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Tennis Sport, Trauma, and Biological Healing

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Tennis players at every level face distinctive musculoskeletal challenges arising from explosive serves, rapid multidirectional movement, and repetitive overhead mechanics. This authoritative volume delivers a comprehensive integrative biomedical framework for understanding, preventing, and managing tennis-related trauma. It synthesizes extensive epidemiological data, sport-specific biomechanical mechanisms, and current knowledge of tissue injury and healing with detailed coverage of both conventional treatments and pioneering regenerative strategies. Key topics include injury classification and mechanisms, intrinsic and extrinsic risk factors, clinical assessment and imaging, platelet-rich plasma applications, mesenchymal stem cell therapies, peptide-based interventions, mitochondrial dynamics in recovery, and advanced physiotherapeutic modalities such as hyperbaric oxygen therapy. The text further addresses phased rehabilitation protocols, functional and performance testing, return-to-play decision-making, and comorbidity considerations. Bridging traditional sports medicine with emerging cellular and molecular approaches, this resource equips competitive players, coaches, physiotherapists, sports physicians, and researchers with evidence-based knowledge to optimize recovery, reduce reinjury risk, and support long-term participation in the sport.

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SKU: 9781662980305 Categories: ,

Description

Authors

Prof. Dr. Mike K.S. Chan and Dr. Dina Tulina

Published by

EUROPEAN WELLNESS ACADEMY – Medical Research

ISBN: 9781662980305

eISBN: 9781662980312

DOI: https://doi.org/10.69669/qu9983

Authors Bio:

Prof. Dato’ Sri Dr. Mike K.S. Chan is Founder & Chairman of the European Wellness Biomedical Group and Chief Researcher/Chief Technical & Research Director across its international R&D programs. A pioneer of cellular therapy since the 1980s, he helped introduce stem cell and bioregenerative medicine across Asia, building a global network of clinics and research centers—today a chain of 40+ integrative and regenerative medical clinics with 1,000+ staff. He serves as ESAAM Scientific Committee Head for Regenerative Medicine & Stem Cells and ESAAM Chairman/Director for Asia; Associate Professor (AASCP, USA); Associate Professor (Lincoln University College, Kuala Lumpur); Chairman of the European Wellness Academy; Senator of Germany’s BWA; and Honorary Chief Healthcare Advisor to Swiss Strategic Partners. His portfolio includes multiple international patents in immunotherapy, stem cell transport media, and parenteral formulations, and he is a multi-award recipient in Europe and the Middle East. An active academic collaborator (MIT, Cambridge, USC, UCI, Heidelberg), Prof. Chan has authored/co-authored 60+ books and 170+ scientific publications, and has delivered 1000+ lectures and seminars across 60+ regions on anti-aging, regenerative medicine, peptides, and stem cell therapies.

Dr. Dina Tulina is a Medical Advisor and physician specializing in anti-aging, regenerative medicine, and comprehensive wellness. She integrates preventive, biological, and natural care to promote longevity and vitality beyond conventional practice. At European Wellness Global, she contributes to biomedical innovation with holistic approaches and the translation of research into practical applications. Guided by her belief that true health is balance and vitality, and functional longevity, Dr. Tulina is dedicated to shaping the future of personalized and preventive healthcare.

Table of Content

PREFACE XVII
CHAPTER I INTRODUCTION 1
Epidemiology of Trauma in Tennis. 11
Prevalence and Incidence Across Playing Populations 16
Chronic and Acute Trauma in Tennis 21
Region of Trauma in Tennis and Its Frequency 26
Tissue Involvement and Sides of Trauma and Injuries 34
Classification of Tennis Sport Injuries 39
Classification by onset. 40
Classification by consequence for participation 40
Classification by severity 41
Classification by tissue type and anatomical region 42
Classification by recurrence 42
Classification by mechanism 43
The concept of a catastrophic event 43
Injury Mechanisms in Tennis 44
The serve 46
The forehand groundstroke 47
The backhand groundstroke 47
Overhead shots 48
Court movement 48
Fatigue 49
Intrinsic risk factors 49
Extrinsic risk factors 50
Equipment-related mechanisms 51
The synthesis of mechanisms 51
Quantitative Kinematics of the Serve 51
Adaptive and Maladaptive Responses of the Overhead Shoulder 52
The Catch-Up Phenomenon and Scapulothoracic Coupling 54
Ankle Inversion Sprain Kinematics 55
Groundstroke Mechanics and the Wrist 56
Integrated Mechanism Model and Practical Synthesis 56
CHAPTER II RISKS OF INJURY IN TENNIS PLAYERS 59
Conceptual Framework and Intrinsic Risk Factors 59
Extrinsic Risk Factors and Integrated Risk Assessment 65
Additional Biomechanical Contributors to Injury in Tennis 73
Repetitive Movement, Running, and Jumping Demands 74
Environmental Interaction: Surface, Climate, and Equipment 76
Neuromuscular Control 77
Fatigue 78
Individual Anatomical Variability and Asymmetry 79
Anthropometry and Structural Variability 80
Psychomotor and Cognitive Influences 81
Integration with Injury Mechanisms 82
Comorbidities and secondary health risks for tennis athletes 83
Cardiovascular Conditions 83
Thermoregulatory and Heat-Related Illness 85
Dermatological Conditions 87
Ophthalmological Conditions 87
Respiratory Conditions 88
Gastrointestinal and Genitourinary Conditions 88
Endocrine and Metabolic Conditions 89
Psychological and Neurocognitive Conditions 89
Summary Table 90
Clinical Framework 92
Diagnosis 93
Clinical History 93
General Inspection and Postural Survey 97
Palpation and Surface Anatomy 97
Range of Motion Assessment 98
Strength and Neuromuscular Assessment 99
Special Tests by Anatomical Region 99
Sport-Specific and Functional Assessment 100
Neurovascular Examination 101
Documentation and Integration 103
Imaging Modalities—Extended Section 104
Plain Radiography 104
Ultrasonography 105
Magnetic Resonance Imaging 106
Computed Tomography 107
Bone Scintigraphy and Nuclear Imaging 108
Adjunctive and Emerging Modalities 108
Modality Selection by Clinical Indication 109
Clinical Reasoning 110
Functional, Biomechanical, and Performance Testing 111
Functional Movement Screening 112
Y-Balance and Dynamic Stability Testing 112
Isokinetic Strength Testing 113
Handheld Dynamometry and Manual Strength Assessment 115
Tennis-Specific Performance Testing 115
Three-Dimensional Motion Capture and Biomechanical Analysis 116
Force Plate and Ground Reaction Force Analysis 117
Cardiovascular and Metabolic Testing 118
Integration and Clinical Reasoning 119
Laboratory and Cardiovascular Testing 120
Hematological Testing 120
Inflammatory and Biochemical Markers 121
Endocrine and Metabolic Testing 122
Renal, Hydration, and Electrolyte Assessment 122
Coagulation and Cardiovascular Risk Markers 123
Cardiovascular Pre-Participation Screening 123
Echocardiography and Advanced Cardiac Imaging 124
Exercise Stress Testing 124
Heart Rate Monitoring and Wearable Cardiovascular Assessment 125
Educational and Practical Synthesis 129
CHAPTER III MANAGEMENT OF TENNIS INJURIES 131
Traditional Treatment Approaches in Tennis-Related Injuries 131
Acute Management: Modified PRICE and POLICE Frameworks 132
Pharmacological Interventions 133
Physical Therapy and Therapeutic Exercise 134
Modalities and Adjunctive Physical Treatments 136
Bracing, Taping, and Orthotic Support 137
Surgical Management 138
Return-to-Play Decision-Making 139
Integration and Educational Synthesis 140
Bio-Regenerative Approach 141
PRP 142
Autologous Blood Injection 143
Prolotherapy. 144
Hyaluronic Acid 144
Biologic Scaffolds and Matrix-Based Therapies 145
Percutaneous Tenotomy and Tissue Modification Techniques 145
Emerging and Investigational Approaches 146
Practical Considerations and Decision-Making 147
Cellular and Tissue Injury Mechanisms in Tennis Sport 148
Mechanotransduction: From Load to Cellular Response. 149
The Four-Phase Tissue Injury and Healing Cascade 150
Tissue-Specific Injury Mechanisms 152
Inflammation, Resolution, and the Path to Chronicity 155
Cellular Senescence and the Aging Tennis Player 146
Genetic and Epigenetic Modulation of Injury Susceptibility 156
Tennis-Specific Cellular Stress Patterns 157
CHAPTER IV REGENERATIVE MECHANISMS IN TENNIS-RELATED INJURIES 161
Cell Types Relevant to Adaptation and Recovery in Tennis-Related Injuries 162
Structural Cells of the Musculoskeletal System 163
Progenitor SC Populations 169
Mesenchymal SC 170
Tendon Stem/Progenitor Cells 175
Satellite Cells 176
Chondroprogenitors and Synovial Mesenchymal Cells 178
Skeletal SCs and Periosteal Progenitors 179
Vascular and Supporting Cells 181
Immune and Inflammatory Cells 185
Neural and Specialized Cells 187
Comprehensive Summary Table 189
Benefits of SCs Derived from Different Tissue Sources 193
Mitochondria and Mitochondrial Organelles in Tennis-Related Injuries: Cellular Energetics, Recovery, and Emerging Therapeutic Targets 198
Mitochondrial Structure and Function in Musculoskeletal Tissue 200
Mitochondrial Dynamics: Fission, Fusion, and Mitophagy 201
Mitochondria in Specific Tennis-Relevant Conditions—Summary Overview 202
Mitochondrial Reactive Oxygen Species and Oxidative Stress 203
Mitochondrial Function in Skeletal Muscle and Tennis Performance 204
Mitochondrial Function in Tendon, Cartilage, and Bone Healing 206
Mitochondrial Dysfunction in Aging and Injury 207
Mitochondrial Transfer and Intercellular Communication 208
Mitochondria as Therapeutic Targets 208
Nano-Organo Peptides in the Management of Tennis-Related Injuries 210
Conceptual and Historical Foundations 212
Molecular and Biological Mechanisms 213
Principal Tissue-Sourced Preparations and Their Tennis-Relevant Applications 215
Cartilage-derived peptide preparations 215
Tendon-derived peptide preparations 216
Muscle-derived peptide preparations 216
Other tissues nano-peptides 216
Integration with Other Regenerative Approaches 217
Practical and Regulatory Considerations 218
CHAPTER V PHYSIOTHERAPY 221
Hyperbaric Oxygen Therapy 222
Hyperthermia for Pain Management 225
Ozone-Oxygen Therapy 228
Transcranial Direct Current Stimulation 231
Rehabilitation in Tennis-Related Injuries: A Comprehensive Framework 235
Foundational Principles of Rehabilitation in Tennis-Related Injury 236
Phase-Based Rehabilitation Progression 239
Region-Specific Rehabilitation Considerations 244
Integration of Advanced Modalities into Rehabilitation 248
Return-to-Play Decision-Making 249
Psychological Dimensions of Rehabilitation 250
Long-Term Considerations and Prevention of Reinjury 251
BIBLIOGRAPHY 253

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