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A Six-Week Neuromuscular Training Program for Competitive Junior Tennis Players

Barber-Westin, Sue D; Hermeto, Alex A; Noyes, Frank R

Journal of Strength and Conditioning Research: September 2010 - Volume 24 - Issue 9 - p 2372-2382
doi: 10.1519/JSC.0b013e3181e8a47f
Original Research
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Barber-Westin, SD, Hermeto, AA, and Noyes, FR. A six-week neuromuscular training program for competitive junior tennis players. J Strength Cond Res 24(9): 2372-2382, 2010-This study evaluated the effectiveness of a tennis-specific training program on improving neuromuscular indices in competitive junior players. Tennis is a demanding sport because it requires speed, agility, explosive power, and aerobic conditioning along with the ability to react and anticipate quickly, and there are limited studies that evaluate these indices in young players after a multiweek training program. The program designed for this study implemented the essential components of a previously published neuromuscular training program and also included exercises designed to improve dynamic balance, agility, speed, and strength. Fifteen junior tennis players (10 girls, 5 boys; mean age, 13.0 ± 1.5 years) who routinely participated in local tournaments and high-school teams participated in the 6-week supervised program. Training was conducted 3 times a week, with sessions lasting 1.5 hours that included a dynamic warm-up, plyometric and jump training, strength training (lower extremity, upper extremity, core), tennis-specific drills, and flexibility. After training, statistically significant improvements and large-to-moderate effect sizes were found in the single-leg triple crossover hop for both legs (p < 0.05), the baseline forehand (p = 0.006) and backhand (p = 0.0008) tests, the service line (p = 0.0009) test, the 1-court suicide (p < 0.0001), the 2-court suicide (p = 0.02), and the abdominal endurance test (p = 0.01). Mean improvements between pretrain and posttrain test sessions were 15% for the single-leg triple crossover hop, 10-11% for the baseline tests, 18% for the service line test, 21% for the 1-court suicide, 10% for the 2-court suicide, and 76% for the abdominal endurance test. No athlete sustained an injury or developed an overuse syndrome as a result of the training program. The results demonstrate that this program is feasible, low in cost, and appears to be effective in improving the majority of neuromuscular indices tested. We accomplished our goal of developing training and testing procedures that could all be performed on the tennis court.

Cincinnati Sportsmedicine Research and Education Foundation, Cincinnati, Ohio

Address correspondence to Sue D. Barber-Westin, sbwestin@csmref.org.

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Introduction

Tennis is a sport played by over 75 million participants worldwide (37). The health benefits of this activity are well recognized. In a recent review, Pluim et al. (38) found strong evidence that tennis players have superior aerobic fitness, a decreased risk of cardiovascular disease, a lower body fat percentage, and improved bone health compared to controls. Houston et al. (19) followed 1,019 male collegiate athletes who had participated in tennis, golf, football, baseball, and basketball 20-40 years after graduation. One-half of the tennis players were continuing to participate in the sport at midlife, compared to one-quarter of the golfers and none of the other-sport athletes.

The elite adolescent player averages 2.3 hours of practice or play per day, a mean of 6.1 days a week. The average point requires 8.7 changes of direction, with each change creating a load of 1.5-2.7 times the body weight on the knee (22). In the junior player, intense participation in tennis alone or in tennis combined with other sports significantly increases the risk of injury (21). This is because of the heightened frequency, intensity, and duration of participation, along with the large biomechanical and physiological demands of competitive play. These factors are especially problematic in athletes who have not developed adequate strength and aerobic conditioning to offset the tremendous forces placed on both the upper and lower extremities. The incidence of injury, which varies between studies, ranges from 0.05 to 2.9 injuries per player per year (39). The most common injuries that occur during tennis are to the lower extremity, such as muscle strains, meniscus tears, and ligament sprains, which account for 39-59% of the total incidence of injuries (21). This is followed by injuries to the upper extremity, occurring in 20-45%, and then the central core, noted in 11-30%.

The effort to reduce injuries in tennis should promote a decrease in loads or stresses placed on both the lower and upper extremities by improving technique, strength, dynamic balance, agility, and aerobic fitness. To date, no study exists in the medical literature that we are aware of on the effects of a training program on neuromuscular indices (speed, agility, core strength and endurance, and single-leg function and balance) in adolescent competitive tennis players. We believed that, with the tremendous number of junior players participating in tournament and school competition and the high rate of injuries, a training program should be developed and assessed first for its effectiveness in improving these indices and second, for its effectiveness in decreasing the rate of injuries. A program that does not improve these factors would not be expected to have a significant impact on reducing injuries in competitive athletes, and therefore, the measurement of the change in specific neuromuscular indices was the primary goal of this investigation.

In this manner, we took into account our prior experience in training athletes with an anterior cruciate ligament (ACL) prevention program, Sportsmetrics (17) (Cincinnati Sportsmedicine Research and Education Foundation, Cincinnati, OH, USA). This program has been shown to be effective in improving neuromuscular indices in female athletes, because studies have reported improved overall lower limb alignment (from excessive valgus to neutral) on a drop-jump test (34), increased hamstrings isokinetic peak torque (17,34,49), increased knee flexion angles on landing (17,40), and reduced abduction and adduction moments and ground reaction forces on landing (17). This training program was also reported to significantly reduce the risk of noncontact ACL injuries in female athletes participating in basketball, soccer, and volleyball (16).

We developed a tennis-specific training program for competitive junior players, implementing the essential components of Sportsmetrics along with other exercises designed to improve dynamic balance, agility, speed, and strength. The additional exercises were implemented in an effort to improve indices not previously studied by knee injury prevention programs (such as agility and speed). Because compliance with injury prevention programs has been shown to be problematic (15), we believed that these additional tennis-specific drills and tasks would be beneficial in both improved performance and compliance of the players in attending the majority of the training sessions. Third, our experience has shown that athletes, parents, and coaches are more willing to participate in a performance-enhancement program that contains injury prevention components compared to just an injury-prevention program alone.

The purpose of this study was to determine the effectiveness of this new training program using a battery of tests on improving specific neuromuscular indices. The goal was to conduct all training and testing on the court, with limited equipment required so that this program could be offered at any tennis facility regardless of financial limitations. We hypothesized that this training program would significantly improve speed, agility, core strength and endurance, and single-leg function and balance.

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Methods

Experimental Approach to the Problem

This study was undertaken to develop a training program for competitive junior tennis players using the components of a previously published training program proven to improve neuromuscular indices in athletes, along with additional sport-specific exercises and drills. A battery of tests was conducted to determine the effectiveness of this training program.

All testing and training were conducted on clay courts (Har-Tru). Players selected were those who routinely played in local tournaments and high-school teams. Before each testing and training session, the subjects completed approximately 5-8 minutes of dynamic warm-up exercises. The subjects underwent a single hop for distance test, a triple crossover hop for distance test, a baseline speed and agility forehand test, a baseline speed and agility backhand test, a service box speed and agility test, a single-court suicide run, a 2-court suicide run, and an abdominal endurance test. Three days later, the subjects were placed into the supervised neuromuscular training program conducted 3 sessions per week for 6 weeks. The sessions lasted 1.5 hours and consisted of a dynamic warm-up, jump training, strength training, speed and agility drills specific for tennis, and flexibility. All training sessions were supervised by a certified Sportsmetrics instructor and a tennis professional certified by the United States Professional Tennis Association. Then, the subjects underwent all of the previously described tests within 1 week of conclusion of the training program in an identical manner as that done before the training program was initiated.

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Subjects

All testing and training procedures were fully explained, and written informed parental consent was obtained for each subject, all of whom agreed to participate. The study was approved by the Internal Review Board for use of human subjects. Fifteen junior tennis players (10 girls, 5 boys, mean age 13.0 ± 1.5 years, range, 11-16 years) voluntarily participated in this study. All subjects had no history of knee injury or pathology and had no symptoms of pain, patella instability, or visible joint effusion. All subjects had participated in competitive tennis for a minimum of 2 years before this study was initiated. Training was conducted just before the start of the middle- and high-school tennis season (November, December) and at a time period when none of the players were peaking for important tournaments. No subject participated in other sports or training programs during the course of the study. The subjects participated in routine tennis practice on 2 off-days a week (Tuesday, Thursday).

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Procedures

Single-Leg Hop for Distance Test (2,33)

A tape measure was secured to the ground for a distance of approximately 0.5 m. The subjects began by standing on the designated leg to be tested with their toe just behind the starting line. They were instructed to hop as far as possible forward and land on the same leg, holding that position for at least 2 seconds (Figure 1). The subjects were allowed to use their arms for balance as required. After a series of 3-5 trials, the subjects completed 2 single-leg hops on each limb. The distance hopped was recorded, the data from the 2 tests for each leg averaged, and limb symmetry calculated by dividing the mean distance hopped of the right leg by the mean distance hopped of the left leg, and then multiplying the result by 100. Research previously conducted by the authors (2) demonstrated that a limb symmetry index of 85% or greater is present in the majority (93%) of athletes. This test has acceptable reliability, with intraclass correlation coefficient (ICC) > 0.85 (14,42).

Figure 1

Figure 1

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Single-Leg Triple Crossover Hop for Distance Test (33)

The subjects began by standing on the designated leg to be tested with their toe just behind the starting line. Then, they hopped 3 consecutive times on that leg, crossing over the measuring tape on each hop. The subjects had to be in control and hold the landing of the third hop for 3 seconds for the test to be considered. The subjects were allowed to use their arms for balance as required. After a series of 3-5 trials, the subjects completed 2 single-leg hops on each limb. The total distance hopped was measured and the right-left leg limb symmetry index calculated as described above. This test has acceptable reliability, with ICC > 0.85 (42,46).

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Baseline Speed and Agility Forehand and Backhand Tests (10)

A cone was placed in the center of the baseline and on the singles sideline of the subjects' forehand side, 0.9 m inside the court (Figure 2). The subjects began on the starting position (center of the baseline) and, upon command, ran to the cone on the sideline, completed a forehand swing with the racquet, ran back to the starting position, and continued back and forth for a period of 30 seconds that was timed with a digital stopwatch. One repetition equaled 1 full run from the center to the swing cone and back to center cone or a distance of 5 m. The number of repetitions completed in the 30-second time period was recorded and converted to the total distance covered. If a subject reached the swing cone at the end of the 30 seconds, half of a repetition was added to the total count. The test was also done with the swing cone placed on the singles sideline of the subjects' backhand.

Figure 2

Figure 2

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Service Box Speed and Agility Test (10)

The subjects began in the middle of the service box in an athletic position. Upon command, they ran and touched the center service box line and then the singles sideline with their racquet, back and forth, as many times as possible within 30 seconds, which was timed with a digital stopwatch (Figure 3). Each time the subject touched a line counted as 1 repetition. The distance between the 2 lines was 1.1 m. Each subject performed this test twice, with a 5-minute rest between tests. The mean number of repetitions was calculated and converted to the total distance covered. This test has acceptable reliability, with an ICC of 0.85 calculated in this investigation.

Figure 3

Figure 3

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Suicide Tests

Each subject completed a single-court suicide run (Figure 4). Beginning on the doubles sideline, the subject moved forward and touched the singles sideline, ran backward and touched the doubles sideline, ran forward and touched the center of the baseline, ran backward and touched the doubles sideline, and so on until all lines were touched for a total of 46.6 m. The racquet was used to touch the lines. The time to complete the test was recorded with a digital stopwatch in one-hundredths of a second. Two subjects performed the test at the same time as described by Delextrat et al. (5,6) to encourage them to provide maximal effort.

Figure 4

Figure 4

The subjects also completed a 2-court suicide run on a bank of 2 courts which were adjacent to each other. Beginning on the doubles sideline of court-1, they ran a standard forward-backward suicide, touching every line on both courts.

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Abdominal Endurance Test

The subjects were positioned on a mat or cushion on their back with their arms by their side while sitting on their hands. Upon command, both legs were lifted together approximately 15 cm off the ground, and the player was instructed to maintain this position for as long as possible. The amount of time that the subjects were able to maintain this position (keeping both legs off the ground) was recorded with a digital stopwatch.

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Neuromuscular Training Program (3)

The training program consisted of the essential components of Sportsmetrics, including a dynamic warm-up, plyometric and jump training instruction, strength training (lower extremity, upper extremity, core), and flexibility (Table 1 [3]). Other strength, speed, and agility exercises and drills were added based on a review of published tennis instruction materials (12,25,27,28,44), the authors' experience, and materials from the Etcheberry Certification for Tennis program (10). The program entailed a gradual progression of the components to avoid overuse problems and injuries. A trial training program involving 4 female players was conducted first to determine player compliance and satisfaction with the program.

Table 1

Table 1

Table 1

Table 1

All training sessions were supervised by a certified Sportsmetrics instructor and a tennis professional certified by the United States Professional Tennis Association. The instructors kept written records of all exercises performed by each athlete for each training session. There were 3 sessions conducted per week (Monday, Wednesday, Friday) for 6 weeks. Each session lasted 1.5 hours. During the jump training and speed and agility drills, players were encouraged to maintain a neutral alignment by reinforcing the knees and ankles to be placed hip distance apart with exaggerated knee and hip flexion on landing from a jump, decelerating, and cutting. The trainers and tennis professionals gave constant feedback on body mechanics during all training drills. Instructional terms and cues such as “land softly,” “ keep your knees and feet directly under hips,” and “bend your knees deeper” were repeatedly used to aid in the education process. Proper stroke instruction and footwork were also continually emphasized. Strength training placed an emphasis on hamstring, quadriceps, gastrocnemius, soleus, hip flexion and abduction, and core to aid in proper lower extremity alignment and muscle recruitment patterns. Upper body strengthening was accomplished with a medicine ball, hand weights, and body exercises such as wall push-ups and seated press-ups. Core strengthening involved a series of exercises, beginning with 150 repetitions and progressing up to 300 repetitions. Static flexibility exercises were performed at the end of each training session.

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Statistical Analyses

All data were normally distributed (Kolmogorov-Smirnov test), and therefore, a 2-tailed paired t-test was used to detect differences for each test between the pretrain and posttrain periods. Effect sizes were calculated and interpreted according to Cohen's standards (4). A level of p ≤ 0.05 was considered to be statistically significant.

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Results

No athlete sustained an injury or developed an overuse syndrome as a result of the training program. All athletes completed at least 14 of the 18 training sessions; 3 players completed 14 sessions, 2 completed 15 sessions, 4 completed 16 sessions, 3 completed 17 sessions, and 3 completed 18 sessions.

Upon completion of training, statistically significant improvements were found for the baseline forehand and backhand tests, the service line test, the 1-court suicide, the 2-court suicide, the abdominal endurance test, and the single-leg crossover hop for both legs (Table 2). Large effect sizes were noted for the majority of these tests, except the single-leg hop.

Table 2

Table 2

Highly significant improvements were noted for both baseline tests, because 67% improved the forehand test score and 80% improved the backhand score. In the service line test, all but 1 player improved. In the 1-court suicide run, all players improved, and in the 2-court suicide, all but 1 player improved their time to complete the test. The greatest average percent improvement was noted in the abdominal endurance test (76%), with all but 2 players demonstrating better times.

Normal limb symmetry (≥85%) was detected in the single-leg triple crossover hop in 87% during both test sessions. A mean improvement of 36 cm was detected in both legs (p ≤ 0.05). Normal limb symmetry was recorded in the single-leg hop test in 87% of the players during the pretrain test and in 93% at the posttrain test. The mean distance hopped did not significantly improve between test sessions. Sixty-seven percent of the players did show some improvement in the distance hopped on the right leg, whereas 47% had improvement in the left leg.

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Discussion

Tennis is a demanding sport for the competitive athlete because it requires a combination of technique, speed, agility, explosive power, and aerobic conditioning along with the ability to react and anticipate quickly and cope with fatigue and pressure throughout a match (11,43). These attributes have been demonstrated to correlate with tournament performance in elite players (24,45). Our training program is unique in that it comprises a blend of neuromuscular training and sport-specific enhancement tasks to specifically improve dynamic balance, agility, speed, and strength. We were unable to find a similar multiweek program designed specifically for adolescent competitive female and male tennis players in the literature to compare our results to, because most studies provide a single-time physiological profile of players (1,7,9,13,18,35,36,48).

The neuromuscular training principles and exercises chosen for this study were derived from a previously published training program (3,16,17) that was shown to be effective in improving neuromuscular indices and reducing the risk of noncontact knee ligament injuries in adolescent athletes. Our program requires a dedicated tennis professional who understands the basis for the neuromuscular training elements to instill them into the tennis-specific drills, along with proper stroke and footwork instruction. Supervision of training of competitive tennis players is essential for continued improvement in both the physical and mental aspects of the game. Kovacs et al. (29) found that just a 5-week period of unsupervised tennis training resulted in significant reductions in speed, power, and aerobic capacity in collegiate nationally ranked players.

The neuromuscular training component included strategies to enhance dynamic balance and agility during both jump training and sport-specific drills. The players were taught to control the upper body, trunk, and lower body position; lower the center of gravity by increasing hip and knee flexion during running, jumping, landing; and land with smaller ground reaction forces. These strategies were also encouraged during the agility and speed drills that involved straight running, lateral movements, and backwards jogging with and without hitting a ball. The plyometric component was used to not only train for power and explosive movements but also to enhance the players' ability to decelerate quickly in a safe manner (26). The ability to efficiently decelerate in tennis is just as important as the ability to accelerate, because the player must be able to stop and change direction in the time period required to make optimal ball contact and be in position to continue the rally. The ability to control the body during both acceleration and deceleration translates into superior dynamic balance and ultimately, performance. Malliou et al. (32) recommended that balance training be incorporated into tennis training programs after noting a fatigue-induced decline in balance performance in 36 elite tournament players. In addition, it is believed that many lower extremity injuries occur because of poor balance and deceleration techniques or an overabundance of acceleration training that is not balanced with deceleration training (26).

Salonikidis and Zafeiridis (47) assessed the effects of 3 training programs on 64 novice tennis players aged 21.1 ± 1.3 years on speed, reaction time, tennis-specific movements, and power of the lower limbs. The programs comprised either plyometric training (6 plyometric exercises), tennis-specific drills training (6 running drills), or a combination of both and were conducted 3 times a week for 9 weeks. The authors reported that the combined training program appeared to be the most advantageous because it resulted in a significant improvement in most of the tests conducted including reaction time, 4-m side steps, 4-m and 12-m sprint runs, drop jump, and lower extremity maximum isometric force. This program was only tested in novice players, and the results are thus unknown for more experienced, competitive players.

Agility in tennis represents the ability of the player to produce a rapid, reactive change of direction in response to the motion or pathway of the tennis ball (50). Competitive tennis players perform countless agility movements during match play. The mechanics of the movement of the entire body during the change in direction must be controlled and efficient and incorporate a high level of dynamic balance. Our program included both preplanned and reactive tasks in forward, backward, sideways, and diagonal patterns to improve agility. Both the dominant and nondominant lower limb sides were stressed equally. For instance, in the ladder drills, players completed the patterns in a nonrandomized order where the drill was initiated with either the right or left foot. The results of the 3 agility tests indicated improvements in 67-93% of the athletes in this study.

Core stability and strength are required for trunk rotation that occurs during the serve and groundstrokes, especially the open-stance forehand (23). These elements play an integral role in tennis performance and are well-established requirements in tennis conditioning programs (8,44). The combination of trunk rotation and upper limb drive (shoulder internal rotation, elbow extension, wrist flexion) are crucial components that help bring about optimal racquet speed and position at ball impact (30). Ellenbecker and Roetert (8) established an isokinetic profile of trunk rotation strength in 109 elite male and female tennis players aged 11-54 years. The men had symmetrical strength between the forehand and backhand directions, and the women had only small (4-8%) differences in strength between these directions. The authors suggested that core-stabilization programs should focus on both directions of trunk rotation to enhance muscle strength and balance. Our program incorporated numerous drills and exercises to improve core strength and stability in both directions, such as twisting lunges with a medicine ball and exaggerated forehand and backhand medicine ball throws. Abdominal exercises on mats were performed at the end of the training sessions, beginning with 150 repetitions the first week and progressing up to 300 repetitions, using a variety of exercises. The training program appeared effective, because all but 2 players improved in the abdominal endurance test.

Although the program included upper body strength exercises, it is recommended that players perform additional upper body strength training either during the program sessions or on opposite days that training is conducted. It is also suggested that this training program be conducted during a 6-week time period in which the player is not peaking for important tournaments or school competition. In this manner, the player focuses on the goals of the program and will be less likely to miss training sessions because of travel or tournament scheduling conflicts.

There are many tests that are available to determine alterations in neuromuscular indices. We choose a small battery of tests to measure lower limb symmetry and balance, agility and speed, and abdominal endurance. We avoided previously described tests that required equipment not normally available in tennis facilities or that required advanced medical knowledge. For instance, the United States Tennis Association has a testing protocol in which many of the tests require a physical therapist or athletic trainer to perform with tools such as a goniometer, blood pressure cuff, grip-strength dynamometer, and skinfold calipers (44). The tests described in our study can be performed by any individual without the need for expensive equipment. Our future assessments will include the low-cost, established multistage fitness test to determine VO2max (31,41) and medicine ball throws to assess upper body strength (44). Girard and Millet (13) conducted a study on elite male tennis players aged 13.6 ± 1.4 years and found asymmetry between the strength of both upper and lower limbs. The authors suggested the importance of continual monitoring these factors during puberty and modification of training to reduce these imbalances and the risk of injuries. Kovacs et al. (29) also recommended that coaches assess on a regular basis strength, speed, agility, and aerobic capacity of elite players to ensure better compliance with training programs.

We videotaped the single-leg hop tests to show the athlete and parents the player's body position on landing to determine if they had adequate control of the core, upper extremity, and lower extremity. We found subjectively that only approximately one-third of the players were able to maintain an adequate body position on landing before training (Figure 5). The others demonstrated noteworthy medial-lateral displacement at the knee joint, along with poor upper body control and posture. Some athletes had exaggerated trunk flexion that affected their ability to hold the landing position. Twenty percent of the players were unable to hold the landing and fell to the ground (Figure 5C). After training, marked subjective improvements were noted in the neuromuscular control on landing in all but 2 of the players. The improved technique translated into superior confidence and significant increases in the distance hopped in the triple crossover hop. We believe this test provides a measure of dynamic balance in addition to limb symmetry, more so than the single hop for distance task. There was no significant improvement in the single hop for distance test for either the right or left limb, which could have been because the training program did not include single-hop training. The only single-leg exercise was the triple hop, which was done during weeks 3-4. Still, we believe that these single-leg hop functional tests are valuable in detecting lower limb asymmetry that typically would not be depicted by the other testing procedures.

Figure 5

Figure 5

Unfortunately, tennis is associated with a unique profile of injuries because of its demands and the tremendous range of age and skill level of players. To date, there have been no published injury prevention training programs designed specifically for this sport. In a review of 119 articles, Pluim et al. (39) concluded, “we were unable to identify measures proven to prevent tennis injuries.” Kibler and Safran (21) noted that specific alterations in mechanics, such as incomplete flexion of the knee (less than 10°) in the cocking phase of the serve, increased loads in the shoulder and elbow by 23 and 27%, respectively. Overuse injuries are common, including patellofemoral pain syndromes, patellar tendinitis, bursitis, Achilles tendinitis, plantar fasciitis, rotator cuff inflammation, lateral epicondylitis, and medial epicondylitis. In a study of 4 United States National Association national junior tournaments, the incidence of medical withdrawals was calculated to be 11.7 per 1,000 athletic exposures in the 14 and under age group, which increased to 20.6 in the 16 and under group and 22.7 in the 18 and under group (20). Our future goals are to determine if this program is effective in reducing injuries in junior tennis players and to assess if a difference exists between genders in changes in neuromuscular indices after training.

There exists a tremendous array of tennis instructional materials, from books to videotapes to online sources. Although many of these resources provide sound advice based on medical and research experience, it is difficult to find a specific training protocol in which the exercise progression is provided in detail and is based on a program proven to improve neuromuscular indices in young athletes. Therefore, our purpose was to develop a tennis-specific training program for competitive junior players that implemented the essential components of Sportsmetrics and added exercises and drills designed to improve dynamic balance, agility, speed, and strength. The results of this study show that this program is feasible, low in cost, and appears to be effective in improving the majority of neuromuscular indices tested. One limitation is that there was no control or comparison group in this investigation, which will be included in future studies.

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Practical Applications

We devised a 6-week training program for competitive junior tennis players. The program is unique in that it incorporates jump training and other drills from a previously published training program reported to improve neuromuscular indices and reduce the risk of knee ligament injuries in adolescent athletes. The supervised training sessions are conducted 3 times a week for 1.5 hours per session. The program includes a dynamic warm-up, plyometric and jump training, strength training (lower extremity, upper extremity, core), tennis-specific drills, and flexibility. This program is low in cost and appears to be effective in improving speed, agility, abdominal endurance, and single-leg function and balance in young tennis players. All training and testing procedures are performed on the tennis court, and we recommend that this program be conducted during a time period in which the player is not peaking for important tournaments or school competition. Further research is required to determine if this training program can reduce the incidence of injuries in tennis players.

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Acknowledgment

The authors would like to thank Gateway Golf and Country Club, Fort Myers, Florida.

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Keywords:

speed; agility; dynamic balance; plyometrics

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