcomes and Dutch wheelchair tennis ranking were calculated with Spearman correlation. Independent t tests were used to test for differences between national and international players. Results:Moderate correlations were found between VO2peak and SWT outcome (r = .40–.47). The tennis ranking correlated weakly with VO2peak (r = –.35) and strongly with SWT outcome (r = –.80). A significant difference was found between national and international players for achieved stage (P = .027) and VO2peak (P = .027). Conclusions:The SWT outcome only explained a small part of the variance in VO2peak among players, so it cannot be considered a valid test for aerobic capacity. However, SWT outcomes are related to the skill level of the player and give a good indication of the overall peak wheelchair performance.

BackgroundThis study describes the epidemiology of men's and women's tennis injuries reported by the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP) during the 2009/2010–2014/2015 academic years.MethodsInjuries and athlete-exposure (AE) data originated from 19 varsity men's programmes (38 team-seasons); women's tennis data originated from 25 varsity programmes (52 team-seasons). Injury rates, injury rate ratios (IRRs) and injury proportions ratios (IPRs) were reported with 95% CIs.ResultsThe ISP captured 181 and 227 injuries for men's and women's tennis, respectively, for injury rates of 4.89 and 4.88/1000 AE for men and women, respectively. There were 32.2% and 63.9% reductions in men's and women's tennis practice injury rates between 2009/2010–2011/2012 and 2012/2013–2014/2015, but no reductions in competition injury rates. Competition injury rates were higher than practice injury rates in men's (IRR=2.32; 95% CI 1.72 to 3.13) and women's tennis (IRR=1.77; 95% CI 1.35 to 2.33). Most injuries in men's and women's tennis occurred to the lower extremities (47.0% and 52.4%, respectively), compared with the trunk (16.6% and 17.6%, respectively) and upper extremities (23.8 and 23.8, respectively).ConclusionsInjury rates in NCAA men's and women's tennis were similar overall. Practice injury rates in men's and women's tennis have declined, although competition rates have not changed. These findings may help inform injury prevention programmes in the future.

Overuse injuries are a serious problem in junior tennis. Gaining insight in age-specific risk factors can contribute to prevention. The developmental cognitive processes that take place during adolescence make talented players more inclined to take risks. This may be even more pronounced in the high performance culture in which they move. Therefore, this study focuses on the relationship between risk-taking and overuse injuries in talented tennis players. Seventy-three talented tennis players (45 boys and 28 girls, age 11–14 years) were monitored for 32 weeks, using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems. Risk-taking was measured at the start of the season with the Iowa Gambling Task. Linear regression analyses were executed to predict (a) overuse injuries, (b) time loss overuse injuries and (c) overuse severity, by risk-taking, exposure time, and injury history. In boys, risk-taking contributed significantly to time loss overuse injuries [F(1,39) = 7.764, P = 0.008, R2= 0.15] and to overuse severity [F(1,39) = 5.683, P = 0.022, with an R2 of 0.13] In girls, time loss overuse injuries [F(1,23) = 6.889, P = 0.018, R2= 0.20] and overuse severity [F(1,23) = 7.287, P = 0.013, R2= 0.24] were predicted by exposure time. Coaches and trainers should be aware that talented male tennis players who are inclined to take risks, are more likely to maintain risky behavioral patterns related to overuse injuries.

PURPOSE: To assess the efficacy of different in-play cooling strategies for mitigating heat strain during simulated tennis match-play activity in a hot/humid environment representing the most extreme conditions during the US Open (36 degrees C, 50{%} RH). METHODS: On three occasions, nine males completed an intermittent treadmill-protocol with an exercise intensity and activity profile simulating a 4-set tennis match, with 90-s breaks between odd-numbered games and 120-s between sets, according to ITF rules. During breaks, either (1) the currently used cooling strategy - an ice-filled damp towel around the neck and a cold-damp towel on the head and thighs (ICE), (2) wetting of arms, neck, face and lower legs with a sponge in front of an electric fan (FANwet), or (3) no cooling (CON), were applied. Rectal (Tre) and mean skin (Tsk) temperature, and heart rate (HR) were measured throughout. Thermal sensation (TS) and ratings of perceived exertion (RPE) were assessed during breaks. Trials were terminated upon reaching a Tre {\textgreater}/=39.5 degrees C or volitional exhaustion. RESULTS: Seven, five and one participant completed FANwet, ICE and CON respectively. By end set 1, DeltaTre was lower in FANwet (0.92+/-0.15 degrees C) compared to CON (1.09+/-0.09 degrees C; P=0.01), and by end set 2 DeltaTre was lower (P{\textless}0.001) in FANwet (1.55+/-0.23 degrees C) and ICE (1.59+/-0.17 degrees C) compared to CON (1.99+/-0.19 degrees C). Mean RPE (FANwet:13.9+/-2.2; ICE:13.6+/-1.8; CON:16.6+/-1.8), HR (FANwet:163+/-21; ICE 164+/-22; CON: 175+/-19 beats.min), Tsk (FANwet:36.56+/-0.69 degrees C; ICE 36.12+/-0.44 degrees C; CON:37.21+/-0.42 degrees C) and TS were lower in FANwet and ICE (P{\textless}0.05) compared to CON by end set 2. CONCLUSIONS: The currently recommended ICE strategy successfully mitigates thermal strain during simulated tennis match-play in hot/humid conditions. The FANwet intervention is an equally effective alternative that may be more practical in limited resource settings.

The aim of the study was to examine whether differences in playing level influence the activity profile and physiological demands of advanced and recreational veteran men's tennis players during an hour of tennis match play. Ten advanced (International Tennis Number [ITN] 3-5, 45.3 ± 5.1 years) and 10 recreational (ITN 7-9, 44.8 ± 4.7 years) veteran men's tennis players participated in 4 experimental sessions: (1) an ITN on-court assessment, (2) a laboratory incremental treadmill test, (3) an hour of simulated tennis match play, and (4) 30 minutes of tennis match play using a portable gas analyzer. Subjects' [latin capital V with dot above]o2 and heart rate (HR) were recorded by portable analyzers. Moreover, energy expenditure was evaluated by indirect calorimetry. Temporal structure and distance covered were determined from video recordings. Subjects' [latin capital V with dot above]o2 (24.5 ± 4.1 vs. 23.3 ± 3 ml·kg-1·min-1), HR (148.3 ± 11.5 vs. 149.8 ± 8.4 bpm), duration of rallies (DR) (6.3 ± 4.1 vs. 7.6 ± 5.5 seconds), and effective playing time (EPT) (21.7 ± 5.0 vs. 23.6 ± 5.4%), HR (148.3 ± 11.5 vs. 149.8 ± 8.4 bpm), and energy expenditure (263.1 ± 49.4 and 281.3 ± 61.8 kcal·min-1) during play did not differ significantly (p > 0.05) between advanced and recreational players. The advanced players covered significantly more meters than the recreational players during their 1-hour tennis matches (mean ± SD: 3568.8 ± 532.2 vs. 3173.8 ± 226 m, p < 0.01) at lower running speeds. The results indicate that, independently of ability, tennis match play satisfies the American College of Sports Medicine recommendations for quantity and quality of exercise for the development and maintenance of cardiovascular fitness in healthy adults and seems to be a viable and highly popular mode of healthy activity.

OBJECTIVE: To assess possible ergogenic properties of corticosteroid administration. DESIGN: A balanced, double blind, placebo-controlled design was used. PARTICIPANTS: Twenty-eight well-trained cyclists and rowers. INTERVENTION: Four weeks daily inhalation of 800 microg budesonide or placebo. Main outcome measurements: The subjects performed three incremental cycle ergometer tests until exhaustion, before and after two and four weeks of placebo or budesonide administration, to measure maximal power output (Wmax). Once a week they filled in a profile of mood state (POMS) questionnaire. RESULTS: There was no significant difference in Wmax between the placebo (376+/-25 watt) and the corticosteroid group (375+/-36 watt) during the pre-intervention test, and there were no significant changes in either group after two and four weeks of intervention. No effect of the intervention on mood state was found. CONCLUSION: Four weeks of corticosteroid or placebo inhalation in healthy, well-trained athletes did not affect maximal power output or mood state. Hence no ergogenic properties of four weeks corticosteroid administration could be demonstrated, which corroborates previous studies with short-term corticosteroid administration.

Athletes participating in elite sports are exposed to high training loads and increasingly saturated competition calendars. Emerging evidence indicates that poor load management is a major risk factor for injury. The International Olympic Committee convened an expert group to review the scientific evidence for the relationship of load (defined broadly to include rapid changes in training and competition load, competition calendar congestion, psychological load and travel) and health outcomes in sport. We summarise the results linking load to risk of injury in athletes, and provide athletes, coaches and support staff with practical guidelines to manage load in sport. This consensus statement includes guidelines for (1) prescription of training and competition load, as well as for (2) monitoring of training, competition and psychological load, athlete well-being and injury. In the process, we identified research priorities. Funding Agencies|International Olympic Committee

A systematic search of published reports was carried out in three electronic databases from 1966 on to identify relevant articles relating to tennis injuries. There were 39 case reports, 49 laboratory studies, 28 descriptive epidemiological studies, and three analytical epidemiological studies. The principal findings of the review were: first, there is a great variation in the reported incidence of tennis injuries; second, most injuries occur in the lower extremities, followed by the upper extremities and then the trunk; third, there have been very few longitudinal cohort studies that investigated the association between risk factors and the occurrence of tennis injuries (odds ratios, risk ratios, hazard ratios); and fourth, there were no randomised controlled trials investigating injury prevention measures in tennis. More methodologically sound studies are needed for a better understanding of risk factors, in order to design useful strategies to prevent tennis injuries.

Concerns have long existed over the participation of adolescent athletes in professional sports. In 2004, the Sony Ericsson WTA Tour (WTA Tour) commissioned a Professional Development Advisory Panel (PDAP) to evaluate the WTA Tour’s age eligibility rule (AER) and professional development programmes (PDPs) for female tennis players since their inception in 1995. More than 75% of the 628 respondents supported the principles of the AER, and 90% indicated a need for PDPs. Statistical analysis of WTA Tour players’ careers found that premature retirements (players leaving the Tour at or before age 21) decreased significantly from 7% before the AER to less than 1% afterward, and median career length increased by 43%. The PDAP recommends that the WTA Tour continues a phased-in, developmentally appropriate AER, enhances the PDPs, and works with other sport governing bodies to coordinate rules and programmes at earlier ages to aid the transition of adolescents into adult sports.

Background —It has been postulated that depending on the type of exercise performed, 2 different morphological forms of athlete’s heart may be distinguished: a strength-trained heart and an endurance-trained heart. Individual studies have not tested this hypothesis satisfactorily. Methods and Results —The hypothesis of divergent cardiac adaptations in endurance-trained and strength-trained athletes was tested by applying meta-analytical techniques with the assumption of a random study effects model incorporating all published echocardiographic data on structure and function of male athletes engaged in purely dynamic (running) or static (weight lifting, power lifting, bodybuilding, throwing, wrestling) sports and combined dynamic and static sports (cycling and rowing). The analysis encompassed 59 studies and 1451 athletes. The overall mean relative left ventricular wall thickness of control subjects (0.36 mm) was significantly smaller than that of endurance-trained athletes (0.39 mm, P =0.001), combined endurance- and strength-trained athletes (0.40 mm, P =0.001), or strength-trained athletes (0.44 mm, P P P P P =0.006) and interventricular septum thickness (10.5 versus 11.8 mm, P =0.005) and showed a trend toward a difference with respect to posterior wall thickness (10.3 versus 11.0 mm, P =0.078) and left ventricular internal diameter (53.7 versus 52.1 mm, P =0.055). With respect to cardiac function, there were no significant differences between athletes and control subjects in left ventricular ejection fraction, fractional shortening, and E/A ratio. Conclusions —Results of this meta-analysis regarding athlete’s heart confirm the hypothesis of divergent cardiac adaptations in dynamic and static sports. Overall, athlete’s heart demonstrated normal systolic and diastolic cardiac functions.

We investigated whether left ventricular hypertrophy in elite cyclists is associated with functional changes or abnormal energy metabolism. Left ventricular hypertrophy is a powerful risk factor for sudden cardiac death with different prognostic significance among the various geometric forms. Cyclists may have a combination of mixed eccentric and concentric hypertrophy. Magnetic resonance imaging was used to define left ventricular mass, geometry and function. Thirteen highly trained male cyclists and 12 healthy controls were investigated. Proton-decoupled phosphorus-31 cardiac spectroscopy was performed to assess parameters of myocardial high-energy phosphate metabolism. Left ventricular mass and end-diastolic volumes normalized for body surface area were significantly higher in cyclists (124.1 +/- 9.4 g.m-2 and 106.2 +/- 11.4 ml.m-2, respectively) than in controls (85.9 +/- 9.3 g.m-2 and 79.1 +/- 11.6 ml.m-2, respectively), (both P0.0001). The left ventricular mass to end-diastolic volume ratio, as a parameter of left ventricular geometry, was not significantly increased in cyclists compared to controls. Resting left ventricular ejection fraction, cardiac index, and systolic wall stress in cyclists did not differ significantly from those of controls. The phosphocreatine to adenosine triphosphate ratio was not significantly different between cyclists and controls (2.2 +/- 0.34 vs 2.2 +/- 0.17, ns). Cyclists show prominent left ventricular hypertrophy with normal geometry. The finding that the hypertrophic hearts of the cyclists had normal left ventricular function and a normal phosphocreatine to adenosine triphosphate ratio suggests that sport-induced left ventricular hypertrophy is a physiological adaptation rather than a pathophysiological response.

Inhaled β₂-agonists are commonly used as bronchodilators in the treatment of asthma. Their use in athletes, however, is restricted by anti-doping regulations. Controversies remain as to whether healthy elite athletes who use bronchodilators may gain a competitive advantage. The aim of this systematic review and meta-analysis is to assess the effects of inhaled and systemic β₂-agonists on physical performance in healthy, non-asthmatic subjects. To this end, MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched up to August 2009. Reference lists were searched for additional relevant studies. The search criteria were for randomized controlled trials examining the effect of inhaled or systemic β₂-agonists on physical performance in healthy, non-asthmatic subjects. Two authors independently performed the selection of studies, data extraction and risk of bias assessment. Parallel-group and crossover trials were analysed separately. Mean difference (MD) and 95% confidence intervals were calculated for continuous data and, where possible, data were pooled using a fixed effects model. Twenty-six studies involving 403 participants (age range 7-30 years) compared inhaled β₂-agonists with placebo. No significant effect could be detected for inhaled β₂-agonists on maximal oxygen consumption (VO₂(max)) [MD -0.14 mL · kg⁻¹ · min⁻¹; 95% CI -1.07, 0.78; 16 studies], endurance time to exhaustion at 105-110% VO₂(max) (MD -1.5 s; 95% CI -15.6, 12.6; four studies), 20-km time trial duration (MD -4.4 s; 95% CI -23.5, 14.7; two studies), peak power (MD -0.14 W · kg⁻¹; 95% CI -0.54, 0.27; four studies) and total work during a 30-second Wingate test (MD 0.80 J · kg⁻¹; 95% CI -2.44, 4.05; five studies). Thirteen studies involving 172 participants (age range 7-22 years) compared systemic β₂-agonists with placebo, with 12 studies involving oral and one study involving intravenous salbutamol. A significant effect was detected for systemic β₂-agonists on endurance time to exhaustion at 80-85% VO₂(max) (MD 402 s; 95% CI 34, 770; two studies), but not for VO₂(max) (placebo 42.5 ± 1.7 mL · kg⁻¹ · min⁻¹, salbutamol 42.1 ± 2.9 mL · kg⁻¹ · min⁻¹, one study), endurance time to exhaustion at 70% VO₂(max) (MD 400 s; 95% CI -408, 1208; one study) or power output at 90% VO₂(max) (placebo 234.9 ± 16 W, salbutamol 235.5 ± 18.1 W, one study). A significant effect was shown for systemic β₂-agonists on peak power (MD 0.91 W · kg⁻¹; 95% CI 0.25, 1.57; four studies), but not on total work (MD 7.8 J · kg⁻¹; 95% CI -3.3, 18.9; four studies) during a 30-second Wingate test. There were no randomized controlled trials assessing the effects of systemic formoterol, salmeterol or terbutaline on physical performance. In conclusion, no significant effects were detected for inhaled β₂-agonists on endurance, strength or sprint performance in healthy athletes. There is some evidence indicating that systemic β₂-agonists may have a positive effect on physical performance in healthy subjects, but the evidence base is weak.

Background: The reported incidence, severity and nature of injuries sustained in tennis vary considerably between studies. While some of these variations can be explained by differences in sample populations and conditions, the main reasons are related to differences in definitions and methodologies employed in the studies. Objective: This statement aims to review existing consensus statements for injury surveillance in other sports in order to establish definitions, methods and reporting procedures that are applicable to the specific requirements of tennis. Design: The International Tennis Federation facilitated a meeting of 11 experts from seven countries representing a range of tennis stakeholders. Using a mixed methods consensus approach, key issues related to definitions, methodology and implementation were discussed and voted on by the group during a structured 1-day meeting. Following this meeting, two members of the group collaborated to produce a draft statement, based on the group discussions and voting outcomes. Three revisions were prepared and circulated for comment before the final consensus statement was produced. Results: A definition of medical conditions (injuries and illnesses) that should be recorded in tennis epidemiological studies and criteria for recording the severity and nature of these conditions are proposed. Suggestions are made for recording players’ baseline information together with recommendations on how medical conditions sustained during match play and training should be reported. Conclusions: The definitions and methodology proposed for recording injuries and illnesses sustained during tennis activities will lead to more consistent and comparable data being collected. The surveillance procedures presented here may also be applicable to other racket sports.

Tennis is one of the major global sports, with over 75 million participants worldwide. Many more follow the Grand Slams, Davis Cup and Fed Cup events, overseen by the International Tennis Federation (ITF) and the professional tours, governed and managed by the Association of Tennis Professionals (ATP) and the Sony Ericsson WTA (Women’s Tennis Association) Tour. The ITF is the world governing body of tennis and is the guardian of the Rules of Tennis. However, both the ATP and WTA have flexibility in the way in which they run their respective tours (eg, they have different rules for playing in the heat and for the medical cover at events). All three organisations are involved in the development of the game and all have committees and departments that have responsibility for sports science and sports medicine. Even though these departments are run independently, representatives of all groups sit on the ITF Sport Science & Medicine Committee. In the area of anti-doping, a unified, WADA-compliant policy has been agreed that is managed by the ITF. In this article the work of the ITF, ATP and WTA sport science and medicine departments is presented in more detail. Founded in 1913, the ITF is responsible for the Olympic Games (tennis re-joined in 1988), the Grand Slam tournaments (Australian Open, Roland Garros, Wimbledon and the US Open), the Davis Cup (men only) and Fed Cup (women only) team events, and a wide range of junior, veteran, wheelchair and lower level professional events. Among the aims of the ITF …

This review focuses on the characteristics of tennis players during match play and provides a greater insight into the energy demands of tennis. A tennis match often lasts longer than an hour and in some cases more than five hours. During a match there is a combination of periods of maximal or near maximal work and longer periods of moderate and low intensity activity. Match intensity varies considerably depending on the players’ level, style, and sex. It is also influenced by factors such as court surface and ball type. This has important implications for the training of tennis players, which should resemble match intensity and include interval training with appropriate work to rest ratios.

The purpose of the study was to specify the changes in blood glucose concentrations in the course of repeated tournament and practice matches, and to quantify the Incidence of hypoglycaemia in elite tennis players. The study consisted of two parts. In the first, 147 tournament players completed a questionnaire about the incidence of hypoglycaemic symptoms during repeated tennis matches. In the second part of the study, the players participated in two subsequent matches (one singles match followed by a doubles) under (T) tournament (n = 57) and (P) practice (n = 20) conditions. Of the 147 players consulted, 94 (63.9%) reported experiences with hypoglycaemic symptoms during a tennis tournament (n = 80) and/or tennis practice (n = 62). The warm-up period for the second match day was identified as the most sensitive point for the occurrence of hypoglycaemic symptoms (n = 29), compared to the final stages of the first (n = 11) or second match (n = 7). Under both practice and tournament conditions, a significant (p0.01) drop in blood glucose concentration was found during the warm-up period for the second match per day (T: from 5.8 +/- 1.4 mmol x L(-1) to 4.3 +/- 0.8 mmol x L(-1) and P: from 5.4 +/- 1.1 mmol x L(-1) to 4.1 +/- 1.5 mmol x L(-1)). In conclusion, precautions should be taken to prevent a sudden drop in blood glucose concentration and hypoglycaemic symptoms during the early stages of a player's second tennis match in one day.

The purpose of the study was to compare selected physiological responses during singles tennis match play and continuous running at a similar mean oxygen uptake (\(\dot V{\rm O}_{\rm 2} \) ). The study consisted of two main parts, which were separated by 1 week. In the first part, 12 nationally ranked senior tennis players [six females and six males; 47.2 (6.6) years old and 47.0 (5.4) years old, respectively] each completed a 2-h singles tennis match (TE). Mean \(\dot V{\rm O}_{\rm 2} \) during TE [23.1 (3.1) ml·kg–1·min–1 for the women and 25.6 (2.8) ml·kg–1·min–1 for the men] was measured by a portable spirometry-telemetry system and corresponded to 56% (women) or 54% (men) of their respective maximum \(\dot V{\rm O}_{\rm 2} \) . In the second part, the relative \(\dot V{\rm O}_{\rm 2} \) data measured during TE were used to set a similar workload during a 2-h treadmill run at a constant level (RU). At the measured time points, heart rate [140.1 (15.5) beats·min–1 vs 126.4 (15.1) beats·min–1], lactate concentration [1.53 (0.65) mmol·l–1 vs 1.01 (0.38) mmol·l–1] and glucose concentration [5.45 (0.84) mmol·l–1 vs 4.34 (0.56) mmol·l–1] in capillary blood, as well as the respiratory exchange ratio [0.93 (0.03) vs 0.88 (0.03)], were higher (P

Diastolic LV function and myocardial HEP metabolism are impaired only when LVH is caused by permanent pressure or volume overload, and not by a temporary increase in cardiac workload during part of the day as in elite athletes. Therefore, training-induced and pressure/volume-overload-induced LVH seem to represent different phenotypes of LVH, possibly related to genetic reprogramming which only occurs during permanent cardiac overload [17]. Moreover, there is an association between impaired LV diastolic function and altered myocardial HEP metabolism in patients with hypertension and in patients with aortic valve disease. Finally we did not find a correlation between myocardial HEP metabolism and LV mass in any of the groups studied. The latter indicates that LVH should be regarded as an epiphenomenon to cardiac overload, and not as a primary factor causing abnormal HEP metabolism.

Background —The question of whether training-induced left ventricular hypertrophy in athletes is a physiological rather than a pathophysiological phenomenon remains unresolved. The purpose of the present study was to detect any abnormalities in cardiac function in hypertrophic hearts of elite cyclists and to examine the response of myocardial high-energy phosphate metabolism to high workloads induced by atropine-dobutamine stress. Methods and Results —We studied 21 elite cyclists and 12 healthy control subjects. Left ventricular mass, volume, and function were determined by cine MRI. Myocardial high-energy phosphates were examined by 31 P magnetic resonance spectroscopy. There were no significant differences between cyclists and control subjects for left ventricular ejection fraction (59±5% versus 61±4%), left ventricular cardiac index (3.4±0.4 versus 3.4±0.4 L · min −1 · m −2 ), peak early filling rate (562±93 versus 535±81 mL/s), peak atrial filling rate (315±93 versus 333±65 mL/s), ratio of early and atrial filling volumes (3.0±1.0 versus 2.6±0.6), mean acceleration gradient of early filling (5.2±1.4 versus 5.8±1.9 L/s 2 ), mean deceleration gradient of early filling(−3.1±0.9 versus −3.2±0.7 L/s 2 ), mean acceleration gradient of atrial filling (3.6±1.8 versus 4.5±1.7 L/s 2 ), and atrial filling fraction (0.23±0.06 versus 0.26±0.04, respectively). Cyclists and control subjects showed similar decreases in the ratio of myocardial phosphocreatine to ATP measured with 31 P magnetic resonance spectroscopy during atropine-dobutamine stress (1.41±0.20 versus 1.41±0.18 at rest to 1.21±0.20 versus 1.16±0.13 during stress, both P =NS). Conclusions —Left ventricular hypertrophy in cyclists is not associated with significant abnormalities of cardiac function or metabolism as assessed by MRI and spectroscopy. These observations suggest that training-induced left ventricular hypertrophy in cyclists is predominantly a physiological phenomenon.

Background 31 P-MRS during cardiac stress may provide (patho)physiological insights into the high-energy phosphate metabolism of the myocardium. Accordingly, the purpose of the present study was to determine the metabolic response of normal human myocardium to severe atropine-dobutamine (A-D) stress. To corroborate the results from the present in vivo study, a 31 P-MRS experiment was performed with a moving phantom to simulate respiratory motion. Methods and Results The phantom experiment showed no relation ( P =.371) between the intensity ratio of two separate phosphate peaks and amplitude of phantom excursions. The phosphocreatine (PCr) and ATP signal strength and the PCr/ATP ratio were determined from the left ventricular wall in 20 healthy subjects (posttest likelihood for coronary artery disease was 31 P-MRS at rest and during high-dose A-D stress (rate-pressure product increased threefold). Stress-induced changes were −21% for PCr ( P P P Conclusions The phantom experiment shows that the in vivo decrease of myocardial PCr/ATP due to high-dose A-D stress we observed is not a motion artifact. Consequently, this indicates that myocardial high-energy phosphate metabolism of the normal human heart is altered at high workloads.

Judo (‘the gentle way’) originated as an offshoot of jujitsu and was developed by Professor Jigoro Kano (1860–1938) in Japan. It was originally called Kodokan Judo by Kano and the martial art was always intended to be more than just a sport. The three fundamental tenets of judo are described as: physical education, contest proficiency and mental training with the ultimate goal of making the individual a value to society.1 The first Olympic judo competition took place in 1964 at the Tokyo Olympic Games and the sport is now recognised in 201 countries worldwide. Very little has changed since judo was invented in 1888, apart from the introduction of weight categories and the extension of the sport to include the participation of children. Judo students are encouraged to play a positive role …

OBJECTIVE—To examine the correlation between heart rate variability and left ventricular mass in cyclists with an athlete's heart. METHODS—Left ventricular mass and diastolic function were determined at rest and myocardial high energy phosphates were quantified at rest and during atropine-dobutamine stress in 12 male cyclists and 10 control subjects, using magnetic resonance techniques. Ambulatory 24 hour ECG recordings were obtained, and time and frequency domain heart rate variability indices were computed. RESULTS—In the cyclists, the mean of all RR intervals between normal beats (meanNN), the SD of the RR intervals, and their coefficient of variation were significantly greater than in control subjects (p