Let's do great things for men’s tennis, together!

How to Prevent Re-injuries
Body Helix
March 24, 2022
* This article was originally posted on the Body Helix Blog

NO MORE SUBSTANDARD GEAR

While watching the BNP Paribas Open at Indian Wells this past week, the all too familiar scene on the tennis tour was injuries. The sport of tennis requires all-direction extreme lunging and movements. It requires incredible endurance. Injuries are inevitable in this physical sport, especially at the highest, most grueling levels. Injuries can short-circuit careers. Big names like Barty, Collins, Federer, Nishikori, Tsona, and Thiem are all recovering from injuries and unable to play.

I watched while trainers wrapped Simona Halep’s thigh with that antiquated elastic bandage during her semifinal match. My regular readers know how utterly infuriating this is for me – knowing there are superior materials and technology available. ATP, WTA, and USTA – please stop treating high level players like commodities. It’s incredibly disturbing that my sport continues to use inferior gear. Team Body Helix created the world’s finest compression products so we could end substandard treatment. Yet, year after frustrating year, I continue to witness apathetic tennis organizations and sponsors refusing to provide the best gear for their revenue-generating players.

It’s too bad that our high-level athletes are missing out. The good news is that my injured tennis buddies and our Body Helix customers are wearing superior compression. In fact, their gear is better than that of the highest-paid tennis players in the world. And it’s great for you, too.

INJURY REHAB CHECKLIST
I’ve put together a checklist to consider if you are plagued by injuries—or an injury prevention regime:

• Increase consistent recuperative sleep time. Shoot for bedtime of 9:00-10:00 pm.

• Avoid diuretics. They can inhibit proper hydration efforts. Dehydration pulls fluid out of your tissues, which causes overall body aches and pains.

• Hydrate before, during and after your training. Be steady with hydration.

• Wear the highest medical-grade compression in the world.

• Variety rules when it comes to training. Try varied types of exercises to balance your body.

• Do dynamic warmups prior to your workout and ensure proper cool downs after.

If you do experience an injury, immediately shut down the stress to the affected area to eliminate further or more severe injury. The first stage of recovery is all about minimizing additional damage and letting the body begin the healing process. The body’s first reaction to injury is inflammation and pain. The better you can regulate inflammation, control pain, and protect the injured body part to avoid any further damage, the easier the recovery process.

Find a physical therapist and let them show you how to rehab correctly. I advise that you rethink the plan of “just let it get better on its own.” The risk of an injury healing improperly may cause the body to adapt to function around the pain instead of healing and returning to normal functioning. Stretching too far or starting activity too early can slow or even reverse the healing process.

Without proper rehab and strengthening, the probability of injury recurrence is high. Just because the pain may have stopped, doesn’t mean the injury is fully healed. Ultimately, the injured area will need to be conditioned for the rigors of your specific activity or sport and in all planes of motion. Minimizing muscle loss and strength deficits are also important rehabilitation goals. Injury rehabilitation includes restoring coordination and balance, improving speed, agility, and sport-specific skills progressing from simple to complex.

LISTEN TO YOUR BODY

The adult human body has more than 600 muscles and more than 200 bones. Whether we’d like to admit it or not, most of us are bound to experience an injury at some point in our lives. Think this through. Was your injury area weak before the acute injury? Do you have enough flexibility? Do you listen to the warning signs like tightness, aching, etc.? Even experienced athletes may not understand or recognize the messages their body is sending.

Aiming for a quick fix to just move on and get back to your routine is not listening to your body. That’s silencing a symptom just for the time being. Your body is performing trillions of tasks a minute, just to keep you alive and thriving. It’s a brilliant machine that wants to work for you! And it’s constantly giving you new information on how to care for it to obtain optimal results.

The human race is the only species that exerts energy when it doesn’t need to. Humans are also the only species that deprives itself of sleep on purpose. Competitive sport comes with pain, stress and pushing your mind and body to the limit. We need to stop and question ourselves. Are we training smart or just training hard? When your body is feeling something, anything, you should consider that a signal for something. So often we feel aches, pains, stiffness, or soreness and think it’s totally arbitrary.

Be curious and trust your instincts instead of trying to shut them up.

Take steps now to improve your body. Prioritize self-care and you’ll show up better and brighter to every other part of your life —guaranteed. And whatever you do, don’t settle for inferior products like those forced upon Simona Halep. Put a far superior product like a Thigh Helix on it and get better. Simona, if you read this, contact me. It is a privilege for team Body Helix to help all athletes move through it.

The 3 Most Common Types of Knee Injuries
Body Helix
June 2022
* This article was originally posted on the Body Helix Blog

The 3 most common types of knee injuries. Do you know when to use a knee compression sleeve?

Did you know that the knee is the body’s largest joint? And it’s one of the strongest. Because the knee’s structure is complex, the joint is susceptible to many types of injuries – especially for athletes. The knee comprises an intricate network of muscles, tendons, bones, ligaments, cartilage, and fluid.

Knee injury accounts for 41% of all sports injuries. Certain sports have an increased risk of knee joint injury because of the movements inherent to the sport. Sudden stops, twists and turns or the pressure put on the knee joint while running can cause knee pain or injury. And unlike hip damage, which tends to become more common as we get older, knee injuries do not discriminate based on age.

When we approach knee injuries (not arthritis or inflammation), it is helpful to consider the acuteness of the injury. In this blog, we’ll review knee injuries through the lens of Acute, Subacute, and Chronic pain.

ACUTE INJURIES

Injuries are in the “Acute” phase immediately following the injury within the first few days. Acute injuries can benefit from Rest, Ice, Compression, and Elevation (RICE method). A ligament tear during this phase might be managed with a functional brace until surgery can be arranged.

Post-operatively, a knee compression sleeve might be advised to help reduce swelling and increase proprioception, which is the sensory information that contributes to the sense of position of self and movement. A decrease in pain is often a benefit of these features.

An injury may result in knee damage but may not cause a ruptured ligament. This type of injury is among the most common injuries seen in athletes. It is related to the incredible forces placed on the knee either because of explosive or repetitive movements. The damage can occur to the knee meniscus as well as incomplete rupture of the ligaments, tendons and supporting structure of the knee.

In these injuries, the Acute phase management is the same: recommended treatment of RICE. For the compression component of this treatment, it is essential to note that there are many options for compression sleeves available on the market today. While they may all look similar, be assured they are not all created equal. When selecting compression, be sure to use comfort as a primary requirement. After all, if it is uncomfortable, you will not wear it.

Body Helix compression knee sleeves are designed for optimal comfort and can be worn during the Acute phase to aid in injury management. For this indication, check out our positive reviews by physicians, advisers, and customers alike.

SUBACUTE INJURIES

Injuries are considered “Subacute” during the initial healing phase and generally considered to be about six weeks. However, healing continues even after the six-week period, and the healing will be more prolonged with a more severe injury. Unloader and functional braces are less beneficial than comfortable compression during this healing phase. A study shows that using a compression sleeve like Body Helix work just as well as a functional brace after surgical repair of an ACL (anterior cruciate ligament) rupture.

A knee compression sleeve is advised during the subacute rehabilitation phase because it controls swelling, supports all knee structures, and increases proprioception. These benefits are present for minor and major injuries, as well as during post-op recovery.

Additional rehabilitation options include weight reduction, stretching, and strength and balance training. Body Helix compression wraps can be worn comfortably while all range of motion activities are pursued.

CHRONIC INJURIES AND INJURY PREVENTION

Braces for injury management during sports are not very common if the injury is severe enough to require an uncomfortable, activity-restricting device. In addition, using braces for injury prevention is an active research area. College and professional American football players have worn braces for prevention of injury to the MCL (medial collateral ligament). To date, studies have shown no benefit, but studies are ongoing.

Knee compression sleeves have shown positive benefits for re-injury prevention, pain reduction and improved proprioception. Comfort, along with no migration and no impairment of normal motion, are desirable features of a compression sleeve. Body Helix knee sleeves are designed with these goals in mind.

A compression sleeve can provide comfortable support, improve blood flow to muscles, and limit swelling around an injured joint. However, the best compression product should not restrict movement in any way. Remember, not all compression is created equal. Body Helix compression products have incredible stretch and elasticity. Our sleeves will stretch more than the human body. This means you won’t alter your mechanics of motion during activity.

Our form-fit technology allows for uniform medical grade compression (20-30 mm Hg) and ensures the product stays in place. And our products can be machine washed and dried. We have six different types of knee sleeves available for your specific need. Click here to learn about which knee sleeve is right for you.

Lifetime Sports Are Precious
Fred Robinson | fred.robinson@icloud.com
August 2021
* This article was originally posted on the Body Helix Blog

Choose wisely

Tennis, Swimming, Climbing, Cycling, Pickleball, Cross-fit, Weightlifting, Volleyball, Soccer, Rowing, Basketball, Skiing, Kayaking, Golf, Badminton, Running, Squash, and Gymnastics – just to name a few. Several sources on Google say the list of different kinds of sports tops out at about 8,000 worldwide. We have so many opportunities to find a sport we can enjoy for a lifetime – and the health benefits that come with it. 

Some sports are expensive, and some sports are practically free. There are high injury-risk sports, and sports as safe as walking to your mailbox. Some love competition, and for others competing is frustrating. There are those of us who participate and those who spectate. 

Maybe you need some motivation or maybe you just haven’t found the sport to match your needs. You may have to try out a few different activities. Determine if you’d like to be part of a team or not. Decide if you’d like to invest in equipment or not. There are even quizzes online to help you choose a sport that is most suited to you. Your sport should feel like play, not work. 

Activity benefits

In America, we are inundated with sports. Sports are part of the fabric of our culture. America’s emotional connection to big-money athletics is real – if not a little puzzling. For now, let’s agree that spectating is okay as long as there are active lifestyle choices that accompany it.

There are many benefits to being active. Physical activity through sports can protect against many chronic diseases and can improve your memory and brain function (all ages). Being physically active can improve your quality of sleep and combat fatigue. Being consistently active aids in weight management.  

Sports can have emotional benefits as well as obvious physical fitness advantages. Humans like to belong to a group – a team. Being connected to others who are also drawn to your sport brings valuable rewards like improving self-esteem, building relationships, and developing critical thinking. A sport or activity can cultivate perseverance and the self-satisfaction that “hard work pays off”. Other intangibles associated with sports are collaboration, controlling emotions, and learning to accept defeat (character building). There will never be a shortage of work or stress we put ourselves through. Allowing even a small amount of time for recreation will pay huge dividends over our lifetime. Sports can improve our quality of life. It doesn’t get more compelling than that!  

If you have a sport already, think about trying a new one. If you play tennis, think about biking. If you weightlift, add yoga. If you are sedentary, start somewhere. Move. There is a lot more to life than connecting to a monitor screen and letting your life and health drift off into oblivion.  

Bodies break down more frequently from lack of use rather than overuse. Pick a lifetime sport with a rather low-risk injury potential. This gives you the best shot at living a longer, more active, and more healthy life. But wait there’s more. The chances that your family members and friends will also live longer, and healthier lives just increased right along with yours. Don’t underestimate your influence and how that influence can be parlayed into lifestyle improvements for others around you. 

Many of us who played sports in high school or college remember those glory days. However, some sports are not conducive to being ‘lifetime’ sports. In fact, after school days, many athletes stopped playing and stopped being active. When the sport disappeared, the waistline did too! Simple solution: Go find a new lifetime sport and learn how to play. Former athletes may already be a step ahead in learning skills and using their bodies. Translate that dexterity to a new activity that will work for you in the decades to come. Bring your buddies along with you and make new friends, too. Give it a try!

Imagine

I’m using my blogger’s license to paraphrase John Lennon’s “Imagine.” Imagine for a moment how things might be different if more folks were engaged in regular physical activity. Imagine what the nationwide impact would be on healthcare costs (medical and mental health costs). Imagine how much of the social-media-time-suck could be avoided. Imagine the impact of setting an example of optimal health for our kids. Imagine the impact of true camaraderie of a group of friends who enjoy your sport. Imagine the positivity that comes with the endorphins created through exercise. Imagine more fun in our world. “You may say I’m a dreamer, but I’m not the only one. I hope someday you’ll join us…” I know this may sound goofy, but for me, this concept is one of the sanest thoughts we could ever have. 

Culture shock

Regrettably, our culture is steeped in unhealthy choices. Look at our grocery stores and advertising. Look at how many billions of dollars flow into junk food companies, tobacco, alcohol, antibiotic and hormone-treated livestock, genetically modified foods – not to mention the immeasurably lucrative pharmaceutical industry needed to treat the diseases that these unhealthy things cause. 

Other unhealthy choices are inactivity, excessive screen time and skimping on sleep. All these are stressors. Add those to work stresses, financial issues, children or elder care and this pandemic. It is a bit overwhelming. The best first thing you can do is take a step toward being an active individual. Your future self will thank you. 

Coach’s challenge 

If you feel like you are sliding in the wrong direction or are already there, make the commitment to get more active. Put up a badminton net in your yard. Get a lawn croquet set. Play kickball with the neighborhood kids. There’s a good chance will you laugh a lot, sweat a lot, and relieve a lot of stress.  

If you are able to be active at any level or any age, do it. It is a wise choice. This gift is precious. Treasure it. If you are unable to be active, then choose other activities that stimulate you like playing chess, crafting, writing, sewing, playing an instrument, or gardening. Become a mentor or a tutor. Each of us can find worthy endeavors. Give yourself permission to be healthy and happy. There are opportunities all around us. Choose to Move Through It.

It is my greatest hope that you will implement some tips from our Bio-Cultivating and Neural-Cultivating blogs. Further, it is my hope you will be inspired to pass these learnings along to family and friends. We all have people in our lives who have the desire but lack the accurate information to improve their health. It is frustrating to sift through the bombardment of data and the misinformation in today’s world. It’s no wonder some give up in frustration. I believe that we deserve the healthiest choices that honest modern science can offer. It is my mission to help as many of us as possible get and stay healthy.

For those interested in learning more go to amyloidosis.org where a thorough discussion of the illness and treatment is provided.

Improve your tennis game with tips from Team USA
USTA
August 2021
* This article was originally published on USTA.com on July 27, 2021

You've watched them play on the biggest stages in tennis, and now they're here to help you.

 We asked six esteemed members of Team USA - Dana Mathewson, Nicole Melichar, Tommy Paul, Jessica Pegula, Tennys Sandgren and Conner Stroud - who'll represent the United States at the Tokyo Olympics and Paralympics this summer, for some of their best tennis tips. 

 Hear from our stars on how they get mentally prepared on match day, their best tip for your tennis game, and what it means to them to represent the red, white and blue on the international stage.

How do you mentally prepare for a match?

Dana Mathewson: I try to visualize how I want to play. That’s something I’ve been working on a lot recently, as well as backing myself and feeling confident in my skills leading up to a match. In the past, I’d give the opponent too much credit and think of what things they did well, and completely forget my own strengths. Now, I try to think of whatever I can to make myself feel the most confident in that moment. 

Nicole Melichar:  I do like to watch my opponents play, just so I have an idea of what their tendencies are. I like to imagine myself in those situations, sort of like visualization, just to see what I would like to do, and avoid, and certain tactics I would like to apply. 

Tommy Paul: Usually, I just get a game plan and visualize that game plan in my head and talk to my coach.

Jessica Pegula: Mentally, I usually prepare by taking time for myself, going through my preparation, my warm-up, making my drinks or prepping my racquets and stuff like that. I try to take that time to mentally prepare and maybe listen to some music. 

Tennys Sandgren: I listen to the loudest music I can and try to amp myself up. 

Conner Stroud: The first thing I do to mentally prepare for a match is rest really well the night before and wake up early the following day to do my pre-match practices and rituals. I also like to have a game plan or pointers written down for myself so that, prior to my match, I can reinforce it in my mind. I will also stretch and push around the court in order to relax. These steps seem to be the most effective for me when I prepare for a match. 

If you could give adult and junior players one tip to improving their game, what would it be?

Dana Mathewson: I think I’d tell them to just do the repetitions. I know that drills can be repetitive and boring, but the more you train a specific shot, the more you’ll be able to rely on it in tense situations. It may not seem fun to hit a thousand cross-court forehands, but when you’re in a big match and it comes time to hit that shot, you’ll be happy it comes second-nature to you because of all your hard work!

Nicole Melichar: Coming from a doubles player, I would say to be fearless of the net. Always want the ball and go after it... If they pass you, it’s okay, but just always want the ball because I think that’s the best way to improve as a doubles player.  

Tommy Paul: Get your serve as good as you can, because that’s pretty much the most important shot in tennis. 

Jessica Pegula: Play a lot, compete a lot and learn how to win matches even if you don’t think you’re good enough to. I think it’s really important to go out there, challenge yourself, stick to that and always keep working on things, little things, every single day. Also: think long term, and not get so upset about how one match or one event went.  

Tennys Sandgren: Move your feet, move your feet. If you think you’re moving your feet enough, you probably aren’t, you should probably move your feet a little bit more.  

Conner Stroud: A tip that has helped me most is to focus on the ball during your entire stroke. Sometimes, a few mishits and or shanks will occur and my coach asks me if I am watching the ball intently as it hits my strings. Most of the time, when this mistake happens, I realize that I was not focusing on the ball, and my hits will improve. In essence, if you feel as though you are not hitting the ball cleanly, remind yourself to focus on the ball as it makes contact with your strings.  

What does it mean to you to play on a team, especially for Team USA?

Dana Mathewson: Playing for your country is a huge honor, and it’s something that I love to do. I always play a little bit harder when I have those letters on my back, because I know I’m representing something greater than just myself. I’ve always loved team sports, so being able to be part of Team USA is amazing and I’m so excited to do it again in Tokyo this summer.  

Nicole Melichar: It means the world to me. I love team sports. I think maybe that’s why I play doubles mainly. I think Team USA is such an unbelievable country with so much history in sport, and obviously, we are a country with thousands of amazing athletes. Just to be with this awesome group of girls and our captain Kathy Rinaldi, who I’ve known since I was a little kid, is just so amazing. 

Tommy Paul: I love the team environment, it’s always something I love playing in front of… in front of people, or playing for people.. Not to mention playing for USA it’s probably the coolest thing, that’s something I’ve definitely always wanted to do so I’m really excited to do it.

Jessica Pegula: It means a lot. It’s pretty crazy that we get to represent our country. It’s something that doesn’t happen often in tennis, too, because we are always playing individually so it’s really fun to be on that team atmosphere and to go represent together. It’s just a really amazing experience. 

Tennys Sandgren: To be on a team is fantastic. After playing college tennis, I’ve missed being on a team, so I’m excited to do it again. To play for Team USA, that’s a massive honor - a massive, massive honor. 

Conner Stroud: Playing on any team, but specifically for my country’s team, is very special and important to me. When I have USA written on the back of my shirt, I make it a point to play my best on the court so as to positively represent my country. Playing on a team with teammates is also amazing, as tennis can be a rather individual sport. I enjoy the element of team spirit that this team offers me, and I especially enjoy coming together to cheer each other on. 

Experimenting During the Pandemic and Discovering How to Fuel
Keith Richardson
krichardson19@gmail.com
May 2021

When tournaments were cancelled in March 2020, I thought it would be a good time to re-evaluate all aspects of my game and make any needed changes to become a better player once the tournaments came back on the calendar. I left no stone unturned.

Started with the grips. Went full circle and tried to move toward more of Western grip on the forehand. Had visions of a Tiafoe topspin, buzz-saw weapon. Worked great in practice and drills when I knew it was coming to that side, but I floundered when I played a real match. Slid back to my trusty Continental that I’ve hit for more than 60 years and decided I was too old to change. Changed my left foot on my serve, my toss, and concentrated more on placement rather than chasing power. Still need more repetition for confidence, but I would put these changes in the plus column, and hopefully they’ll be there in a real match situation.

Socks, clothes, shoes, hats, headbands, sunglasses, strings, racquets, and string tension. On the apparel, I was searching for comfort and confidence and tested several brands. Compression or no compression on the socks? Low cut or regular? Settled on regular with compression. Happy. Collared shirts, Henleys, or T-shirt style? All white or colors? I settled on collared and T-shirt style, and leaning toward going back to all white for old time’s sake. Came back to Diadora’s clay model on the shoes, which makes me happy since Borg used to wear them. My thinking on all this was that if I was comfortable, I would not be distracted and could divert what little mental energy I possess to the “Big C”: CONCENTRATION.

On the headgear, I settled on my trusty Body Helix and NSMTA hat since I’m not cool enough to pull off a headband: will try that again once I get my ponytail. Sunglasses were also a keeper, as my fellow player and ophthalmologist friend Phil Rebolt convinced me it was a pretty good idea.

Racquet change back to Yonex after a 44-year separation was a positive checkmark, as well as testing the rainbow of polyester strings and landing at 40 lbs. for the tension. Really? Only 40 lbs.? Yep, love it. Thank goodness I still had my Ektelon stringer!

Fueling. Yes, Fueling! Of all my experimentation, this has been the biggest game changer for me, and now is as important to my game as my racquet, strings, or shoes. I thank my friend Fred Robinson for educating me on on-court fueling and hydration when I bonked against him at the 2019 ASI in humid Atlanta, Ga. He convinced me to try electrolyte tablets, vs. water on the courts, and pre-match food choices the night before and the morning of my next match.

I took his advice. I began checking out bike and running stores and discovered Fizz Electrolyte tablets, manufactured by Hammer Nutrition located in Whitefish, Mont. This was a good sign. I love Montana and the fly fishing it affords, plus I’ve been to Whitefish on family vacations and cross country skiing with my brother as well.

As cool as Montana and Whitefish are, I knew this company had to be a winner! I was not disappointed. I began comparing their protein, energy, and recovery products with others that I had been testing and made the switch to Hammer. Best move of all time. Their products are top drawer, but where they really shine is their ​proven fueling process, and their in-house experts are ready to educate and help you fuel to be your best. It doesn’t hurt either that Hammer’s President and Founder, Brian Frank, is a tennis player who grew up in the same club as Michael Chang and Brad Gilbert! Their Customer Service is unbelievable! Hammer specializes in fueling the endurance athlete, from ultra-marathoners to mountain and road bike crazies.

My kind of people! However, I believe tennis players are endurance athletes, and we need advice and guidance on how to prevent cramps, have plenty of gas in the tank on the court, and then be able to recover after a humid three-setter to play again the next day. Brian is in agreement, and has pinpointed Hammer Products specifically for us tennis players to “fuel right, feel great.”

With Hammer’s guidance and their “5 Secrets of Success” booklet, I have now changed my pre-match fueling, my on-court hydration, and most importantly, my recovery after a long match. I’m lighter and more focused on the court, and I’m not worried about running out of gas.

Once the match is over, I begin recovering for the next match and wake up the next day with very little soreness, and I’m ready to rumble! Or, as Hammer says, I’m ready to “Keep on Hammering!”

Calories—and the Right Type of Calories—Count!
Steve Born
sborn@hammernutrition.com
April 2021
* The views expressed in this article do not necessarily reflect the position of the NSMTA

Proper calorie intake involves two primary things:
1)    What fuels or foods you supply your body
2)    How much you supply your body

Both are equally important, so let’s focus closely on each.

Too many athletes fuel their body under the premise that “I’m burning so many calories that I can eat whatever I want. Calories are calories, right?” The answer, of course, is “NO.” The quality of what you put in your body determines what kind of energy you can expect the body to provide you in return.

Fuels comprised of simple sugars (anything that ends in “ose”—glucose, sucrose, fructose, etc.) won’t do the job for two reasons:

1)    When consumed in proper amounts (i.e. the very limited amount your body can comfortably digest), they simply cannot supply sufficient amounts of calories for energy production. However, you can’t consume more of these sugar-loaded fuels, or make a more-concentrated sugary drink, in those hopes of meeting your calorie needs, because they won’t digest with any efficiency, causing any number of performance-ruining digestive issues.

2)    When these sugar-laden fuels eventually digest, the energy they supply is very short-lived, a “flash and crash,” “peak and valley” type of energy. Feeling great for a short period of time, then digging yourself out of an energy rut for a much longer period, is no fun at all, and certainly no way to experience high-quality training sessions or to perform your best in your tennis matches. 

Hammer Nutrition fuels are comprised of maltodextrin, a starch-like complex carbohydrate. Maltodextrin is clearly a better fuel option than simple sugars for two key reasons:

 1)    Your body can easily digest—with no delay from entry to exit of the GI tract—a greater volume of calories from complex carbs (maltodextrin) than it can from simple sugars. This allows your body to receive maximal amounts of calories for energy production, while eliminating the stomach distress issues so common with simple sugars. One nutritional expert states, “The gold-standard carbohydrate source originates from longer-chain carbohydrates (maltodextrin) because more caloric volume crosses the gastric lining with less distress to the competing athlete.” Or, as another nutritional scientist states, “maltodextrin allows one to swallow more energy in less volume.”

2)    Because maltodextrin is hundreds and hundreds of saccharide molecules weakly linked together—not just one or two molecules like all of the “ose” sugars—it supplies a longer-lasting, more evenly-supplied energy. And when that energy eventually starts declining, it’s much more gradual, not the dramatic plummet that is typical with simple sugars.

Now that you know to avoid simple sugars and use complex carbohydrates to fuel your body, the question is, “How much?” The answer is: “The fewest calories necessary to keep your body doing what you want it to do hour after hour.” For most people, this translates into a total of 120-180 calories per hour. Sometimes you won’t need 120 calories an hour, and larger athletes (190+ pounds) may, on occasion, find that they can comfortably take in a few more.

Always remember that the goal of calorie intake is not to try to match what you lose (calories burned) with equal or near-equal amounts of calories from your fuel. Though you may be burning several hundred calories an hour, your body is simply not equipped to replace those calories in equal or anywhere-near-equal amounts. We want to supply our body with enough calories to maintain consistent energy production, while remembering that the vast amounts of calories from body fat stores will naturally help “bridge the gap” between what we’re losing and what our bodies can comfortably accept in return. In fact, during bouts of exercise lasting 90 minutes or longer, nearly two-thirds of your energy needs will be fulfilled from body fat stores.

BOTTOM LINE: Give your body a “helping hand” when it comes to calories—120 to 180 is usually the amount most of us need on an hourly basis—then let your body do what it’s designed to do, using the calories from fatty acids to help fill in the gap.

“Fueling lean,” as we at Hammer Nutrition like to put it, makes so much more sense because you’re working in cooperation with your body, not against it. And if, by chance, you do find that a few more calories are needed, that’s an easy problem to fix: you simply consume a few more… problem solved! It’s a much easier problem to resolve than an “Uh oh. I overdid it on the calories and now my stomach is starting to rebel” problem, assuming that the problem can be fixed at all.

Since the beginning, we’ve always recommended complex carbs over simple sugars. Your body craves the former, and will reward you with the high-quality energy you’re looking for. Conversely, your body won’t perform well at all with the latter. “Avoid the ose’s!”

Also, our banner has always read, “Replenish, Don’t Replace,” and when it comes to calorie intake, we’re certain that once you get away from the 500-700 calories per hour regimen that, sadly, so many so-called experts still incorrectly recommend—and follow our “body cooperative” amounts—your body will perform much better, you’ll feel better, and you’ll get the results you trained for.

Click here to go to Hammer Nutrition’s website

What’s on Your Plate?
Boost Your Performance: Plant-Based Diet and the Tennis Player
Myke Landauer
mykeloomis@gmail.com
December 2020

Plant-based diets for athletes have grown in popularity in recent years, as several elite athletes, such as U.S. women’s soccer star Alex Morgan, NBA All-Star Kyrie Irving, and world-record marathon runner Fiona Oakes, have adopted a plant-based lifestyle. The most notable vegans in the tennis world are superbly fit Novak Djokovic and Serena and Venus Williams.

But what about the average weekend warrior or competitive senior tennis player, like ourselves? We need to take back control of our health by fueling our bodies only with healthful food.  

A diet primarily made up of plants is shown to reduce the risk of ischemic heart disease, type 2 diabetes, hypertension, certain types of cancer, and obesity.

I was certainly ready to reduce all these risks, but for me the biggest barrier was lack of information on how to approach it and not be overwhelmed by such a daunting task. I decided to approach it as if I were training for a big tournament, and as if my life depended on the results.

So, last July I fully committed to going plant-based. I talked to doctors who supported this lifestyle, I learned how to prepare EASY and great-tasting meals for myself and my picky-eating husband Phil Landauer, and I cleaned out my kitchen and started over with healthier food choices. 

I also watched the Netflix documentary “Game Changers,” which shows how elite, plant-based athletes are able to perform at their highest levels by increasing their strength, speed, fitness, and stamina after adopting this new lifestyle. During this six-month period, my usual joint and muscle pains were reduced, my gut health greatly improved, and my energy level was much higher. I also lost 27 pounds strictly by changing my way of eating without increasing my exercise.

Lifestyle changes can be difficult to make without a plan. It’s best to be well-informed and guided by the experts to help you navigate your way to a healthier life both on and off the court. Brent Abel and I have put together a live Zoom webinar Immersion for boosting your tennis performance with a plant-based diet. ​

* * * * * * * * * *

On December 12, from 10 a.m. to 1 p.m. EST, Dr. Jim Loomis, medical director of the Barnard Medical Center and a leading voice in plant-based nutrition, will answer frequently asked questions about your diet and nutrition habits. He will also give you all the medical information you need to understand how quickly your body will react to making subtle changes in the way you eat.

Caryn Dugan, a.k.a. the STL Veg Girl, will provide easy recipes and cooking demos to get you started on a healthier lifestyle. She will give you ideas for great snacks for pre- and post-match eating. Caryn is the founder of the Center for Plant Based Living in St. Louis, Mo.

Brent has included sign-up incentives as well:

– A free tennis instructional course valued at $197 from Brent Abel
– A free instructional interview ($97 value) from both Brent Abel and Myke Loomis-Landauer

CLICK HERE to sign up for this special event on December 12.
NSMTA members will receive a 25% discount for signing up for this informative immersion, which drops the price from $39.99 to only $29.99
Please enter the promo code: NSMTA25 when registering.

Make the decision today to commit to a healthier lifestyle.

What’s on your plate?

See you at the courts!
Myke Landauer

The Connection between Ball Flight Recognition, Anticipation, and Coordination in Tennis
Paul Fein
PFein@nsmta.net
November 2020

“One of the secrets of successful match play is, to my mind, the power of anticipation.” − Suzanne Lenglen, 1920s superstar, in the book, How To Learn Lawn Tennis

Hand-eye coordination has always been a keystone of athleticism in moving-ball and moving- athlete sports, especially tennis. In his 1981 book, Off The Court, Arthur Ashe intriguingly asserted, “Foot-and-eye coordination is more important in tennis than hand-eye coordination…. Anybody can swing a racquet. It’s the great feet that win Grand Slam titles.”

Former world No. 6 Jose Higueras, who developed the USTA Player Development teaching and coaching philosophy, explained that tennis is played in the following order: first, with the mind and eyes; second, with the feet; and last, with the hands. So before players finally hit the ball with their hands, they have to move their feet after they recognize the flight characteristics of balls and make decisions with their eyes and mind.

How do players accurately recognize balls with their eyes to make the correct split-second decisions with their mind?

Here are some suggestions.  

First, try to recognize everything you can, and as early as you can, about the flight of the oncoming ball. That recognition starts when both the ball and your opponent are in your line of vision.

Second, watch your opponent’s body. Is he off-balance? If so, is he falling backward or sideways? If he falls backward, his shot will usually lose power and fly higher than intended. Is he arriving late, barely on time, or early for the ball? Is the racket arm or arms going to arrive on time? Generally, the later the player and/or his racquet arrive, the greater the loss of power and/or control of the shot.

Third, watch his arm and wrist at the contact point. Does the racquet turn in his hand or hands at impact? A loose grip usually results in a loss of power and occasionally in a mishit shot. Is he contacting the ball out of his “strike zone” in terms of height or closeness to his body? That also can reduce the quality of his shot.

Fourth, watch the racquet face because clues abound there about the oncoming shot. Changes in the tilt of the racquet face, whether major or subtle, will change the speed, spin, and trajectory of the shot. If the racquet face tilts backward, estimate how much. That will tell you how much underspin the shot will have, all other things being equal. On sliced groundstrokes and volleys, if the racquet head is dropped—so the racquet shaft is not parallel to the ground—expect sidespin to accompany underspin. Remember, however, that a dropped racquet head can also produce topspin forehands and backhands. If the racquet face rotates forward, expect topspin. If it stays vertical throughout the hitting zone and the forward swing is relatively level, the shot will be flat.

Fifth, watch the ball intently as it leaves your opponent’s racquet. What is its general direction, approximate speed, and projected depth? How much topspin or underspin is on the ball? How will the wind affect his shot? Run only as fast as you need to run. That means you sometimes sprint, sometimes run moderately fast, and sometimes move slowly.

Sixth, focus closely on how the ball bounces. Even though you generally can predict how it will bounce, your initial judgment is occasionally a bit off. In that case, make split-second adjustments to your footwork and/or swing.

Elite players have the ability to instantaneously zero in on the most critical visual cues in a given situation to nearly always anticipate correctly and adjust their hand-eye coordination and foot-eye coordination, accordingly. This perceptual skill comes from years of rigorous training, trial and error, and experience.

Geoff Cykman’s Blueprint for Fitness
Geoff Cykman
geoffeuro@aol.com
July 2020

Several people have written to the NSMTA and inquired specifically about my fitness routine. As a relatively successful senior tennis player, now in my third year of the 65 division, I’ve amassed eight national gold balls and competed on three USTA national cup teams.

In our younger days, pure talent was almost always the determinant of tournament success. But as we age, fitness becomes more and more of a factor. Since I achieved best results late in my career, starting in the 50 division, I believe there’s a definite correlation between a high fitness level and on-court success.

I’d like to share a few of the things I do for training, as well as some of the things I do not do anymore.

First, just a brief background. When I was 35, I played a tough local singles tournament in San Francisco. I had three or four grueling matches, and ended up winning the final in three close sets, struggling mightily to barely pull it out.

I got in the car shortly after the match ended, drove the 15 minutes to my house, and discovered I was so stiff that I could hardly extricate myself from the car. In fact, I needed help from my wife. A “light” went off in my brain telling me it was time to get myself in much better physical shape. I weighed only 140 pounds at the time. I had almost no muscle mass and, as a result, very little energy reserves.

It was the summer of 1988, and Mark Grabow, the famous strength and conditioning specialist for the Golden State Warriors, was working at my tennis club, the San Francisco Tennis Club, where he was training future NBA Hall of Famer Chris Mullin. They worked most every day, and Mullin went from being a 1st-round draft pick bust to an All-Star the following year.

So I engaged Mark to design a fitness program specifically for me and the sport of tennis. I’ve basically followed most of it since then, although I have made changes in the last 10 years or so, which have been dictated chiefly by the aging process.

1. While I have done weight training consistently for the past 30-plus years, I have reduced the amount of weight and increased the repetitions.

2. I cross train, mostly road biking for pretty good distances/elevation gains, but at a pace that keeps the heart rate near more conservative target ranges. An added benefit of cycling is there is hardly any pounding, unless it’s off road.

3. I’ve focused on a more balanced, nutritious diet, cutting out most sugar and processed foods. For breakfast, I often eat vegetables such as kale, and berries and quinoa, along with organic eggs, onions, and mushrooms. For protein, I often eat canned salmon, because it’s wild, and sardines. For other meals, I just try and avoid the basic foods we’ve all been told to avoid whenever possible. I don’t go overboard in this area as food is one of life’s great pleasures. So is wine!

4. From about age 50, I starting doing yoga with an instructor who fortunately is also a pretty good tennis player and thus knows the routines that most benefit tennis players. As we age, flexibility work becomes much more important because our connective tissue (facia) loses its elasticity, which restricts movement. Our brain tells us to move, but our body involuntarily says “not so fast.” Increased flexibility will get you to the ball sooner, and will keep you more balanced when you do get there.

5. As we get older, proper rest becomes even more important. I believe taking days off from strenuous physical activity is important in order to give the body ample opportunity to recover. On these days, I try and do some light stretching. We athletes need at least 7-8 hours of sleep per night, especially when we tax our bodies more, such as in tournaments. I never take naps, although lately I’ve thought I should start doing this. When I do nod off, I often wake up very groggy, but that’s probably just me.

6. Lastly, and especially during the last few years, when playing tournaments, I try to focus on having fun—and not think about winning and losing. I firmly believe that if one can train one’s mind to accept this concept, the game itself becomes less physical and less tiring. This definitely helps to reduce the odds of getting injured. And of course, one usually plays better, thus increasing the chances of winning, which is more fun.

Along with these six to-do suggestions, here are three things I do not do anymore.

1. I no longer play singles against players who are noticeably younger and/or who hit the ball too hard and force me into awkward defensive positions. As we age, our reaction time simply slows down; and when this happens, the risk of injury goes up.

2. I do not play more than 2-3 times per week outside of tournaments, and when I do play, one workout is usually just drilling and playing doubles, which, of course, is far less strenuous than singles. Some people may wonder if you can keep your game sharp by practicing only two or three times a week. Yes, I absolutely think you can. I think you can actually be sharper because by limiting play, you keep your body and mind fresher, which helps me focus better on the court. And at this age, we mostly already know how to play, plus, long hours of repetitious practice can lead to overuse injuries.

3. With the exception of tournaments, I almost never play rigorous tennis two days in a row. This routine gives my body more time to recover.

I hope these tips help my fellow senior players. This is a game we can indeed play forever. But it is also a physically demanding game.

The more—and sooner—we take care of our bodies, the more likely we will be able to play this game for a long as we want, and are able to get the enjoyment tennis brings to us all. Tennis truly is the sport for a lifetime.

The Turville Slice Backhand
Larry Turville & MyTennisTools.com
Abstract by Paul Fein
lturville@msn.com
June 2020

Larry Turville has frequently dominated his senior and super senior divisions this century. Besides his power game, the lean 6'7" Floridian hits a mean slice backhand. In this instructive video, he reveals how he hits two kinds of slice backhands.

Larry demonstrates how to execute the classic slice backhand both down the line and cross-court. You can watch his impeccable swing and footwork in regular time and then slowed down in Instant Replay. 

Larry also shows you how to hit the side spin slice backhand and points out the differences in the swing path. This backhand, often used on approach shots, is alarmingly diabolical for his opponents because it curves away from them. To make his opponents' lives even more difficult, Larry explains his tactical one-two punch: a classical cross-court backhand followed by the coup de grace, a vicious backhand side spin drop shot down the line. Even if you reach this wicked drop shot, you'll likely need to see a chiropractor the next day.

How can such a nice guy do such terrible things to his fellow players? I don't know. But if you study this senior master, you can do it, too.

Heart Health for Tennis Players
Paul Fein
Pfein@nsmta.net
February 2020

     “The two fulcra of medicine are reason and observation. Observation is the clue to guide the physician in his thinking.” – Giorgio Baglivi

“The doctor of the future will give no medicine but will interest his patients in the care of the human frame, in diet and in the cause and prevention of disease.” – Thomas Edison

Cardiovascular diseases (CVDs) are the No. 1 cause of death worldwide, according to the World Health Organization. CVDs take the lives of 19.9 million people each year, an estimated 31% of all deaths. In the United States alone, nearly half (48%, 121.5 million in 2016) of all adults have some type of cardiovascular disease, according to the American Heart Association’s “Heart and Stroke Statistics—2019 Update,” published in the Association’s journal Circulation.

The WHO reports that these diseases are triggered chiefly by tobacco smoking, an unhealthy diet, the harmful use of alcohol, and physical inactivity.

Playing tennis provides one of the most enjoyable and successful ways to prevent cardiovascular diseases and to mitigate, or even reverse, the effects of CVDs for those already suffering from them.

I consulted Dr. Silvina Delgado, a leading cardiologist and a specialist in sports medicine in Argentina, to learn more about the benefits of tennis and how tennis players can maintain optimum heart health. Toward these ends, she has parlayed her two passions—medicine and tennis—to start the Cardio-Tenis Foundation For Life in her home city of Resistencia–Chaco. When the peripatetic Delgado isn’t educating or treating patients, she’s competing in national and international tournaments and currently ranks No. 1 in the world in ITF women’s 40 singles and doubles.

How has your being a cardiologist influenced your tennis game?Although my profession is very stressful, I really like my job. I enjoy my specialty and make a difference in the lives of my patients by imparting my knowledge. My profession influenced my game by helping me become a more thinking, rational player. It also improved my concentration and made me understand that one must be very well-trained and prepared to achieve the maximum performance.  
However, I always say that it is easier to practice medicine than to play tennis because when one studies and indicates to each case the corresponding treatment, the problem is already solved or controlled. On the other hand, when you play tennis, you never know how the match will end until the last point is played.
Tennis is a complex sport, where every day you can learn something new, where you never get bored, and where the outcome of a match depends on many factors. These factors include stroke and footwork technique, strategy and tactics, the style of opponents, the type of surface, physical preparation, the psychological part, and the climate.

How has your being an elite tennis player benefited your cardiac patients?
I believe that being an elite tennis player has benefited my patients because I’m able to motivate them to exercise regularly. They know that beyond their work and family responsibilities, they can with perseverance become more physically active. Many times my patients and friends have told me that I am an inspiration for them, because of my successful sports career, for the energy I transmit when I play, and for the way I speak in seminars, in my office, and to the media.
Most importantly, I instruct patients to play the sport they like and discontinue their sedentary life. Once they understand the health benefits of physical activity, they’ll become healthier and happier.

What is the purpose of your Cardio-Tenis Foundation For Life in Argentina? I have two main objectives. The first objective is to implement cardio-tenis as a new fun way to do physical activity for health. Specifically, we strive to correct cardiovascular risk factors and to do cardiac rehabilitation.
The second objective is to raise awareness among the population of the importance of cardio-protected spaces as well as cardio-protected events.

What are cardio-protected spaces and cardio-protected events?They are cardio-protected events that you organize. Some examples are cardio-protected marathons, matches or tournaments of different cardio-protected sports, congresses, and cardio-protected days.

What has your Cardio-Tenis Foundation accomplished?We’ve achieved several very important things to improve the health of South Americans. Now our entire country knows about cardio-tenis, and it’s also popular in the neighboring countries of Paraguay, Peru, Chile, Brazil, Bolivia, and Uruguay.
We are promoting two bills in our Argentina legislature to require cardio-protected spaces, cardio-protected events, training in cardiopulmonary resuscitation, and the use of automated external defibrillators.
We have given seminars to demonstrate cardio-tenis and multiple talks to publicize our objectives and educate Argentines.
Finally, we created the first cardio-protected city, Gancedo, which is located in the province of Chaco and famous for having one of the largest meteorites in the world. In addition, wherever we have cardio-tenis, we will perform an evaluation of athletes and conduct various programs such as Tennis Xpress, to motivate people to know and enjoy this exciting sport. In these cardio-protected places, we will show the importance of it by doing training in CPR, in the uses of AED, and in cardiovascular rehabilitation.

What is the Tennis Xpress program, and how does it help the Argentine people? It is a sports initiation program for adults who want to learn to play tennis quickly, where they teach the concepts, rules and basic strokes of tennis allowing students to play singles and doubles matches between friends or acquaintances in a short time. There are few sessions, usually six, once a week. During the week following the instruction session, players practice what they have learned.

The Copenhagen City Heart Study, which used 20,000 healthy people and was published in 2018 by Peter Schnohr and colleagues, showed that playing tennis, compared to a sedentary lifestyle, extended one’s life expectancy by an average of 9.7 years. Even though correlation does not prove causation, why does playing tennis appear to be so beneficial and important for a healthy heart and life? It has been clearly demonstrated that people who are physically active have at least a 30% lower risk of death during follow-up care compared to inactive people. Obviously, playing tennis is much more than leading an active life; it is an exciting sport. Tennis not only is fun, but it also brings many physiological, physical, and psychological benefits. Furthermore, tennis can be played throughout one’s life, with different objectives: recreational, social, or competitive. So we can understand why more and more people want to enjoy it. Referring specifically to cardiovascular health, I would like to emphasize that tennis can become a way out of a sedentary lifestyle, a way to make physical activity a new habit in life, and a way to reduce blood pressure, control blood sugar (pre-diabetes or diabetes), cholesterol (dyslipidemia), and other important indicators of heart health. In my case, tennis is my passion and my way of coping with the worst moments of my life. It also opened many social and professional doors for me.

At what age should recreational players and tournament players,—who deal with much greater physical strain and mental stress, see a cardiologist for the first time? You must consult a cardiologist when you notice something is wrong, whatever your age is. So it is very important to pay attention to certain warning signs, such as chest pain at rest or during exercise, palpitations, and headaches, which are associated with high blood pressure.
Generally, in the asymptomatic population, when you are 35 to 40 years old, you should have a cardiological examination because you may have cardiovascular risk factors, such as high cholesterol, diabetes, hypertension, smoking, genetic inheritance, stress, obesity, and sedentary lifestyle. These risk factors are associated with a higher probability of cardiovascular events. The most known cardiovascular events are angina pectoris, acute myocardial infarction, sudden death, and cerebrovascular accidents.
Every day we hear or read about someone with high blood pressure, high cholesterol, or a cerebrovascular accident who died of a heart attack at work or home or a while playing a sport.
I would like to stress that, as the World Health Organization reported, the main cause of death in the world is cardiovascular diseases. So prevention is always better than cure.

How often should recreational players and tournament players subsequently see a cardiologist?      There is no established frequency of cardiological examinations. Each case is evaluated on its merits, and the patient is followed up accordingly. But it is imperative that patients respect the instructions they receive during the medical consultation and the follow-up guidelines given in each cardiological consultation.

In 1996, the British Lawn Tennis Association became the first elite sporting organization in the UK to adopt cardiovascular screening of all their national junior athletes for conditions predisposing to sudden cardiac death (SCD). These adolescent players underwent 12-lead ECG and 2-dimensional echocardiography preceded by a full cardiovascular evaluation during the peak competitive season. Should serious junior tournament players undergo cardiovascular screening? As a cardiologist and sports doctor, I have no doubt that young players should have an adequate cardiological physical examination with a blood pressure test, sports clinical history, and minimally, an electrocardiogram. In this way one can detect murmurs, altered pressure values, or some finding in the electrocardiogram that can determine signs or criteria of risk that may predict or prefigure cardiovascular events during their sports practices. In these cases, more specific complementary tests should be indicated.
In this way one can make a difference in the lives of athletes and give their family peace of mind. In my city, Resistencia–Chaco, the Chaqueña Federation of Tennis requires that junior tennis players obtain a medical certificate given by a cardiologist with the requirements previously mentioned. 

Which on-court, or off-court, symptoms should prompt a player to have her heart checked by a cardiologist?The symptoms that indicate a cardiological examination should be done include chest pain and/or pain in the upper limbs at rest or during exercise, headaches or neck pains associated with high blood pressure, shortness of breath (dyspnea), or agitation when walking, which was previously absent. Other symptoms are shortness of breath at night and the need to sit down (paroxysmal nocturnal dyspnea), palpitations, or rapid or slow heartbeat associated with dizziness, and loss of consciousness (syncope).

Should every tennis club, resort, and center have an Automated External Defibrillator (AED)? And, if so, why?  (Note: In the U.S., the cost of a machine ranges from $1,200 to $2,000.)Of course, this would be the right thing. Don’t forget that a cardio-protected space increases the survival rate of a cardiac arrest or sudden death by 70%, provided it is performed with resuscitation and electric shock within three minutes. 

If a tennis player experiences sudden cardiac arrest while playing, and the facility has no AED, what should onlookers do to help her?

First, the spectators must activate the emergency service and inform them that a cardiac arrest occurred and that they need an AED. Second, start cardiopulmonary resuscitation maneuvers immediately until the emergency service arrives and then use the AED.

When should cardiopulmonary resuscitation—commonly called CPR—be used?Cardiopulmonary resuscitation is an emergency procedure that can save lives. It can be performed by any person trained to do so, even if they are not health professionals. You must use CPR when a person is unconscious, is not breathing, and has no pulse.
For the precise method to use CPR, I will quote the July 2019 Harvard Heart Letter’s article titled, “Hands-only CPR: A lifesaving technique within your reach: The simple version of cardiopulmonary resuscitation pushing hard and fast on the chest can double a person’s odds of surviving cardiac arrest.”

How to do hands-only CPRIf someone suddenly collapses, shake them and yell “Are you okay?” If you don’t see what appears to be normal breathing, call 911 (Emergency). If you put your phone on speaker, the 911 operator can talk you through what to do, but here are the basic steps:
1. Place the person on the floor.
2. Kneel beside the person.
3. Place the heel of one hand on the center of the person’s chest. Place the heel of the other hand on top of the first hand and lace your fingers together.
4. Position your body so that your shoulders are directly over your hands. Keeping your arms straight, push down with your arms and hands, using your body weight to compress the person’s chest.
5. Push hard enough to press the chest down approximately two inches.
6. Continue pressing the chest at a rate of 100 to 120 compressions per minute. This rhythm corresponds to the beat of two songs popular in the late 1970s, “Stayin’ Alive” and “I Will Survive.” New York-Presbyterian Hospital created a curated list of more recent (as well as some older) songs with similar beats; see www.nyp.org/cpr.
7. Continue hands-only CPR until emergency medical personnel arrive. If possible, enlist another person to take over for you after a few minutes because doing the compressions can be tiring.

When the temperature and humidity are very high, what should tennis players do to avoid a heart attack or heat stroke?

Playing sports when the temperature is high can cause dehydration, so sports medicine specialists recommend drinking plenty of water during the day. Due to the heat, some sports activities should be suspended, until the temperature falls a little, to avoid a complication that can be fatal. A heat stroke can occur from an increase in body temperature caused by prolonged exposure to the sun and/or exercising in hot, humid weather and/or with little ventilation, to the point that the body loses water and salts essential for its proper functioning.

The danger posed by extreme heat prompted the US Open last year to activate its protocol to protect players when the temperature hit 33 degrees Celsius (91.4 degrees Fahrenheit) and the humidity reached 70%. If one player requested it, they were allowed 10-minute rest breaks. This was the first time in US Open history that this policy was adopted for the men. The Australian Open already had a rule for extreme heat. So you can clearly see the importance of taking precautions in the heat.

What other suggestions do you have to prevent heat stroke in addition to adequate hydration? First, tennis players should avoid alcoholic beverages and very sugary beverages because they dehydrate. Second, they should eat plenty of vegetables and fruits, not only for their great nutritional value, but because they contain a lot of water. Third, they should avoid eating heavy meals. Fourth, they should wear lightweight and light-colored clothes because that will lower the body temperature by as much as four degrees, while heavy and dark clothes will increase the body temperature by as much as four degrees.

If players have either high blood pressure or low blood pressure, should they limit their tennis in any way or take any precautions?Hypertensive (high blood pressure) patients should visit their cardiologist regularly and join a group of hypertensive patients who are being treated to control their blood pressure. These patients must comply strictly with the treatment indicated by a cardiologist. The most important precaution is that you should never start physical activity when you feel unwell or your blood pressure is high.
However, beyond these recommendations, it must be clear that being hypertensive is not a contraindication to physical activity. When performed correctly, physical activity is healthful, and it controls the cardiovascular risk factors.
Patients who have low blood pressure should hydrate well, should not play tennis when they are thirsty, and should drink water and other beverages when they play socially or competitively.    

Should men and women tennis players take aspirin daily or weekly? And, why or why not?Acetylsalicylic acid (popularly known as aspirin) is currently used as a secondary prevention measure to reduce the risk of new cardiovascular events in those who have already had a myocardial infarction or stroke.
However, the use of aspirin in primary prevention—in patients who have not experienced cardiovascular events—is under discussion. That is mainly due to the risk of hemorrhages and gastric ulcers caused by aspirin.
For my patients, whether or not they are athletes, I indicate aspirin as primary prevention for those from 50 to 59 years of age with a cardiovascular risk of 10% or more, as long as they have a low risk of hemorrhage, a life expectancy of at least 10 years, and are willing to take the drug daily. For patients from 60 and 69 years of age, I weigh the preventive benefit of daily aspirin against the risk of bleeding. However, in patients 70 or older and 50 or younger, I do not indicate aspirin as primary prevention.

Why is sleep extremely important for cardiovascular health and optimum sports performance?
Sleep is extremely important because it decreases blood levels of stress hormones, which lowers blood pressure and heart rate. The hormones released during sleep boost our immune system.

What are the recommended hours of sleep for each age for tennis players?The WHO recommends that school-age children (6-13) should sleep between 9 and 11 hours. Teenagers (14-17 years) should sleep between 8 and 10 hours. Young adults (18-25 years) should sleep between 7 and 9 hours, and no less than 6 hours or more than 10-11 hours. Adults (26-64) should sleep between 7 and 9 hours.

What are the keys to getting a good night of sleep?
First, sleep in an optimal environment where there is a comfortable bed, and a clean, well-ventilated room. Second, acquire what is called, a hygiene of sleep, which includes going to bed every night at about the same time. Third, exercise at least three times a week, and at least 45 minutes each time to recover from mental and physical fatigue accumulated throughout the day. Fourth, try your best not to think about work or personal problems.

Can heart disease actually be reversed by playing tennis? And, if so, how?Yes, of course. The benefits of physical activity for health are amply demonstrated for cardiovascular rehabilitation, secondary prevention, and primary prevention.
My project is to implement Cardio-Tenis throughout Argentina and the nations that border it. It has three major goals. First, I want to educate and encourage people to get out of a sedentary lifestyle and become physically active to stay healthy. The second goal is to correct cardiovascular risk factors. And the third goal is to prevent another heart event and to do cardiac rehabilitation.

Why are people with diabetes at significantly greater risk for heart disease and stroke?        
Diabetes mellitus is present in almost a third of patients with acute coronary syndrome, and it is considered an independent cardiovascular risk factor usually associated with hypertension, obesity, and dyslipidemia. The metabolic and hematological alterations characteristic of diabetics         induce the early, rapid, and severe progression of coronary disease.   
For cardiologists, the prevention and optimal treatment of acute diabetic coronary syndrome continues to be a great challenge; and it has been clearly demonstrated that aggressive multifactorial treatment reduces the morbidity and mortality of these patients. That’s why when we receive diabetic patients, we treat them intensely because they have a greater risk of suffering cardiovascular events, such as heart disease and stroke, than patients who are not diabetic.

Should diabetics play tennis?
Physical activity, and in this case tennis, clearly has many benefits for diabetic patients. Specifically, it decreases blood sugar and cholesterol, and it helps overweight and obese people lose weight. You can also take patients out of a sedentary life more easily by having them play a fun physical activity, such as tennis, a sport that can be enjoyed from age 5 to 95. Besides pharmacological treatment prescribed by cardiologists, it’s urgent and mandatory that patients implement physical activity.

Is there an association of allergy and cardiovascular disease?
It is estimated that allergies occur in up to 40% of the human population. Katarzyna Bergmann and   Grazyna Sypniewska, both of the Department of Laboratory Medicine, Nicolaus Copernicus University Collegium Medicum in Bydgoszcz, Poland, wrote: “Both cardiovascular diseases and allergic diseases are characterized by excessive inflammatory processes. Recent studies suggest a link between allergy and an increased risk of cardiovascular disease, resulting from overactivity of the immune system in allergic diseases and increased synthesis of proinflammatory mediators, which has been well documented in the pathogenesis of atherosclerosis.”
The conclusion of their 2018 abstract stated: “The hypothesis of the relationship between allergies and CVD risk is a matter of controversy. It is possible that chronic allergic diseases, and thus long-lasting increased inflammation, reflected by increased levels of proinflammatory cytokines may contribute to pathological changes in the circulatory system. This problem requires further population studies.”
It has been demonstrated that all inflammatory processes contribute to the cause and development of atherosclerosis. That is why I agree and affirm that there is a relationship between allergy and an increased risk of cardiovascular disease, as a result of the hyperactivity of the immune system in allergic diseases and the increase in the synthesis of proinflammatory mediators.
Therefore, we as cardiologists, insist that all allergic processes of our patients must be treated by specialists. In addition, we prevent infections through anti-flu and anti-pneumococcal vaccines. We take very seriously everything that can generate inflammation in our patients.

What advice do you give to your heart patients who have allergies and play aerobic sports such as tennis?Some patients suffer from allergies caused by climate change, especially air pollution. (Asian and the Middle Eastern countries dominated the top 10 list of most air-polluted countries, according to a 2018 Greenpeace and AirVisual report that also included the most air-polluted cities—https://www.airvisual.com/world-most-polluted-cities. Every city in the Middle East that was included in the study exceeded the World Health Organization’s annual exposure guideline for fine particulate matter.) In these cases, different symptoms associated with episodes of bronchospasm and/or respiratory infections are observed, which limit or prevent the performance of sports activities until the problem is corrected.
My most important recommendation is to continue playing tennis weekly as long as possible because it is proven that physical activity reduces inflammation, impacts positively on cardiovascular risk factors, and increases immunity. I also advise my patients, when they have any symptoms, to be treated as soon as possible for any type of allergy or infection. Finally, when necessary, I request anti-flu and anti-pneumococcal vaccines.

What is the connection between gum disease and heart disease?At recent cardiology conferences, it was stressed that the cardiologist not only must insist on the correction of cardiovascular risk factors, but also prescribe vaccines to patients and send all patients to the dentist, not only patients who have heart valve problems and therefore have a greater risk of suffering endocarditis or cardia infection.
Independent of the mechanisms by which dental inflammatory processes are related to coronary events, it is clearly demonstrated that everything producing inflammation is closely related to the cause and development of atherosclerosis, which is characterized by an atheromatous, or an abnormal fatty deposit in and a fibrosis of the inner layer of the arteries, and that increases the risk of cardiovascular events.
In short, good oral hygiene is extremely important. So brush and floss your teeth twice a day, and go to the dentist for a professional cleaning at least once a year.
For more information about this important connection, I recommend this 2018 report: https://www.health.harvard.edu/diseases-and-conditions/gum-disease-and-the-connection-to-heart-disease

Which foods should tennis players eat and drink a lot to attain optimum heart health?Nutrition is the fuel for any physical activity and the material for the constitution and repair of the organism. The proper choice of foods in optimal quantities at the right time will allow you to reach your maximum potential.
A healthy diet must meet the following requirements: First, it must be complete. It must provide all the nutrients that the body needs: carbohydrates, fats, proteins, vitamins, minerals and water.
Second, it has to be balanced. The nutrients must be distributed keeping a proportion between them. Thus, carbohydrates have to comprise between 55% and 60% of the total calories per day; fats, between 25% and 30%; and proteins, between 12% and 15%. In addition you have to drink 1.5 to 2 liters of water a day.
Third, it has to be enough. The amount of food has to be adequate to maintain one’s weight within the ranges of normality and, in children, achieve growth and proportional development.
Fourth, it has to be adapted to each person’s age, sex, and size, along with the level of their physical activity and the state of their health.
Fifth, it must be varied. It must contain different foods from each of the groups—dairy, fruits, vegetables, cereals, legumes, meat and poultry, and fish—not only because it will be pleasing to the palate, but because great variety will ensure the body receives all the necessary nutrients.

Which foods should tennis players avoid or at least consume sparingly?Tennis players should avoid eating too much salt (hypertensive), fried food, and sausages (dyslipidemia). Instead, they should try to eat a diet rich in fruits and vegetables. Pre-diabetic tennis players who are overweight or obese, and even more so, those who already have diabetes should avoid consuming excess complex carbohydrates. Nutritional experts also stress that we should not eat products containing trans fat and hydrogenated oils.

Which foods have excess complex carbohydrates?The carbohydrates in some foods—mainly those that contain simple sugars and highly refined cereals, such as white flour—break down easily and cause blood sugar levels to rise rapidly. A diet rich in foods that quickly raise the blood sugar level can increase the risk of developing health problems such as diabetes. These are what are known as: “harmful” carbohydrates (refined foods and sugar), which are easy to obtain, come in generous portions, are tasty, and are not very filling. As a result, people tend to eat more than is necessary.
Some are not necessary at all. Soft drinks and sweets are “empty calories” that do not provide any type of nutrient. Soft drinks, cakes, sweets, frozen desserts, and some fruit drinks usually have large amounts of added sugars. They also tend to have a lot of calories and offer little or no nutrition. Sugar-rich diets are often linked to obesity. Finally, an excess of foods with sugar can cause tooth decay because of the high sugar content that erodes tooth enamel along with the acidity of sweetened beverages.

How can tennis parents instill good nutrition habits in their children?Make good carbohydrate choices. Buy whole grains, fruits, vegetables, and low-fat dairy products. Limit foods with added sugar, and encourage children to be active every day. And do not forget to always set a good example. Children will see their parents’ healthy habits and adopt them, and this will make them have a healthier lifestyle in childhood and for the rest of their lives.

Do you have any other advice about how to avoid foods that have little nutritional value and can harm one’s health?Yes, here are some more tips. First, to find out if a food product has added sugar, look at the list of ingredients to see if it has sugar, corn syrup, or other sweeteners, such as dextrose, fructose, honey or molasses, among others. Avoid products that have sugar or other sweeteners at the top of the ingredient list.
Second, instead of choosing foods with sugar, eat healthier options, such as fruits, a naturally sweet carbohydrate food that also provides the fibers and vitamins that everyone, especially children, needs.
Third, one way to reduce the amount of added sugar is to prohibit soft drinks and other drinks sweetened with sugar. Instead of soft drinks or juices, which usually have both added sugar and carbonated drinks), serve skim milk, water, or 100% natural fruit juice.

Dr. Priyanaka Rohatgi, Nutritionist at Apollo Hospital in India, wrote, “We call it a toxic chemical because sugar is eight times more addictive than cocaine…. Sugar causes metabolic dysfunction, which leads to weight gain, obesity, decreased HDL (good cholesterol), increased LDL (bad cholesterol), elevated triglycerides, increased blood sugar, high uric acid, and high blood pressure. Should tennis players also limit their sugar intake?We know that the American Heart Association recommends a maximum of 6 teaspoons of added sugar per day for women and 9 teaspoons for men. Tennis players, specifically, have to limit foods containing simple sugars before and between matches. A food high in simple sugars, such as a regular soda, candy, chocolate, frozen yogurt, or fruit juice, will cause a “hypoglycemic reaction,” leading to low energy levels within one hour of ingesting the food. Highly refined carbohydrates, such as fat-free cookies or desserts and donuts, will cause the same effect.
Therefore, try to limit the general consumption of these foods. If you have them, save them for after training, games, or at the end of a meal. Try to take them with other foods that have a large amount of nutrients that contain complex carbohydrates and protein.

The American Heart Association recommends no more than 1,500 milligrams of sodium per day. Research published in The Lancet (online, May 20, 2016) found that most of the world’s population consumes more than 3,000 milligrams of sodium daily. Should hypertensive tennis players monitor their salt intake in the same way that conscientious overweight and obese people count their food calories? All hypertensive patients should control salt intake and perform physical activity as a first measure. If this is not enough, a drug or drug treatment is started to lower their blood pressure. At least 30% of people in the Americas suffer from hypertension, in large part due to excessive salt intake. As a result, thousands have suffered strokes, heart attacks, and sudden deaths, according to the Pan American Health Organization and the World Health Organization.
Argentina’s motto is “Less salt, more life.” After Argentina became the second country in the world after South Africa to pass a comprehensive law to reduce salt consumption, the percentage of the national population that adds salt to food after cooking or sitting at the table was reduced from 25% in 2009 to 17% in 2013.

Why is resistance training—usually this means weight training—good for the heart?Resistance training is good for the heart because it improves cardiorespiratory fitness, making lungs and heart work more efficiently. In addition, it helps reduce the pulsations per minute of the heart because when your musculature is strengthened, your heart becomes stronger, which allows it to pump more blood in each heartbeat. That, in turn, makes the heart beat fewer times per minute, and, therefore, the heart gets less tired.
It has been clearly demonstrated that resistance training has a positive impact on the main cardiovascular risk factors. Specifically, it improves blood pressure, lowers bad cholesterol (LDL) and increases good cholesterol (HDL), improves blood fluidity, lowers blood sugar, and burns fat, which helps overweight and obese patients control their weight.

Do you recommend estrogen therapy for women tennis players? Or does it actually increase a women’s risk of cardiovascular disease, such as heart attack or stroke? It has been demonstrated that women who practice sports that demand a lot of effort and resistance, suffer from menstrual disorders more frequently than women who do not practice physical exercise. These menstrual disorders may be varied, possibly depending on multiple factors that can be interrelated and, as a result, can lead to modifications of the menstrual cycle.
These menstrual disorders can be of different types, so it is very important to determine the cause of them in case it is necessary to apply hormone therapy. The truth is that athletes have lower estrogen values than normal.

What are the benefits of estrogen?Research scientists have discovered two benefits to estrogen. First, they have found a direct relationship between this hormone and a decrease in the risk of suffering Alzheimer’s disease. Second, they found a direct relations between estrogen and an increase in bone density in female athletes with amenorrhea, which is an abnormal absence or suppression of the menstrual flow.
The question of whether women with amenorrhea associated with exercise should follow hormone therapy has been debated for many years, and it has been suggested that estrogens are capable of increasing bone density. A new study, which was carried out in the Department of Obstetrics and Gynecology, of the University of Alberta, in Edmonton, has confirmed the results. Bone density increased significantly in 8 runners with amenorrhea who took estrogen for 24 to 30 months.
Finally, it is important to know that estrogen protects against cardiovascular events, so it would be very important to keep them within the normal values (range). 
Therefore, I believe that each case should be evaluated promptly and with the corresponding professionals specialized in endocrinology and gynecology in order to determine whether or not to implement estrogen therapy in athletes. This decision takes into account the patient’s age, the sporting activity and the intensity, duration, and weekly impact of the sport.
All things considered, I would recommend estrogen in tennis players only if I determined there are low levels of estrogen with alterations of the menstrual cycle, and following consultation      with the gynecologist and/or the corresponding endocrinologist.

If a person has had a heart attack, heart surgery, or another cardiac event, what’s the best way to prevent future heart problems? Should they continue to compete in tournaments, or even play tennis at all?Tennis is defined as an acyclic, anaerobic sport of 10% to 30% with an aerobic recovery phase of 70% to 90%. It can also be defined as a sport of multiple sprints or spikes, so it’s important to evaluate what to play and when to play, according to each athlete and their personal goals.
The best way to prevent future cardiac problems is to join a cardiac rehabilitation program in which the participants make changes to achieve a healthy lifestyle for the heart and to treat the risk factors of cardiovascular diseases. This program includes physical training, education about heart health, and counseling to reduce stress and to help you return to an active lifestyle.
Once they complete the different stages of the cardiac rehabilitation program, and the corresponding cardiological evaluations are made, if players are able to do so, they return to their usual sports practice in a progressive and controlled manner, until they feel increasingly better and safer. In principle, non-competitive activity is indicated by the stress that implies it, and friendly matches are gradually incorporated, always trying to make the goal recreational.
The cardiovascular risk factors are taken into account according to the patient’s age and background. But in general terms, we suggest that tennis is played in a non-competitive manner.
In my experience, I see many patients with periodic follow-up and adequate cardiological control who begin to play tennis with friends. They start playing doubles which is less intense and more fun. Then, if they feel good, they play singles.
Each case must be evaluated on its merits to determine whether the patient should play tournaments in the future or not. Many highly competitive players dismiss the medical indications and recommendations, and decide to risk their health by competing even in high-level tournaments.

If a person is overweight, what precautions should she take when she plays tennis? Should obese people play tennis, or does that endanger the heart?Overweight people, after adequate medical control in which there are no alterations that show increased cardiovascular risk, can and should engage in physical activity of mild to moderate intensity at least 90 minutes a week.
In the case of tennis, they should in principle practice for a longer duration at a mild to moderate intensity as rallies and then gradually add different exercises that increase intensity to burn more calories. They should avoid as much as possible abrupt stops and jumps to decrease the impact of pounding on their joints.

Do you recommend that tennis players wear devices such as Fitbit (www.fitbit.com) which track exercise, sleep, weight, nutrition, female health, heart rate, and cardio-fitness level?
I recommend it for all those tennis players who want to do it, because it provides very useful parameters for cardiologists and for them. Monitoring these devices often becomes a motivation for them to improve their fitness and heart health. People see the positive results from their concrete actions in daily life; and, at the same time, heart patients are more committed to follow their treatment. The only disadvantage is that some tennis players feel uncomfortable using them.

When a cardiologist orders a specific cardiac workup which includes pertinent bloodwork, what are the most important blood indicators—besides cholesterol and C-reactive protein—that are used to evaluate heart health?The most important blood indicators are: hematocrit, blood count, blood sugar (diabetes), renal function markers with urinalysis, all types of cholesterol (dyslipidemia), thyroid hormones (even more so if the patient reports episodes of palpitations or a history of arrhythmias), uric acid, and electrolyte values such as sodium and potassium. And nowadays, in cardiology and in sports medicine, importance is given to vitamin D, calcium, and magnesium.
Vitamin D deficiency is associated with cardiovascular and cancer mortality, according to two studies recently published in The British Medical Journal. Although the evidence is still insufficient to supplement the diet with vitamin D, the researchers stress that its eventual preventive effect deserves to be studied.
I remind you that vitamin D, produced by the human body in contact with sunlight or acquired through certain foods, is essential for the intestinal absorption of calcium and for the health of bones. In recent times, in addition, this vitamin has been proposed to treat various pathologies, from hypertension to diabetes. A genetic study published in The Lancet Diabetes & Endocrinology  established a close link between vitamin D and hypertension.
In addition, according to the analysis of genetic variants related to the synthesis of vitamin D, performed in 140,000 people with European ancestry, for every 10% increase in the level of vitamin D, the risk of high blood pressure decreases by 8%.
“In view of the costs and adverse effects of anti-hypertensive drugs, the possibility of preventing or reducing hypertension with vitamin D supplements becomes very attractive,” wrote The Lancet Diabetes & Endocrinology. That is why cardiologists stress the importance of vitamin D. 
There is also a meta-analysis led by Rajiv Chowdhury, a specialist in Public Health at the University of Cambridge, who noted that vitamin D3 can reduce cardiovascular mortality in older adults. All these studies notwithstanding, before implementing a general vitamin D supplementation, it is necessary to establish the optimal dose and the duration of the intervention.

What is the ejection fraction? The definition of the ejection fraction, written by Dr. Richard L. Weiss, M.D. on behalf of Penn Medicine Cardiologist (Heart Specialist), is as follows:
“The amount of blood that is pumped out by the heart in one beat is called the ejection fraction. An ejection fraction reflects the strength of the heart muscle. The normal ejection fraction for the left ventricle is 50% to 60%. The heart muscle may be weakened from a heart attack, heart failure, or an infection. Any weakening of the heart muscle may lower the ejection fraction.”

Why is the ejection fraction an important indicator of heart function?When the heart is not functioning efficiently, different organs—such as the kidney, brain, and heart—suffer. This can occur when patients have had a heart attack, heart failure (ischemia), myocarditis, and valvular heart disease.
The ejection fraction is a very important parameter for cardiologists, because it is an indicator of cardiovascular prognosis and mortality. It is also a very useful tool to optimize the monitoring and treatment of our patients.    

What is the normal resting heart rate for men and women?  And what does an abnormally high resting heart rate indicate? Should that concern tennis players?In general, the normal resting heart rate for men and women is 50 to 90 beats per minute. If the heart rate is high at rest, it can indicate several things: great physical effort, an adrenergic or stress state, alterations at the level of the thyroid gland, dehydration and/or heat stroke, anemia, compensatory response to high blood pressure heart failure, fever and/or the ingestion of any drug that stimulates the adrenergic system.
The most important thing is to evaluate if the tennis player has symptoms; and do an  electrocardiogram to find out if it is your normal accelerated rhythm (sinus tachycardia) or the  alteration of the heart rhythm (arrhythmia).

Should an abnormally high resting heart rate concern tennis players?I definitely believe that it should be a symptom or finding to take into account, and even more so, if it happens frequently associated with symptoms.
In these cases, tennis players should consult a cardiologist as soon as possible. The cardiologist will identify if it is something that is permanent, or if it is sometimes felt at certain times as palpitations or accelerations of the heart rate. In addition, if palpitations occur during physical effort and are accompanied by chest pain and/or sweating and/or dizziness, the physical activity should stop and the athlete should immediately go to a cardiologist.

What is the normal heart rate recovery for men and women? And what does an abnormally high heart rate recovery indicate? The heart rate of recovery is the difference between the heart rate while exercising and the heart rate two minutes after having stopped exercising. For example, if after a training exercise, your heart rate is 140 beats per minute; and two minutes later, your heart rate is 90 beats per minute, your heart rate of recovery is 50 beats per minute (140 minus 90).  
Some studies have linked the recovery of heart rate with heart health. A 2017 study published in the Journal of the American Heart Association and titled “Heart Rate Recovery and Risk of Cardiovascular Events and All‐Cause Mortality: A Meta‐Analysis of Prospective Cohort Studies” (https://www.ahajournals.org/doi/10.1161/JAHA.117.005505) concluded: “Attenuated HRR is associated with increased risk of cardiovascular events and all‐cause mortality, which supports the recommendation of recording HRR for risk assessment in clinical practice as a routine.”
Therefore, in general, the greater the HRR number, the healthier the heart is.

Should a lower HRR number concern tennis players?Tennis has moments of high intensity, and maximum physical effort can severely stress the heart. Many times, during a tennis match, there is no strict control of the heart rate, so I recommend that the players listen to the alerts of their body. An alert that tennis players frequently refer to is the feeling that they take longer than before to recover between the points. This is very valuable information, especially on the senior (45-95 age divisions) circuit where risk factors increase and cardiovascular disorders are more common.

The American Heart Association suggests that asymptomatic men over 45 and asymptomatic women over 55 should consider having a treadmill stress test before beginning a lifestyle that incorporates vigorous exercise. Do you agree? I completely agree because a treadmill stress test can detect or rule out a cardiovascular problem. A good test result will ensure that a patient can play sports safely. Furthermore, these are precisely the ages at which cardiovascular risk factors can manifest themselves.

The International Olympic Committee (IOC) recommends that athletes have an echocardiogram every two years. Do you agree with this rigorous screening strategy?  I agree that by observing the heart in a two-dimensional way and using Doppler ultrasound, we can diagnose heart diseases that can be treated in time without risking the athlete’s life. One of the most common problems is hypertrophic cardiomyopathy. It is associated with sudden death, so it is important to perform the echocardiogram.

“There is a one in four chance that you will develop atrial fibrillation at some point in your life,” wrote Marc Gillinov, M.D., a staff cardiac surgeon at Cleveland Clinic, and Steven Nissen, M.D., chairman of the Department of Cardiovascular Medicine at Cleveland Clinic, in their 2012 book, Heart 411. What do you advise for tennis players who have suffered atrial fibrillation?Atrial fibrillation is the most frequent cause of cardiological hospitalizations due to arrhythmias in clinical practice. It is 1.5 times more frequent in men than in women, and as one’s age increases, the frequency of arrhythmia increases.
I advise tennis players to always have regular cardiac examinations. The most important thing is to have blood pressure treated and controlled, because it is one of the most frequent factors associated with the development of arrhythmia. Tennis players should also be knowledgeable about the problems in the arteries of the heart (ischemic heart disease) and heart failure (impaired ability and function of the heart), among other things.

How strong is the connection between negative emotions—especially anger, anxiety, and depression—and coronary heart disease? Social tennis should, at least in theory, relieve stress. Tournament tennis, however, can prove stressful, especially in long, close matches on hot days. What coping skills or relaxation techniques do you recommend to reduce or relieve stress and thus improve heart health?It has been clearly demonstrated that negative emotions like anger, anxiety and depression, are associated with more coronary events. So I consider it important to encourage social tennis because it should, at least in theory, relieve stress. This is why I consider the practice and dissemination of cardio-tennis important.A tennis tournament can be stressful, so I think it’s important to work on visualization, positive thoughts, and correct breathing in order to relax. These techniques will help you face each match situation in a positive way and enable you to clearly analyze the areas you need to improve. A positive attitude will also help you compete better while you enjoy every moment. All these relaxation techniques can reduce or relieve stress and thus improve the health of your heart.

William C. Roberts, M.D., Executive Director, Baylor Heart and Vascular Institute; Dean, A. Webb Roberts Center for Continuing Medical Education; and Editor-in-Chief, The American Journal of Cardiology, stated: “Statin drugs, in my view, are the best cardiovascular drugs ever created, in that they have the greatest potential to prevent atherosclerotic plaques and their complications, and they also have the greatest potential to arrest plaque formation, and therefore, to prevent additional atherosclerotic events. These drugs are to atherosclerosis what penicillin was to infectious diseases.” Do you agree? And what has your experience been with statin drugs?I totally agree. They are the group of medicines, which we cardiologists use as primary and secondary prevention. These drugs have the greatest impact on the reduction of cathovascular mortality. I prescribe these drugs every day and with excellent results.   

According to the website mendedhearts.org, “By launching precision medicine initiatives, health systems can essentially customize care. Using diagnostics, genome sequencing, and data analytics, doctors can tailor treatment regimens to the patient, sparing them side effects from a drug that doesn’t work for them.” How important is precision medicine in the field of cardiology?It is very important to practice precision medicine as well as provide personalized attention and treatment of patients. If precision medicine can be implemented within an entire health system, the results would be really impressive in the population. That would massively reduce the cardiovascular diseases, which are the main cause of death in the world.

Can tennis be harmful to someone’s health?When people take tennis competition too seriously, it can be harmful to their health. To provide an example of this danger, I’d like to share an anecdote. At a tournament, a friend informed me that he could not play because of a muscle tear in his left leg. He also said he had some heart problems. He had undergone some heart tests, and a cardiologist in his province recommended that a study be done to look at the arteries of his heart (coronary angiography). 
He showed me the studies and asked for my advice as a cardiologist and friend. I examined the studies, looked him in the eyes, touched his shoulder, and said: “The best thing that could have happened is that I played this tournament and learned about your heart problem so I can advise you what to do.”
A few days later, my friend called to thank me for my advice, and he informed me that three stents had been placed in his coronary arteries.
I decided to tell you this story because it is so important for all tennis players. Luckily, we saw each other at the tournament. The story had a happy ending. But if he did not respect the indications and instead competed in the tournament, there was a very high risk of his suffering a serious cardiovascular event or even sudden death.
As a final message for the tennis players, I want to emphasize that you should never minimize chest pain, discomfort in the mouth or the stomach, dizziness, or exhaustion disproportionate to the effort made. If you have any of these symptoms, you should stop playing and immediately consult a cardiologist. Quick action can save your life.

What is telemedicine?It is a very important tool that is used around the world to greatly help health professionals and patients. It consists of evaluating, diagnosing, and treating patients remotely using telecommunications technology. For additional information, I recommend visiting https://chironhealth.com/telemedicine/what-is-telemedicine/

How will telemedicine change the way cardiologists treat their patients?In Argentina, telemedicine was implemented in some provinces with excellent results. From the cardiological point of view, it makes it possible to make diagnoses on time and with greater precision. That leads to the initiation of more effective treatments, enables physicians to make referrals at the most appropriate time, and often prevents serious cardiac events.

What do you tell noncompliant heart patients who do not show up for appointments and skip medication doses, lower doses, delay refills, or don’t fill a prescription? When patients do not take their medication, it is an extremely serious problem. I always tell them that complying with the prescribed medication has to be their priority because that gives them a better quality of life and improves their prognosis.

Paul Fein has received more than 40 writing awards and authored three books, Tennis Confidential: Today’s Greatest Players, Matches, and Controversies; You Can Quote Me on That: Greatest Tennis Quips, Insights, and Zingers; and Tennis Confidential II: More of Today’s Greatest Players, Matches, and Controversies. Fein is also a USPTA-certified teaching pro and coach with an Elite rating, former director of the Springfield (Mass.) Satellite Tournament, a former top 10-ranked men’s open New England tournament player and No. 1-ranked Super Senior player in New England. His websites are www.tennisconfidential.com and www.tennisquotes.com. His email address is: lincjeff1@comcast.net.

You Can Improve (Even at Your Age!)
Jimmy Parker, USPTA Master Pro
prkrtennis@aol.com
January 2020

Isn’t it reassuring to know that you can improve your tennis game regardless of your current skill level or what age you are?

Recent findings in the field of neuroplasticity confirm that new skills can be learned at any age. There are so many facets to the game of tennis that there is actually an inviting plethora of ways to play better. 

The obvious way most people would think about improving would be to work on their “strokes.” Instead, I prefer to think in terms of “shots,” which pertain more to particular situations.  For instance, instead of generalizing about your forehand stroke, think about the context in which the forehand will be used – is it a passing shot, a return of serve, an approach shot, a slice, a topspin, on the run, or what?  There are hundreds of variations, so you can always add to your repertoire. 

Probably even more important is how you use your shots – your strategy and tactics. It’s a tactical game with no style points for beautiful strokes! As you become more aware of how you’re winning and how you’re losing, you can design practices more appropriately. And by experimenting with where you hit the ball when, you can improve your versatility, percentages, and put more tools in your toolbox.

Yes Virginia, getting in better shape might not hurt either. 

Working on your strength, speed, agility, endurance, flexibility, or even just improving your diet might not just pay dividends on the court, but in terms of longevity as well. (More years to enjoy your now improved game!)

The fourth general area in which you can improve is the domain of the mental and emotional skills. We all know that how you manage yourself on-court trickles down to other areas of your game. How’s your concentration and ability to stay focused? What about your ability to regulate tension level, diagnose opponents, change the momentum of a match? Are you confident and resilient enough to bounce back from a patch of poor play, and are you able to maintain a sense of challenge and fun regardless of the score? These skills enable you to get the most out of your shots, your tactics, and your physical capabilities. 

The nice thing is that you don’t have to improve by leaps and bounds to make a difference. Did you know that the average winner on the ATP Tour wins an average of only 53% of the points? That suggests that the loser, had he won only 4% more points, could have won the match! To improve by 4% is doable for all of us! But we have to practice with purpose.  As we become more articulate about how and what we practice, the rich array of facets that the game provides offers a lot of opportunities for you to make yourself into a better player! 

Come To Your (Tennis) Senses
Jimmy Parker, USPTA Master Pro
prkrtennis@aol.com
December 2019

If you’ve ever read “Golf in the Kingdom” by Michael Murphy you’ll have an inkling of where I’m going with this. You see, there are some metaphysics buried in the game of tennis (as in golf, as Murphy well elucidates), and if you can get a sense of it, you’ll become a better player – of any game, actually.

While watching a slow-motion replay of a shot hit by a pro on the “telly”, we’re watching the outward manifestation of a whole constellation of factors that went into the hit. Every incoming shot has a velocity, a direction, a net clearance, a spin and finally, depth. In addition, the court surface has a coefficient of friction, there may be wind, the balls may be fluffy or worn, your strings could be loose or tight and so on. Yet, this miraculous mechanism that we call the body, under the unfathomably magic direction of the brain, is capable of taking into account the plethora of influences, then responding perfectly, all in less than a second!

How is this possible? Everyone knows that if we try to “think” our way through it all, it doesn’t work very well. “Paralysis by analysis” and all that. No, there is a hidden dimension to all of this, as there is to much of this world.

As Murphy describes golf in the book:

“’tis a microcosm of the world…in golf you see the essence of what the world itself demands. The game is a mighty teacher, always ready to lead us on. It is a good stage for the drama of our self-discovery. And I say to you, as you grow in golf, you come to see the things you learn there in every other place.”

And so it is with the game of tennis. What you learn on-court has an application off-court, and vice versa.

Most players think that “Once I get my stroke mechanics down, then I’ll deal with all that inner game stuff.” My feeling is that you’ll never really learn how to play to your potential, mechanics included, until you get the “inner game stuff.”

And the inner game begins with awareness. It comes from the inside out – the growing ability to feel, to notice, to sense. The concept of your “authentic swing” is simply that you know when you’re on the right track based on how you’re hitting a shot – you can feel it! And no two players do it exactly the same way! It’s an experience, and not merely a set of instructions. A good instructor then, draws it out of you just as the root of the word educate suggests – draw from, elicit. It’s not simply a process of pouring a bunch of do’s and don’ts into a student. Real learning comes from within.

The path of awareness will eventually lead you to your instincts, to your own intuition. It’s right brain stuff, not the linear, step-by-step left brain. That’s where your best tennis will come from. We all know at some level that Federer is not ticking off a list of things to remember as he exercises his shot-making genius. He is playing in a spontaneous, “in-the-moment” mode, sensing what is required, and responding to the multi-layered exigencies of that particular instant.

At some point, we’ve all hit that perfect shot that we wonder afterwards, “How in the hell did I do that?” It is that miracle that gives us some insight into the powerful unseen forces at work!

And so it is that we must draw on our whole self to get the most out of our game. When we join our visions, energies, thoughts and muscles, when we literally come to our senses, when we’re truly present, the extraordinary becomes possible.

Be The Person You Want To Be On The Court
Neal Newman, Ph.D.
nealnewman3@yahoo.com
February 2019

I am a senior tennis player who loves and enjoys playing tennis. I am also a psychologist, who specializes in sport psychology/performance psychology. Jimmy Parker has asked me to submit an article to post on the National Senior Men’s Tennis Association website.

I have decided the most important message I can communicate is the message I received from my mom. She and my step dad, Mildred Newman and Bernard Berkowitz, were psychologists and psychoanalysts, who co-authored the best seller, “How To Be Your Own Best Friend.” My mom always told me that anyone can have problems, and we can work on that, but most important of all is to show good character.

How do we show good character on the court? I suggest that our task is to play courageously and Do Our BEST as a player, while ALSO being a GOOD PERSON with our doubles partner and tennis opponents, and anyone else involved with the tennis event you are playing. This translates to being a positive SELF COACH, who is SELF ACCEPTING of mistakes and limitations while effectively guiding our game in terms of maintaining an optimal Mental State, staying with Technique, and selecting suitable game Strategy. It also means being OTHER ACCEPTING, in the sense of being empathic and respectful of others. Why not help create a therapeutic environment while we play? This can translate to enjoying others’ good shots, as well as our own. This can mean being empathic to ourselves and our opponents.

Let me share a favorite story about my son Cole. He has had his share of tennis successes. He was a high school state doubles champion in Ohio, was an All- American tennis player at Denison University, and we have won five Father Son National championships. He is now teaching tennis in Santa Monica, California. When he was about 14 years-old, he was playing in a local tennis tournament in his hometown, Columbus, Ohio. You need to understand that junior players would play these events in hopes of getting good rankings. A colleague of mine came to work one day after matches had started and said his son told him that Cole was his hero.

Here is what happened. Cole’s opponent started cramping. It was a hot day, and they were having a tough match. The tournament director saw the opponent had stopped due to cramping. He said he had x number of minutes to start playing before he would have to default him. The opponent was struggling. Just as he was about to default him, Cole rushed over and asked if he could take his bathroom break. The tournament director said fine. Cole went over and bought Gatorade to bring to his opponent. His opponent drank some, and with that further break and fluids was able to recover and continue the match. The opponent actually went on to win that set, but Cole was able to win the match. When Cole came home, he didn’t even mention what had happened in his match that day.

One more story. I didn’t play junior tennis. I didn’t take lessons and didn’t play any junior events. I did, however, play on my high school team at the High School of Music & Art in New York City, and at Earlham College in Richmond, Indiana. After college, I continued to play, and began playing tournaments regularly for the first time in my early 30’s. I had never been ranked as a player, but while playing doubles with a good friend, Andy Thompson, who had played at Ohio State, we had a good year. We were in position to get a top ranking in the Western’s, (now called USTA Midwest Section).

Back then, you had to submit your tennis results. There were no computers automatically compiling your results. Andy, as the more experienced tournament player, had submitted the results, but it turns out, to the wrong address. He submitted the information to the Midwest address on the back of the yearbook but was supposed to send the ranking information to a different address that was stated inside the yearbook. An honest mistake. The problem was the information then didn’t get forwarded to the ranking committee until after the stipulated deadline. It had been sent on time, but the executive secretary of the Western Tennis Association, a stickler for rules, told Andy we would not get ranked that year, because the ranking committee didn’t get the information in time.

Andy called me with the disappointing news. I had not been ranked before, so I was extra disappointed. I told him I would call the executive secretary. I explained to her that the ranking information had been submitted on time, but that I thought it was confusing that the address on the outside of the yearbook differed from the address on the inside. She said, “Are you the Neal Newman that played my son in a tournament a couple weeks ago?” I said yes. Her son, who was a terrific player at the University of Cincinnati, had come home after our match and said he had just had the most fun he had ever had on the tennis court. We had played a long three-setter, which I think he won 7-5 in the third. (The details are hazy. I seem to recall my wins better). Despite being a stickler for rules, she said she would let Andy and me be ranked if I would serve on an Ohio Valley Tennis Association Committee for a year. I guess you win some and you lose some, but it pays to be a good person.

To me, being a good person on the court includes being the person and player you want to be, while also being empathic and respectful of others. It is ok if you sometimes make mistakes and underperform as a player and person. Be in a self -accepting Learning Frame, where you learn from your mistakes and develop. I suggest setting a goal of being the person you want to be on the court. Mentally rehearse how you would like to be. See, hear, and feel yourself being a way you feel good about, as a player and person. Doing this ahead of time can maximize the chances of you being that way.

I wish you the best in learning to be the person you want to be on the court.

(Information About The Author: Neal Newman, Ph.D. is a psychologist in Columbus, Ohio. He is retired from Ohio State University where he worked at the OSU Counseling & Consultation Service. He also taught music performance enhancement seminars at the OSU School of Music. He continues to maintain a small private practice, specializing in sport psychology and performance enhancement. As a tennis player, Neal has won 40 USTA national doubles titles, mostly teamed with Larry Turville, Phil Landauer, and his son, Cole Newman. He has won four ITF Individual World Championships in doubles, teaming with Larry Turville. He has won two ITF World Team Championships, representing the United States. He has been ranked #1 nationally in doubles in each age group, 35-60, and in Father Son competition. He was inducted into the USTA Midwest Hall of Fame in 2015.)

Tennis Shoulder: Causes, Cures And Prevention
Robert Travis
drchiptravis@yahoo.com
February 2019

Even non-tennis players know the term "tennis elbow" but few have heard of "tennis shoulder". Whereas low skill players often are the ones who suffer from tennis elbow, it is the more highly skilled and long-term players who suffer tennis shoulder. The disorder is documented in a 1982 study, which indicated it stopped participation in tennis for 50% of professional players. The loss of playing time, the research noted, was between two weeks to forever. I don't believe the condition is nearly so prevalent today in the professional game for one specific reason: weight training.

I was a chiropractic student in 1982 when I read a study in a medical periodical, "The Physician and Sports Medicine". The article described the condition as a painful and debilitating injury that could many times be visually detected: the dominant shoulder posture could be lower and wider than the non-dominant shoulder. There was a rear-view picture of a player with the condition. The player was clearly Jack Kramer. His right shoulder was at least two inches lower than his left and an inch or a bit more, wider.

This postural asymmetry is due to the over-stretching of the muscles that elevate and retract the scapula/shoulder blade. Those muscles are the trapezius, the levator scapula, and the rhomboids. When a player follows through on the serve motion, those muscles must decelerate the racquet arm. Over time and years of hard serving those muscles can become overstretched and therefore allow the shoulder to droop wider and lower. The "tissue damage" is painful and [can lead to the shoulder being] dysfunctional. The doctors conducting the study interviewed 100 professional players, male and female, and found 50% had been forced to stop playing due to the pain.

I was a player who had been a serve and volley specialist (even on clay) but had never suffered even a hint of shoulder pain. How was that? My immediate thought was that I had been a weight training guy from age 12 (to the present and I am 74.) Therefore, those shoulder elevator muscles had been strengthened enough to prevent over-stretching.

I wrote an article at that time for a Texas tennis monthly newsletter that explained the condition and how it could be cured and prevented. Amazingly enough, I soon had three tennis pros come to the Texas Chiropractic College intern clinic to see me about their tennis shoulders. All three were cured within a month, which involved about five visits for manipulation of the spinal nerve levels that control those muscles; some specific muscle therapies; and of course, specific weight exercises to tone and strengthen those shoulder elevators.

The chiropractic aspect of the therapy may be key, as those muscles attach to the spinal vertebrae of the neck and upper back/thoracic spine. That is where the spinal nerves that control those muscles emerge. The spinal joints may be compromised and misaligned by the asymmetrical stress. It is clearly less effective to exercise a muscle that has altered nerve stimulation.

The exercises can be explained in one image: reversal of the serve motion with resistance. Using a light three-five pounds weight at first, increasing the weight over a number of weeks to whatever weight can be tolerated up to 20 times in rapid repetition, hold the dumbbell close to the left knee (for right handed servers) and use a reversal of the serve motion up to the back-scratch position. That is called a "concentric" contraction of those shoulder elevators and other muscles involved in deceleration. Then use the serve motion with the weight very slowly and totally controlled (able to stop motion and reverse direction) back to the left knee position, that is called an "eccentric" contraction---the muscles are lengthening under control.

There is another variation of "tennis shoulder" that may not present the visual clue of the low and wide shoulder. That form of shoulder pain involves the primary internal and external rotator muscles. The muscle that is primary for shoulder "internal rotation" of the throwing/serving motion is the subscapularis. The muscle that decelerates this motion is the "infraspinatus". If you stand with the arm out to the side and raised to shoulder level, then rotate the forearm forward---that is internal rotation. When you raise the forearm up and try to rotate backwards, that is external rotation. Internal rotation of the shoulder is the primary throwing/serving motion that must be balanced by external rotator muscles. If the arm is down, elbow at side of waist, a motion forward across the stomach/chest (as forehand) is internal rotation. Rotating backwards is external rotation.

A weak external rotator infraspinatus or too strong internal rotator subscapularis can cause a painful shoulder. The ratio of internal/forward strength to external/backward strength should be about 100 to 80. That is, the external rotator strength should be 80% of internal rotator strength.

Again, the fix and prevention are the same. They are spinal joint adjusting to correct any altered nerve conduction stimulation of the muscles and weight training with light dumbbells progressing to heavier, 20 repetitions or less.

There is a wonderful study available online at PUBMED.GOV, the national Institutes of Health website. Type in "tennis shoulder" (on 12/30/18, there are 609 references that mention tennis shoulder).The reference will be approximately number 10 in that list of 609. It is in The International Journal of Sports Physical Therapy, 2018 Feb:13(1):39-45.

Luckily, the whole article can be read on PubMed if you scroll to the bottom of the summary. It is clear and understandable. The essence of the article states that the internal rotators overwhelm the external rotators, therefore the therapy is to strengthen the external rotators as in the reverse serve motion mentioned here earlier and by "bent rows", a rowing motion retracting the shoulder and arm backwards.

Other than chiropractic spinal manipulation, proper stretching, icing, strengthening, ultrasound, electrical muscle stimulation, and rest (non-play), treatment can include deep muscle massage and other forms of muscle and fascia manipulation. If these conservative measures prove inadequate, medical injections of platelet-rich-plasma (PRP) and stem cell therapy could be tried. Consideration of surgery should be made only after ALL of these modalities were given a fair chance of success. The best therapy is prevention by proper weight training of the shoulder muscles.

Clay Court Tennis – The Soft Choice
Steve Hayden, Tennis Director
Beavercreek Clay Courts Tennis Club
steve@bcctennisclub.com
December 2018

You’ve often seen the ice-pack trail of tennis players, both young and old, tending to their knees, elbows, shoulders and ankle injuries…especially knees. Many of these injuries are due to the repetition and intensity of stroke production and movement (both upper and lower extremities). When considering the long-term impact to a player’s physical longevity and endurance, soft courts provide a distinct advantage over hard courts.

Tennis players can choose to play on a variety of court surfaces such as hard (acrylic covered asphalt or concrete), clay (crushed shale, stone, or brick), grass (short grass on hard packed dirt), or carpet, rubber, polymeric courts. The majority of court surfaces within US tennis facilities are either hard or clay courts. Of the estimated 250,000 tennis courts in the US, 70% are hard, 14% clay, 1% grass and 15% other (carpet, rubber, polymeric, etc). (1) Often the court surface chosen by a player is due to a lack of options or player preference due to the player’s strengths.

While injuries impact all tennis players, studies have shown that the type of court surface affects the types and frequencies of injuries. Overuse injuries often occur in the upper extremities such as tennis elbow, rotator cuff tendonitis and back sprains. Upper extremity tennis injuries are mostly chronic and result from repetitive use, irrelevant of the nature of the court surface. Traumatic injuries often occur in the lower extremities such as knee ligament or meniscus and Achilles tendon tears. Lower extremity injuries are mostly acute and result from traumatic events and are often due to a harder court surface. (2) Injury surveillance amongst elite tennis players during some US National Championships on hard courts, revealed that nearly 50% of all injuries were located in the lower extremities; an incidence almost twice that for the upper limbs and trunk and back. (3)

If you want to play with less stress on your knees (and body), play on a clay court. Clay is considered the slowest surface due to friction of the clay. The clay court reduces the natural skid of the ball which tends to bounce up instead of skidding. A shot hit without spin will lose about 43% of its ground speed after contact with the clay surface thus having a bit less impact on your arm. A shot hit on a hard court will only lose about 23% to 28% of its ground speed (4). A recent study (5) indicates that the distance of player movement on a tennis court is around 30% higher on clay versus a hard court. Matches played on clay required players to cover more running distances, have fewer strokes per time interval, however still engage in more high-intensity activities than the matches played on a hard court. Therefore, a player will have a higher aerobic benefit when playing on clay surfaces.

The granular surface of a clay court acts as a shock-absorbing cushion, allowing players to slide into their returns. This prevents the joint jarring stops that occur on hard surfaces. Pain and/or injuries are substantially lower on tennis surfaces that allow sliding (clay) compared to surfaces that do not allow sliding. Studies show that the differences in lower extremity injury frequency are directly related to the differences in the frictional properties of the surfaces. (6) The frictional characteristics of the tennis court–shoe interface are a major risk factor for lower extremity injuries in tennis. The injury frequency on clay is significantly lower than on hard courts. The surface with the higher frictional coefficient enhances the speed of the game but also induces more frequent injuries as players perform at a greater rate of acceleration, speed and torque, hyperextension and therefore greater potential muscle fatigue. (7) The loading of the lower extremities is smaller on surfaces that allow sliding than on surfaces that do not allow sliding. Surfaces that allow sliding are expected to have about 75% less lower extremity injuries than surfaces which do not allow sliding. (6)

So the more time you spend playing tennis on a clay court versus a hard court, the greater the chance that you will avoid knee injuries. The International Tennis Federation makes this same suggestion for players with knee injuries. (8) Senior tennis players have fewer knee problems if they have spent most of their tennis careers on clay courts.

I close with a quote from a gifted clay court tennis player, “Personally, I find playing on clay much easier on my creaky old joints. I can play almost twice as long on clay as I can on hard courts. As far as falling, I agree that I tend to fall more on clay, but that is probably because I tend to be more 'adventurous' in my attempts to reach shots on clay. Plus, falling on clay results in simply dusting myself off and continuing with the match. Falling on a hard court can ruin my day.”(9)

References
1. Tennis Construction FAQ ; American Sports Builders Association, 2018, https://www.sportsbuilders.org/faq.cfm#tennis10
2. The Activity Profile of Young Tennis Athletes Playing on Clay and Hard Courts; Sciendo, Vol 50:
Issue 1, Apr 2016; https://content.sciendo.com/view/journals/hukin/50/1/article-p211.xml
3. Effects of the playing surface on plantar pressures and potential injuries in tennis; British Journal of Sports Medicine, Jun 12, 2007, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2465293/#ref10
4. The Physics of Grass, Clay, and Cement; Jonah Lehrer, 8 Sep, 2011; http://grantland.com/features/the-physics-grass-clay-cement/#fn-3
5. Upper Extremity Injuries in Tennis Players; PMC US National Library of Medicine, National Institutes of Health, Feb 2017, 33(1): 175-186, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5125509/
6. Injury & Performance on Tennis Surfaces; HPL – Calgary, Dr. Benno Nigg, Canada, Nov 2003, http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.562.7887&rep=rep1&type=pdf
7. The influence of playing surfaces on tennis injuries; Sports Med, Jun 1988
8. Knee Pain: Injury Clinic, 2018, https://www.itftennis.com/scienceandmedicine/injury-clinic/tennis-injuries/kneecap.aspx
9. Talk Tennis; dcottrill, 2008 https://tt.tennis-warehouse.com/index.php?threads/injuries-clay-court-vs-hard-court.202709/

The Best Sport for a Longer Life? Try Tennis
​Gretchen Reynolds
September 2018
* This article was originally posted in the NY Times, September 5, 2018

People who played tennis, badminton or soccer tended to live longer than those who cycled, swam or jogged.

Playing tennis and other sports that are social might add years to your life, according to a new epidemiological study of Danish men and women.

The study found that adults who reported frequently participating in tennis or other racket and team sports lived longer than people who were sedentary. But they also lived longer than people who took part in reliably healthy but often solitary activities such as jogging, swimming and cycling.

The results raise interesting questions about the role that social interactions might play in augmenting the benefits of exercise.

At this point, no one doubts that being physically active improves our health and can extend our longevity. Multiple, recent epidemiological studies have pinpointed links between regular exercise and longer lives in men and women.

But whether some activities might be better than others for lengthening life spans remains in dispute. One widely publicized 2017 study of more than 80,000 British men and women found that those who played racket sports tended to outlive those who jogged.

Those results piqued the interest of an international group of scientists. They previously had examined links between jogging and longevity and concluded that moderate amounts of moderately paced running led to greater gains in longevity than more-gentle or strenuous running.

For the new study, which was published this week in Mayo Clinic Proceedings, these same researchers decided to widen their inquiry and look at a variety of sports and their associations with life and premature death.

To start, they turned to the same data resource they had used for the jogging study, the Copenhagen City Heart Study, an ambitious, ongoing attempt to track the lives and health of thousands of men and women in Copenhagen.

The study’s participants had all completed health exams and lengthy questionnaires about their lifestyles and whether and how often they took part in eight sports common in Denmark, including cycling, swimming, running, tennis, soccer and, perhaps unexpectedly, badminton.

They cross-referenced records with the national death registry to see if and when any of these people had passed away.

Then they compared activities and life spans.

The most obvious finding was that people who had reported almost never exercising were more likely than the active to have died in the ensuing decades.

The associations between particular activities and life span were more surprising.

Cycling was the most popular activity among the Danes in the study, many of whom reported riding for four or more hours every week. Their pedaling was associated with a lengthier life span, adding an average of 3.7 years to riders’ lives, compared to sedentary Danes.

Running likewise was associated with an extra 3.2 years of life.

But these gains were notably less than for playing tennis, which was linked to 9.7 added years of life, or badminton, which was linked to an extra 6.2 years, or soccer, which added almost 5 years to players’ lives.

These associations remained unchanged even when the researchers controlled for people’s education, socioeconomic status and age.

Why and how some sports might add more years to people’s lives than others is impossible to know from this kind of observational study, says Dr. James O’Keefe, a study co-author and the director of preventive cardiology at the Mid America Heart Institute at Saint Luke’s Health Center in Kansas City.

The differing physical demands of some sports could play a role, he says, although little of the exercise in this study was heavily intense, whether people were cycling or backhanding a shuttlecock.

Income and other aspects of people’s lifestyles also likely matter, he says. The researchers tried to account for socioeconomic factors, but it remains possible, he says, that people who have sufficient money and leisure time to play tennis live longer because they have sufficient money and leisure time, not because they play tennis.

Still, he suspects that the social aspects of racket games and other team sports are a primary reason that they seem to lengthen lives, he says.

“We know from other research that social support provides stress mitigation,” he says.

“So being with other people, playing and interacting with them, as you do when you play games that require a partner or a team, probably has unique psychological and physiological effects,” he says, amplifying the benefits of the exercise.

That possibility requires verification, he says, especially in randomized experiments directly comparing different types of exercise.

But for now, people who run or ride solo might consider finding a group or partner with whom to work out, he says.

“Raising your heart rate is important” for health, he says. “But it looks like connecting with other people is, too.”

Want to Decrease Your Chances of Dying??
Jimmy Parker
jparker@nsmta.net
June 2018

Well then, play tennis, badminton, or squash! (Or pickleball?) Recently released research involving over 80,000 adults, indicates that players of racquet sports were an amazing 47% less likely to die of any cause, and 56% less likely to die of a cardiovascular disease compared to those who did not play. Those are some whoppin' numbers!

The study was done over more than a decade in England and Scotland and the average age of participants was 52. About half of them met the minimum recommendations for some kind of physical activity. They were tracked over the next ten years, and almost 9,000 of them kicked the bucket, technically speaking, during that period. The group that at least met the minimum standards for exercise were substantially less likely to end up underground.

As an aside, as recently as the 1940's, many doctors feared that exercise led to what was pejoratively called an "athletic heart." It was noted that many athletes had enlarged heart muscles, the same characteristic that many people who suffered heart attacks displayed. Later it was explained by the fact that many heart attack victims had hearts that had been laboring to pump blood through clogged arteries, and thus developed more heart muscle.

Interestingly, according to the study, some sports simply didn't have much impact on their participants chances of staying alive compared to other exercisers. As expected, it was clear that those who exercised in any way improved their chances of staying vertical. Evolutionarily, the human body was designed to be active. However, it was found that runners and joggers did not substantially improve their chances of staying on the right side of the sod by plying their sport, compared with other exercisers. Ditto for soccer and rugby players.

​Other studies may shed light on this rather surprising conclusion. It has been shown that racquet sports have other components which promote longevity. Not only do they draw on the problem-solving parts of the brain in deciding on tactics and shot selection, but possibly more important, they have a definite social component to them. And there may be more affability in sports where the objective is not to hurl one's opponent to the ground. (Not to mention injuries.) The end result in all of this is simply that tennis players live longer, healthier, happier lives. (Senior) Tennis anyone?

ARCHIVES

How to Prevent Re-Injuries
July 2022

The 3 Most Common Types of Knee Injuries
June 2022

Lifetime Sports Are Precious
Fred Robinson
August 2021

Improve your tennis game with tips from Team USA
USTA
August 2021

Experimenting During the Pandemic and Discovering How to Fuel
Keith Richardson
May 2021

Calories - and the Right Type of Calories - Count!
Steve Born
April 2021

What’s on Your Plate?
Boost Your Performance: Plant-Based Diet and the Tennis Player
Myke Landauer
December 2020

The Connection between Ball Flight Recognition, Anticipation, and Coordination in Tennis
Paul Fein
November 2020

Geoff Cykman’s Blueprint for Fitness
Geoff Cykman
July 2020

The Turville Slice Backhand
Larry Turville
June 2020

Heart Health for Tennis Players
Paul Fein
February 2020

You Can Improve (Even at Your Age!)
Jimmy Parker
January 2020

Come To Your (Tennis) Senses
Jimmy Parker
December 2019

Be The Person You Want To Be On The Court
Neal Newman, Ph.D.
February 2019

Tennis Shoulder: Causes, Cures And Prevention
Robert Travis
February 2019

Clay Court Tennis – The Soft Choice
Steve Hayden
December 2018

The Best Sport for a Longer Life? Try Tennis
Gretchen Reynolds
September 2018

Want to Decrease Your Chances of Dying??
Jimmy Parker
June 2018