Tennis Serve Kinetic Chain Evaluation
If you play tennis, you may have heard of the term Disabled Throwing Shoulder (DTS). DTS is a general term describing the limitations of function that exist in symptomatic overhead athletes in that they cannot optimally perform the task of throwing or hitting the ball . I know you probably thinking: ‘You dumb? I play tennis, not baseball! I don’t know about the stupid DTS!’ But think about it, throwing doesn’t mean throwing a baseball. It is a general term describing the shoulder motion (shoulder internal rotation and horizontal adduction, elbow extension and wrist flexion). DTS is the result of a series of small injuries that you probably won’t bother, in which your body slowly adjusts to the demands of the injuries and eventually affect the optimal function of the body.
Now you may think okay, DTS could affect me, but how? The answer is the tennis serve. Similar to throwing a baseball, tennis serve is one of the most complex dynamic activities involving the entire body, and results in repetitive high velocities, high loads, and a large range of motion demands on all parts of the human body. As a result, your body may make alterations in anatomy, physiology, and/or biomechanics, and create pathomechanics that may create inefficiency in the tennis serve kinetic chain, impaired performance, increased injury risk, or worst of all, cause actual injury. Therefore, to optimize the tennis service performance and minimize injury risk, it requires evaluation of the tennis service kinetic chain.
The tennis serve kinetic chain evaluations can be organized into three big components, the leg/hip/core, the scapula, and the shoulder. You don’t need a PhD to be able to learn and evaluate the tennis serve kinetic chain. All you need is a phone to record your serve.To help players better to assess tennis service kinetic chain, the Women’s Tennis Association and the Shoulder Center of Kentucky developed the Observational Tennis Serve Analysis (OTSA) tool . The OTSA evaluates 9 components of the tennis serve that may be contributing to pathomechanics and musculoskeletal risk factors to injury. It is generally used as part of the comprehensive evaluation of tennis players who want to improve their serving performance or who have an injury. An example of the OTSA with detailed descriptions of the pathomechanics is listed in Table 1.
In addition to the OTSA, a shoulder assessment is generally recommended. A comprehensive shoulder assessment can assess joint health and potential altered physiology that may contribute to any pathomechanics. The shoulder assessment should be emphasizing evaluation of muscle weakness/imbalance and flexibility, scapular dyskinesis, shoulder internal rotation deficit, and total range of motion deficit of the shoulder.
Now you may think okay, I will get a tennis serve kinetic chain evaluation, then what? If the evaluation didn’t identify any kinetic chain deficits, that would be great. But if by any chance that it did, you should look for rehabilitation through qualified professionals. Rehabilitation should involve a comprehensive approach just like the assessment, which should include restoration of all kinetic chain deficits, altered mechanics, and functional joint stability. These include restoration of hip range of motion and leg strength, core stability and strength, scapular control, shoulder muscle flexibility and strength, and shoulder internal and external rotation. This will maximize your ability to develop normal mechanics to accomplish the tennis serving task.
Burkhart SS, Morgan CD, Kibler WB. The disabled throwing shoulder: spectrum of pathology Part I: pathoanatomy and biomechanics. Arthroscopy. 2003;19(4):404–20.
Kibler WB Wilkes T Sciascia A. Mechanics and Pathomechanics in the Overhead Athlete. Clin Sports Med. 2013;32(4):637-651.
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Table 1: The Observational Tennis Serve Analysis Tool