How to protect your spine

from your tennis serve

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/2017/02/how-to-protect-your-
spine-from-your-tennis-serve.
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 When most people think about chronic injuries that occur from
tennis, they usually think of tennis elbow. But if you ask a
serious tennis player about the most common tennis-related
injuries, low back pain will almost always make that list. Theres
good reason for that. We spoke with Dr. Todd Lanman
, a spine surgeon in Beverly Hills, California.
He says that:

imaging studies such as MRI show that 62% of serious amateur,

elite, and professional tennis players have injuries in the spine in
their lower backs. In fact, four out of ten professional tennis
players admit to missing at least one tennis tournament because
of low back pain.
So while low back pain and spine injury may not be as famous as
an injury in that other joint, it is clearly a big problem for tennis
players.
When most people think about chronic injuries that occur from
tennis, they usually think of tennis elbow. But if you ask a serious
tennis player about the most common tennis-related injuries, low
back pain will almost always make that list. Theres good reason for
that. We spoke with Dr. Todd Lanman, a
spine surgeon in Beverly Hills, California. He says that:

imaging studies such as MRI show that 62% of serious amateur,

elite, and professional tennis players have injuries in the spine in
their lower backs. In fact, four out of ten professional tennis players
admit to missing at least one tennis tournament because of low
back pain.
So while low back pain and spine injury may not be as famous as an
injury in that other joint, it is clearly a big problem for tennis players.
If youre an avid player, youve probably thought a lot about your
serve. But you may not have thought a lot about how your body is
affected by your serve. Dr. Lanman states,

One of the most common causes of back pain and injury to tennis
players is the serve. You place extreme forces on your spine during
a tennis serve.
Dr. Lanman is a world-renowned spine surgeon at Cedars-Sinai
Medical Center in Los Angeles. As a top back and neck surgery
specialist practicing in Beverly Hills, he counts many professional
athletes, business leaders, and entertainment luminaries among his
clients.

Consider what a serve does to your body. You start out by

hyperextending your back, stretching out the muscles and
elongating the spine. The spinal column is not vertically straight
during the serve, either, as it would like to be. The serve itself is a
violently rapid contraction of these same muscles coupled with a
forcible rotation of almost the entire body.

Imagine how these forces are transmitted along the length of your
spine. The vertebrae in your lower back (lumbar vertebral) really
The backswing and contact arent even the most spine-damaging
parts of the serve. Dr. Lanman adds,

It really is the deceleration after the ball has been hit that causes
the extreme forces that damage the discs and joints throughout the
spine.
The strongest abnormal forces occur toward the end of your follow-
through, when the body slows itself down. The muscles in the back
and abdomen have to stabilize the body after this explosion of
energy. These core muscles are also the way that tennis players can
protect the health of their spines.

Tennis players with weaker core muscles are more likely to

experience injuries, says Dr. Lanman, So strengthening these core
muscles is an important way to protect against injury.
Treatment and conditioning programs for tennis players desiring to
strengthen their core muscles often focus of eccentric and plyometric
exercises. During eccentric exercises, the muscles contract as they
lengthen. One example of an eccentric exercise is to keep tension on
the biceps while straightening the arms after a curl. Plyometric
exercises involve stretching the muscle before contracting, and
It is also important to remember that the muscles of the back are
just as important to core strengthening as abdominal muscles are.

I tell my patients to work the muscles that extend the back twice
as hard as they work the abdominal and oblique muscles in the
front. The extensor muscles are often overlooked, but they are the
ones that decelerate the motion at the end of the tennis serve,
states Dr. Lanman. It is more difficult to target the back muscles,
but back curls against light resistance are a good start.
Exercises arent always enough to prevent or treat spine injuries
caused by playing tennis, however. Many tennis players will
eventually need spine surgery to relieve pain or other symptoms.
For some, spinal fusion surgery is a reasonable option. However, if
tennis players wish to return to play, Dr. Lanman tells us, artificial
disc replacement is the better option.
Artificial disc replacement is superior to fusion for
maintaining spinal motion and mobility.
With fusion, the spinal bones are fused together, but with
disk replacement, the individual vertebral bones keep their
ability to move. This is essential for elite and professional
tennis players who want to stay at the top of the sport.

Artificial disc replacement surgery can be performed without

any damage to the muscles of the spine, recovery is faster,
and players can return to play more quickly. It really is the
better surgical treatment for active, young adults.
It seems the key to protecting your spine from your serve is
to make sure core strengthening is part of your overall
workout routine. Dr. Lanman reminds, your back muscles are
part of your core, so work them twice as hard as your work
your abs. And if you do end up needing spine surgery
(Heaven forbid) and want to get back out on the court,
artificial disc replacement is a good option.
Sources:

Alyas F, Turner M, Connell D. MRI findings in the lumbar spines of

asymptomatic, adolescent, elite tennis players. Br J Sports Med.
Nov 2007;41(11):836-841; discussion 841.
doi:10.1136/bjsm.2007.037747

Maquirriain J, Ghisi JP, Kokalj AM. Rectus abdominis muscle strains

in tennis players. Br J Sports Med. Nov 2007;41(11):842-848.
doi:10.1136/bjsm.2007.036129

Marks MR, Haas SS, Wiesel SW. Low back pain in the competitive
tennis player. Clin Sports Med. Apr 1988;7(2):277-287.

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