13/05/2021
「網球手與網球手」 - 網球肘 (Lateral Epicondylitis)
網球肘 (臨床命名 Lateral Epicondylitis，普遍稱為 Tennis Elbow) 本來是網球手的常見勞損性傷。在職業網球界別中，網球肘長居常見傷患首三位。
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臨床定義為「腕伸肌肌腱及其於肘部的接合位置的勞損性傷患」，而其傷患產生機制暫時仍未有絕對家論。普遍理論認為是肌腱血管微損傷 (microvascular trauma)、皮層神經線受傷 (cutaneous nerves injury)和腕伸肌肌腱因磨擦而產生勞損是導致網球肘的機制。(Winston et al 2015)
而球拍的發展，令擊球力量大幅提昇外，還意外地增加了腕伸肌的負荷，也是一個值得研究的課題。Miller et at 2006 有關網球拍、網球和場地才質的文獻，影響了很多器材的設計和發展：
“Larger racquet head sizes allow the ball to be hit away from the central axis of the racquet; this generates a higher torque of the racquet in the hand. Consequently, this torque must be opposed by eccentric loading of the forearm muscles, which may induce microtrauma to the extensor muscles of the wrist and possibly cause tennis elbow.” - Miller et al 2006
因為球拍設計，擊球的 sweet spots 亦有所不同。因為專業球手擊球的穩定性比較高，所以肌肉及軟組織因要不斷適應而產生的負荷會較低，雖然訓練量很高，然而患上網球肘的機會反而比業餘球手還要低。還有，現在的材質科學發達，球拍的緩震能力也大大提升，對減低負荷也有很大幫助。
“… three “sweet spots” in a tennis racquet: (1) the center of percussion, (2) the location on the strings where the highest rebound velocity occurs, and (3) the location of the impact that leads to low, smooth oscillations at the grip. Tennis players attempt to hit the ball at the center of all three sweet spots, and expert players are able to hit this location most consistently, thereby minimizing loads on the wrist and arm… racquet oscillations ranging from 80 to 200 Hz may contribute to the development of tennis elbow. Thus, vibration, in addition to racquet torque and “shock” to the arm, have all been implicated as causes of tennis elbow.” - Dines et at 2015
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物理治療所與運動訓練中心的結合，能替學員提供更立即性的服務。物理治療師提供肌肉骨骼問題的專業問診與評估，分析問題根源，利用物理治療的 3M (Movement/Manual/Modality) 治療方法，以改善症狀、優化動作品質，並預防傷害再發生。我們也提供進一步肌力體能訓練之銜接轉介及傷害風險管控，替學員的健康與安全把關。
立刻查詢，我們專員與你聯繫：
https://www.sportsline.com.hk/pages/physio-service
初步了解你的狀況後，我們會有專員與你聯繫，安排適合你的物理治療與運動訓練服務。
Reference:
- Dines J.S., et al. Tennis Injuries: Epidemiology, Pathophysiology, and Treatment. JAAOS — Journal of the American Academy of Orthopaedic Surgeons: March 2015 — Volume 23 — Issue 3 — p 181–189
- Gescheit DT, Cormack SJ, Duffield R, et al. Injury epidemiology of tennis players at the 2011–2016 Australian Open Grand Slam. Br J Sports Med 2017;51:1289–1294
- Miller S: Modern tennis rackets, balls, and surfaces. Br J Sports Med 2006;40(5): 401–405
- Soligard T, Steffen K, Palmer D, et al. Sports injury and illness incidence in the Rio de Janeiro 2016 Olympic Summer Games: A prospective study of 11274 athletes from 207 countries Br J Sports Med 2017;51:1265–1271
- Winston J., Wolf J. (2015) Tennis Elbow: Definition, Causes, Epidemiology. In: Wolf J. (eds) Tennis Elbow. Springer, Boston, MA
