ArticleSports health
External Training Load and the Association With Back Pain in Competitive Adolescent Tennis Players: Results From the SMASH Cohort Study.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Methods of Monitoring Internal and External Loads and Their Relationships with Physical Qualities, Injury, or Illness in Adolescent Athletes: A Systematic Review and Best-Evidence Synthesis.Sports medicine (Auckland, N.Z.) · 2023Pooled it
- A Retrospective Weekly Rating of Perceived Exertion Measure May Assist Training Load Monitoring in Professional Tennis Players.Sports (Basel, Switzerland) · 2026Article
- Body Posture and Low Back Pain in Amateur Tennis Players: A Cross-Sectional Observational Study.Journal of clinical medicine · 2026Article
- Article
- Racket Sports-Related Injuries in Youth Athletes: A Narrative Review.International journal of environmental research and public health · 2026Review
- Injury prevalence and characteristics among tennis coaches in the Netherlands: a cross-sectional survey.BMJ open sport & exercise medicine · 2026Article
- The Reliability and Validity of the Leg Lateral Reach Test in Adolescent Tennis Players.Journal of human kinetics · 2025Article
- Risk Factors and Prevention of Musculoskeletal Injuries in Adolescent and Adult High-Performance Tennis Players: A Systematic Review.Sports (Basel, Switzerland) · 2025Review
- Article
- Identifying Risk Factors for Preexisting or Developing Low Back Pain in Youth, High School, and Collegiate Lacrosse Players Using 3-Dimensional Motion Analysis.Orthopaedic journal of sports medicine · 2024Article
- Shoulder Torque Production and Muscular Balance after Long and Short Tennis Points.International journal of environmental research and public health · 2022Article
- Absence of Injury Is Not Absence of Pain: Prevalence of Preseason Musculoskeletal Pain and Associated Factors in Collegiate Soccer and Basketball Student Athletes.International journal of environmental research and public health · 2022Article
- Force-Time Curve Variable Outcomes Following a Simulated Tennis Match in Junior Players.Journal of sports science & medicine · 2022Article
- Athletic Identity and Shoulder Overuse Injury in Competitive Adolescent Tennis Players: The Smash Cohort Study.Frontiers in sports and active living · 2022Article
- A Continuous Deep Learning System Study of Tennis Player Health Information and Professional Input.Computational intelligence and neuroscience · 2022Article
- Injury Risk Factors of the Tennis Serve: A Systematic Review and Meta-Analysis.Advances in rehabilitation science and practiceArticle
- Training the Adolescent Athlete.Sports healthArticle
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn young tennis players, high loads on the spine and high training volumes in relation to age are associated with a high lifetime prevalence of back pain. The primary aim of this study was to investigate if accumulated external workload "spikes" in the acute:chronic workload ratio (ACWR) of tennis training, match play, and fitness training, and if high or low workload/age ratio were associated with back pain events in competitive adolescent tennis players. Additional aims were to report the incidence of back pain stratified by sex and level of play and to describe the characteristics of players with back pain. HYPOTHESIS: Rapid increases in external workload are associated with the incidence of back pain. STUDY
designCohort study of 198 competitive tennis players, 13 to 19 years, with a weekly follow-up for 52 consecutive weeks. LEVEL OF EVIDENCE: Level 3.
methodsAccumulated external workload spikes (uncoupled ACWR >1.3), and the workload/age ratio, were time-varying exposures in Cox regression analyses with the outcome back pain (pain intensity ≥2/10 in the lower back and/or in the upper back/neck with a pain-related disability).
resultsFor each additional workload spike in tennis training/match play, the hazard rate ratio (HRR) was 1.17 (95% CI, 1.06-1.28) for back pain. The corresponding HRR for fitness training was 1.13 (95% CI, 1.05-1.22). Training workload/age ratio was not related to back pain.
conclusionAccumulated external workload spikes of tennis training, match play, and/or fitness training are associated with a higher rate of back pain events in competitive adolescent tennis players. CLINICAL RELEVANCE: Back pain is a troublesome clinical problem that may affect the performance of talented young tennis players. Structuring the training schedule to minimize rapid increases (ie, spikes) of training load on a weekly basis may enhance performance and reduce back pain in adolescent tennis players.
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