Upper Body Injuries and the
Open Stance Forehand

Scott Riewald, PhD

Many injuries that occur in elite tennis players can be classified as "overuse" injuries, stemming from the repetitive demands placed upon the human body from countless hours of training and competition.

Players now hit with incredible power from virtually anywhere on the court. The two most explosive shots in tennis, the serve and the forehand, also make up 75% of all strokes during a typical match. It's not surprising then that the forces players now generate with these shots can lead to muscular imbalances and potential injury.

At the USTA we believe that the risks of these types of repetitive use injuries can be reduced significantly. We believe that the solution is a properly designed strength and conditioning program, and that this type of program is a necessary minimum for all serious competitive players.

In the first article we looked at lower body and hip injuries that can result from hitting the modern, open stance forehand. (Click Here.) In this article, we'll do the same for the upper body. Then we'll present some key exercises designed to help prevent them.You can find more exercises, as well as find out more about injury prevention in general, by visiting our website. (Click Here.)

Open Stance Forehand Upper Body Injuries

In the modern game, more and more forehands are hit with semi-western and extreme semi-western grips and with open stances. As a consequence, the players are rotating their bodies through the forehand much more than in previous generations.

Most players are now making contact with the torso "open" or basically parallel to the baseline. The shoulders usually continue to rotate until in many cases they are finishing perpendicular or square to the net.

This means that as the players start the forward swing, the torso is opening sooner, with the arm lagging behind. The early opening of the body and the resulting arm lag can place stress on the shoulder, particularly the rotator cuff and stabilizing structures, and the elbow. In some players where this lag may be fractionally longer, it's possible that these stresses and the potential for injury are further increased.

This can lead to tendonitis in the shoulder. It also places the shoulder at further risk for becoming unstable, making it more susceptible to serious injury as the structures are repetitively loaded and unloaded.

In addition when players fail to use the legs and the shoulders sufficiently, or contact the ball late, it can place additional stress on the inside of the elbow, because the player must compensate by using the wrist and forearm to generate the energy for the shot.

This may be especially true when players stop the torso rotation at contact and rely on an extreme windshield wiper or an over the shoulder reverse finish to complete the stroke. Having adequate strength in the rotator cuff and upper back can help stabilize the shoulder and prevent these forehand related injuries.

Here are 3 important exercises to achieve this. You can see more exercises and learn more about this type of injury and overall injury prevention by visiting the strength and conditioning area of our website. (Click Here.)

Low to High Pull

The first exercise is the Low to High Pull. This exercise is a multi-planar exercise. It uses rotational movement patterns and integrates the entire kinetic chain used by players on the forehand. This makes it an excellent, highly specific exercise for preventing upper body injuries.

To perform the Low to High pull, adjust a cable column weight machine so the handle starts approximately one foot off the ground. Position your body so you will have to rotate your torso to reach the handle in its starting position while also being able to bring the cable up and across your body during the lift.

Using a low to moderate weight, grasp the handle with both hands at the starting position while flexing the knees and loading the right leg. Drive off the right leg while first pulling and then pushing the cable across the body so that the movement ends with both hands over the left shoulder with the arms fully extended.

Perform this exercise explosively and lower the weight in a controlled manner between each repetition. Perform three sets of 15-20 repetitions.

Straight Arm Rowing

The second exercise is Straight Arm Rowing. This exercise trains the muscles that stabilize the shoulder blades and help protect the rotator cuff from injury. Loop a piece of elastic tubing through a fence, or around another stationary object, at about hip level.

Standing in an athletic position and holding one handle of the tubing with each hand, elevate the arms so they are at an angle of roughly 45 degrees relative to the body.

Step back so there is tension in the band. Squeeze the shoulder blades together and perform a rowing action by pulling the handles back towards the hips while keeping the arms straight.

Return to the starting position with the body and tension in the tubing under control, and repeat. Perform 1-3 sets of 15 repetitions.

90-90 External Rotation

Here is another basic exercise to strength and protect the rotator cuff, called the 90-90 External Rotation.

Attach a tubing exercise band to a secure location like an exercise machine, a fence post, etc. Face straight ahead, holding the tubing by the handle with your dominant hand.

Lift the arm upward and to the side until it is parallel with the ground. The arm and elbow should be at a 90 degree angle. The palm of the hand faces down.

Raise the hand and arm 90 degrees, rotating them backwards and upwards as a unit from the shoulder joint. Return to the starting position, keeping the tension in the tubing as you go down. Perform 1-3 sets of 15-20 repetitions.