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Tennis Service Stroke Benefits Humerus Bone: Is Torsion the Cause?

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Abstract

Regular tennis play is associated with impressive asymmetries in bone strength in favor of the racquet arm, particularly in the humerus. However, the relative effects of service and ground strokes are not known. Serendipitously, we encountered a 46-year-old regular tennis player who has played service and ground strokes with different arms for over 30 years, and thus allowed differentiation of stroke effects. Grip strength and peripheral quantitative computed tomography scans of both arms of radius at 4 % distal–proximal ulna length, radius and ulna at 60 % distal–proximal ulna length, and at distal (35 % length) humerus were analyzed in this player, and 12 male veteran players of similar age, height, and mass who played a conventional single-sided style. Confidence intervals (95 %) were calculated for asymmetries and bone, muscle and force parameters in the control players—values in the case study player were compared to these intervals. Sizeable differences in bone strength in favor of the serving arm humerus were observed in this player—comparable to those found in the control players. While asymmetries in favor of the ground stroke arm ulna were also evident, no sizeable asymmetry was found in proximal or distal radius, forearm or upper arm muscle size or hand grip force. These results suggest that the service stroke is responsible for the humeral hypertrophy observed in tennis players, and that ulna adaptation may be attributable to the ground strokes. The osteogenic potential of the service stroke may be related to the large torsional stresses it produces.

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Acknowledgments

The authors would like to thank the participants (in particular VTP) for their selfless contribution, without which this study would not have been possible.

Conflict of Interest

Alex Ireland, Hans Degens, Nicola Maffulli, and Jörn Rittweger declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

The study conformed to the Declaration of Helsinki guidelines and was approved by Manchester Metropolitan University’s Ethics Committee before the start of the study. Written informed written consent was obtained from all participants prior to testing.

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Authors and Affiliations

  1. School of Healthcare Science, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester, M1 5GD, UK

    Alex Ireland & Hans Degens

  2. Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Salerno, Italy

    Nicola Maffulli

  3. Institute of Aerospace Medicine, German Aerospace Centre, Linder Höhe, 51147, Cologne, Germany

    Jörn Rittweger

Authors
  1. Alex Ireland
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  2. Hans Degens
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  3. Nicola Maffulli
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  4. Jörn Rittweger
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Correspondence to Alex Ireland.

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Ireland, A., Degens, H., Maffulli, N. et al. Tennis Service Stroke Benefits Humerus Bone: Is Torsion the Cause?. Calcif Tissue Int 97, 193–198 (2015). https://doi.org/10.1007/s00223-015-9995-3

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  • DOI: https://doi.org/10.1007/s00223-015-9995-3

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