Humerus Diaphyseal Stress Fracture in a Teenage Tennis Athlete: Case Report / Fratura por estresse diafisária do úmero em atleta de tênis adolescente: Relato de caso

Abstract A teenage male tennis player had chronic pain in his dominant arm during tennis practice. Magnetic resonance imaging (MRI) suggested humerus diaphyseal stress injury. After 4 weeks, he became asymptomatic and resumed playing. However, pain recurred after 3 days. A new MRI revealed a diaphyseal undisplaced humerus fracture and significant bone marrow edema. The patient remained in rest for 4 weeks. After that, strengthening exercises were introduced and return to training was allowed after 12 weeks. Even if asymptomatic, we suggest that these patients should not return to play before 12 weeks, depending on the physical exam and imaging findings.

Resumo Um tenista adolescente tinha dor crônica no braço dominante durante os treinos de tênis. A ressonância magnética (RM) sugeriu lesão por estresse na diáfise do úmero. Depois de 4 semanas, ele se tornou assintomático e voltou a jogar. No entanto, houve recidiva da dor após 3 dias. A nova RM revelou fratura diafisária não desviada do úmero e edema significativo da medula óssea. O paciente ficou em repouso por 4 semanas. Depois disso, exercícios de fortalecimento foram introduzidos e o retorno aos treinamentos foi permitido após 12 semanas. Mesmo que assintomáticos, sugerimos que esses pacientes não voltem a jogar antes das 12 semanas, dependendo dos exames físicos e dos achados por imagem.

Incidencia de lesiones en tenistas profesionales. Análisis de las condiciones médicas ocurridas durante 6 ediciones de ATP 250 de Buenos Aires / Incidence of professional tennis injuries

Objetivo: conocer la incidencia de lesiones y analizar las condiciones médicas que sufrieron los tenistas que jugaron el ATP de Buenos Aires durante los años 2011 a 2016. Material y Método: Se realizó un análisis retrospectivo de las condiciones médicas que ocurrieron durante la disputa de 6 torneos consecutivos, y se obtuvo la incidencia de lesiones. Resultados: El ATP de Buenos Aires se realiza cada año durante el mes de febrero, siendo parte del calendario anual de la ATP. Presentamos datos estadísticos correspondientes a los años 2011 a 2016, 6 torneos consecutivos, registrados por el cuerpo médico a cargo de la atención médica del torneo. 556 jugadores disputaron 426 partidos, resultando en una exposición de 1036 jugadores/match durante 605 hs de juego. Se diagnosticaron 157 condiciones médicas, 85 fueron lesiones y 72 fueron enfermedades. La Incidencia de lesiones fue de 82 c/1000 match exposiciones; predominaron las lesiones musculares (50,5%) y tendinosas (25,8%), y el miembro inferior fue la región del cuerpo más afectada (48,5%). Además fueron tratadas 72 enfermedades, siendo las más frecuentes la enfermedad por calor (36,1%), las de la piel (34,7%) y las gastrointestinales (13,8%). El motivo más frecuente de atención médica durante los partidos fue alguna de las formas de la enfermedad por calor (62% de los court call). Hubo 26 retiros del juego, y 2 casos requirieron para su tratamiento ser trasladados a un hospital. Conclusión: Tratar tenistas profesionales requiere para el traumatólogo del deporte, un profundo conocimiento de las lesiones musculo-tendinosas y de la prevención y manejo de la enfermedad por calor. Nivel de evidencia: IV (Estudio observacional descriptivo).

Objective: to know the incidence of injuries and to analyze the medical conditions that suffered the tennis players who played the ATP of Buenos Aires during the years 2011 to 2016. Material and method: A retrospective analysis was made of the medical conditions that occurred during the 6 consecutive tournaments, and the incidence of injuries was obtained. Results: The Buenos Aires ATP is held every year during the month of February, being part of the annual calendar of the ATP. We present statistical data corresponding to the years 2011 to 2016, 6 consecutive tournaments, registered by the medical body in charge of the medical care of the tournament. 556 players disputed 426 parties, resulting in an exhibition of 1036 players / match during 605 hours of game. 157 medical conditions were diagnosed, 85 were injuries and 72 were diseases. The Incidence of injury was 82 / 1000 match exposures; Muscular (50.5%) and tendinous (25.8%) lesions predominated, and the lower limb was the region of the body most affected (48.5%). In addition, 72 diseases were treated, the most frequent being heat illness (36.1%), skin disease (34.7%) and gastrointestinal disease (13.8%). The most frequent reason for medical attention during matches was one of the forms of heat illness (62% of the court calls). There were 26 withdrawals from the game, and 2 cases required for their treatment to be transferred to a hospital. Conclusion: Treating professional tennis players requires a thorough knowledge of the musculoskeletal injuries and the prevention and management of heat illness for the sports traumatologist. Level of evidence: IV (observational descriptive study).

Dynamic ulnar impaction syndrome in tennis players: report of two cases / Síndrome do impacto ulnocarpal dinâmico em tenistas: relato de dois casos

ABSTRACT In this report, two tennis players with symptoms of ulnar impaction syndrome are reviewed. Both players have neutral ulnar variance. These cases represent dynamic ulnar impaction syndrome, when the impact between ulna and carpus occurs during conditions of pronated grip. The literature and the treatment of these two cases are discussed.

RESUMO O relato apresenta os casos de dois tenistas portadores de dor no bordo ulnar do carpo com sinais de impacto no semilunar. Ambos são portadores de ulna neutra. Esses casos representam uma entidade denominada síndrome do impacto ulnocarpal dinâmico na qual ocorre o impacto entre a cabeça da ulna e o carpo em situação de pronação com punho fechado durante a atividade física. A literatura e o tratamento dos dois casos são discutidos no artigo.

The effects of individualized exercise training on rotator cuff injury in elite table tennis players / 中华物理医学与康复杂志

Objective To observe any rehabilitative effects of individualized exercise training in the treatment of rotator cuff injury in elite table tennis players.Methods Forty table tennis players from the Chinese National Team were studied.Twenty (the experimental group) had rotator cuff injuries and 20 without the injury formed the control group.An individualized rehabilitation treatment protocol was prepared for each of the players in the experimental group and implemented twice weekly for a total of 8 weeks.There was no intervention for the control group.Before and after the treatment,both groups were assessed using a questionnaire for disabilities of the arm,shoulder and hand (DASH),a motion assessment,and BIODEX isokinetic muscle testing.Results There were significant differences in average DASH scores between the two groups,with the experimental group scoring higher than the controls both before and after the treatment.Before the treatment,at angular velocities of 60°/s,180°/s and 300°/s the peak moments of the ER (external rotation,ER) and IR (internal rotation,IR) muscles and the ER/IR ratio were all lower in the experimental group than among the controls.However,after the treatment the performance of the experimental group had improved in all three tests.Conclusion The ER/IR ratio of the dominant shoulder of table tennis players with rotator cuff injury is lower than that of the players without the injury,but individualized rehabilitation treatment can effectively increase the ratio and help to improve their shoulder function.