Young Simon W, Dakic Jodie, Stroia Kathleen, Nguyen Michael L, Harris Alex H S, Safran Marc R
Department of Orthopaedic Surgery, North Shore Hospital, University of Auckland, Auckland, New Zealand.
Sport Sciences and Medicine, Women's Tennis Association Tour, St Petersburg, Florida, USA.
Am J Sports Med. 2014 Nov;42(11):2654-8. doi: 10.1177/0363546514548852. Epub 2014 Sep 11.
Adequate hip range of motion is required for the transfer of energy from the lower to the upper extremity along the kinetic chain. Repetitive rotational stresses in the lower extremities during tennis may lead to sport-specific range of motion adaptations, which may increase the risk of injury to other joints along the kinetic chain.
To assess whether such range of motion adaptations occur in the hip, and if so, to identify whether they are associated with injury.
Cross-sectional study; Level of evidence, 3.
A total of 125 female professional tennis players, the majority of whom were ranked in the top 200 World Tennis Association singles rankings, underwent a comprehensive preparticipation physical health status examination. Hip range of motion was assessed using a digital inclinometer and side-to-side differences in rotational parameters calculated, and associations with previous injuries were identified.
A history of an abdominal strain was reported by 10% of players, and there was an association between abdominal strains and the presence of hip flexion contractures (odds ratio, 6.1; P = .006). Hip flexion contractures were bilateral in 85% of those found, affected only the nondominant side in 9%, and affected only the dominant side in 6%. We were unable to identify any specific side-to-side rotational adaptations in the dominant or nondominant hips, and no association between loss of hip range of motion and shoulder, lower back, hip, knee, or ankle injuries was found.
We report an association in female professional tennis players between abdominal strains and flexion contractures of the hip with iliopsoas tightness. We did not find evidence of specific hip adaptations in rotational range of motion. If hip flexion contractures are found on clinical examination, a stretching program may be indicated. Further studies are required to assess whether such a program can reduce the risk of abdominal injury.
沿动力链将能量从下肢传递到上肢需要足够的髋关节活动范围。网球运动中下肢反复的旋转应力可能导致特定于该项运动的活动范围适应性变化，这可能会增加动力链上其他关节受伤的风险。
评估髋关节是否会出现这种活动范围适应性变化，如果出现，确定它们是否与损伤相关。
横断面研究；证据等级，3级。
总共125名女性职业网球运动员接受了全面的赛前身体健康状况检查，其中大多数在世界网球协会单打排名前200位。使用数字倾角仪评估髋关节活动范围，并计算旋转参数的左右差异，确定与既往损伤的关联。
10%的运动员报告有腹部拉伤史，腹部拉伤与髋关节屈曲挛缩的存在之间存在关联（优势比，6.1；P = .006）。发现的髋关节屈曲挛缩中，85%为双侧，9%仅累及非优势侧，6%仅累及优势侧。我们未能在优势或非优势髋关节中识别出任何特定的左右旋转适应性变化，也未发现髋关节活动范围丧失与肩部、下背部、髋部、膝部或踝部损伤之间存在关联。
我们报告了女性职业网球运动员腹部拉伤与伴有髂腰肌紧张的髋关节屈曲挛缩之间的关联。我们没有发现髋关节旋转活动范围有特定适应性变化的证据。如果在临床检查中发现髋关节屈曲挛缩，可能需要进行拉伸训练计划。需要进一步研究来评估这样的训练计划是否可以降低腹部损伤的风险。
