Beruflich Dokumente
Kultur Dokumente
Costa Mesa, CA
Abstract:
The research to follow examines in depth the major causes of low-back pain. The subject
is approached taking in consideration the lifestyle of a teenage tennis player, and the specific
conditions and demands this particular sport requires. While breaking down each aggravating
source of low-back pain, I have also connected it to the case studys specific conditions, and
approached it on how the player can benefit from Pilates. The area of the body addressed in this
research is the trunk area, with specific muscles addressed such as internal and external obliques,
quadratus lumborum, erector spinae, and rectus abdominals. By creating a program that aids in
balancing one side of the body and the other, the player is able to develop equal strength on both
sides of the body, while striving for the ability to relax the muscles that are constantly being
used. Ultimately, the goal is to develop equal range of motion on the right side and the left side
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Table Of Contents:
Abstract.Page 2
Table of Contents..Page 3
ConclusionPage 11
Bibliography.Page 12-13
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The following images depict the muscles of the body targeted in this research.
Image A: Posterior View of QL and Erector Spinae (group of muscles spinalis, longissimus,
iliocostalis)
(B) (C)
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Image D: Lateral view of Oblique muscles and Transverse abdominals
Image E: Frontal view of Rectus Abdominals (with segments showing muscles previously
depicted in Image D)
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Tennis players are part of the group of athletes that develop a stronger or dominant side,
therefore increasing the possibilities of pain and injuries caused by muscle imbalances. The
human body is naturally prone to muscle imbalances and tightness due to daily-life activities,
and when factoring in excessive movement patterns that are most often repeated unilaterally, one
restrictions, feasibly leading the body to an injury or impingement. One of the most common
problems athletes and non-athletes experience is low back pain, and a Tennis player who is
constantly using the same group of muscles favoring only one side of the body, is very prone to
experience low back pain. According to the International Tennis Federation website, low back
pain can be a result of multiple factors such as postural deviations like scoliosis, hyperlordosis,
kyphosis, and also fatigue posture; muscle dysfunctions that are often caused by imbalances,
shortening or weakening of a muscle or a side of the body; excessive use of a particular muscle
or group of muscles in determined area of the body; instable movement patterns; and articular
dysfunction in the lower spine that could be addressed as joints that arent properly working.
The athlete studied in this research is an 18 year-old male named Rafael Lenhard, who
has been playing tennis since he was a 7 year-old boy. During his sophomore year of high school
schedule, as the academy prepares them into the best players they can be prior to their college
education. When interviewing Rafael, he mentioned he would often times have low back pain at
the end of long training days and championships. He has also suffered from growing pains
during the first semester of 2013, which put him out of practice for about 4 months. When
analyzing Rafaels lifestyle and previous history it is possible to say that he suffers with at least 4
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out of the 5 major reasons of low back pain, and even though some may not have resulted from
his tennis practice, without proper alignment and postural re-education it will definitely
aggravate his current situation, possibly reducing the number of years he will play in the future.
The first aspect to look into is the presence of a curvature on his spine; while performing
the roll-down it is clear to the naked eye that his vertebrae shift out of the center line towards the
right side of the body, causing somewhat of a curve that would be recognized as scoliosis.
Nowadays, scoliosis has become something somewhat normal since 1 out of 100 will develop
some kind of scoliosis, but fortunately these will mostly be mild cases. In Rafaels case I cannot
diagnose how severe his scoliosis is, but assessing that most scoliosis cases start developing
during childhood, and that Rafael started playing a one-side dominant sport during that period, I
can predict that his case is moderate to somewhat severe, and the program needs to focus on
getting as much length on the right side of his body by stretching the muscles around the spine
and right hip area. One other aspect that I have noticed while working with Rafael is that his
head and neck tend to tip to the left side while he is lying supine. My assumption is that since the
right side of his muscles have been working so much harder than the left side of his muscles, the
scoliosis condition caused the spine to shift more towards the right around the thoracic and
beginning of lumbar spine causing the cervical spine to tilt away from the curve, therefore
making the S-shape curve characteristic of this condition. Lastly, extreme rotation of the spine
can also aggravate this condition, and as a tennis player Rafael is in constant use of spinal
rotation.
Muscular imbalance is also a factor that aggravates lower back pain, and when analyzed
aside all the other causes, it is one of the issues that Pilates has most access and ability on aiding
the healing process. By working bilaterally in an even and balanced body, the muscles are able to
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train and re-learn how to achieve equal strength, flexibility, control and mobility on both sides of
the body. Imbalances on tennis players can simply be analyzed by taking one of the most crucial,
constant and fundamental movement performed: the serve. The serve needs to be very powerful
and will recruit major muscles to be performed. For a right-handed tennis player like Rafael, the
serve will begin with mild torso rotation as the left arm tosses the ball up in the air, followed by
extreme right lateral flexion and deep knee flexion as the right arm slightly bends and prepares
for the strike. Then the player must use the rotator cuff muscles of the right shoulder to get the
racquet even further back, while extending the thoracic spine and creating momentum to jump
reaching as far up as possible, and finishing the movement in a half-circle motion forward with
intense counter lateral rotation of the right upper-body and left lower-body. The movement itself
is completely imbalanced, and according to Rafaels interview, a tennis player will never switch
While still analyzing the serve, the constant extreme right lateral flexion prior to striking
the ball is a clear example of another low-back pain aggravator, which is the misuse and abuse of
muscles during constant repetition. Overusing any muscle in the body can be related to many
different aspects, and sometimes we will have no power over it. During a tennis match there are
many factors that can lead the player to overusing their muscles, therefore being subject to
injury. But the unfortunate side of this is that no matter how prepared a player is there will be
intrinsic and extrinsic factors influencing the way they will play that cannot be predicted nor
changed. Intrinsic factors that can lead to misuse or extreme practice are simply identified as
feelings and emotions. No matter how focused and prepared a player gets, sometimes there may
also be extrinsic factors affecting their performance, and therefore leading to injury, such as
weather conditions, the opponent, environment conditions and so on. Despite these risks to
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misuse muscle recruitment, there is also the fact that players tend to have a rigorous training
schedule, especially at Rafaels age since they are preparing for a career, so there will most
definitely be overuse of particular areas of the body, especially back and shoulders, so the only
solution for this sort of problem is to ensure the player is as properly aligned as he can be,
diminishing the difference of one side of the body to the other, and strengthening both sides of
Tennis can be somewhat be considered a sport that has unstable movement patterns, and
the matches are unpredictable. The player must be extremely focused so that running and striking
the ball can be performed in the best biomechanics possible, allowing the body to have full
mobility with the required stability. With consistent Pilates practice and in a deeper
understanding level, a tennis player is able to train the body focusing on different group of
muscles or specific muscle at a time, allowing them to understand and recognize how each body
The last component that aggravates low back pain is related to pathologies and injuries,
and fortunately there is no occurrence of that on the case study. Low back pain associated with
spinal dysfunction can be a result of either a disc condition or a vertebral condition, and should
be accompanied by a doctor.
Taking in consideration all the factors that are causing low back pain on the case study,
and also analyzing the naturally round-thoracic spine, gait cycle, and various postural habits, I
have designed two programs that will help Rafael develop more balance between the right and
left side of the following muscles: internal and external obliques, Quadratus lumborum, rectus
abdominals and erector spinae. Also we will strive for maximum looseness of the hips,
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emphasizing stretching the hamstrings and increasing the range of mobility. And finally,
approach the thoracic and shoulder area so it opens-up and settles into place.
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Conclusion:
problems but what can be changed is the intensity and frequency this problem happens.
Ultimately, with consistency, precision and dedication to the Pilates practice, a tennis player can
achieve better health, eliminating the nagging pain of low-back-related problems. Muscular
imbalance is one of the most crucial points I have discovered in this research because if every
other aspect is corrected yet one side is still stronger and tighter than the other, there will be no
full range of motion, and the previous weaknesses that had already been addressed and corrected
will most likely occur again. Postural deviations may not be fully corrected or reversed, but the
muscular structure around the spine can learn how to correctly support each movement required
in this sport, therefore allowing for maximum flexion and rotation of the spine. As far as
overdoing movements, demanding sports such as tennis will most likely involve overuse, but by
having a strong and mobile spine and equal strength and flexibility on both sides of the body, a
player is able to continue with his career and daily-life with less pain and better outcomes.
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Bibliography:
Book
Isacowitz, Rael. Study Guide: Comprehensive Course. Costa Mesa, California: Body and Arts
Science International, 2013.
Video Clip
Tennis Serve: The top 5 Secrets of the Power Tennis Serve. Youtube. Paul Gold Channel. 19
Nov. 2014. < https://www.youtube.com/watch?v=mbLjGVd0xRs>.
Websites
Allen, Jared. The Core-Pt. 1: Awareness over Strenght. Dynamic Balance. 2 Dec. 2014.
<http://www.dynamicbalancefoco.com/#!blogger-feed/c1l0u>.
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Erector Spinae. ExRx.net. Exercise Prescription. 3 Dec. 2014.
<http://www.exrx.net/Muscles/ErectorSpinae.html>.
Drury, Billie. Pilates for the Tennis Player Shoulder. Comprehensive Course: Chandler,
Arizona: Ocotillo Pilates, 2012.
Navarro, Antonio. Pilates for Tennis. Comprehensive Course: Costa Mesa, California: BASI
Pilates, 2013.
Toker, Elif. Pilates for Increasing Tennis Performance and Avoiding Injuries resulting from
Imbalance. Comprehensive Course: Mersin, Turkey: BASI Pilates, 2012.
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