Gesellschaft für Orthopädisch-Traumatologische Sportmedizin

GOTS: Verletzungen im Tennis

GOTS – Newsletter vom 18.02.2010

Sehr geehrte Damen und Herren,

die Sportart Tennis erfreut sich einer weltweiten Beliebtheit, erfordert durch ihre Globalisierung und den damit ganzjährigen Terminkalender aber auch eine besondere Betrachtung aus der Sicht der Sportmedizin. Mehr dazu finden Sie in diesem Newsletter.

Die GOTS erwartet in Kürze ihr 1.000 Mitglied. Sind Ihre eigenen Kontaktdaten noch aktuell? Im Newsletter finden Sie Informationen, wie Sie Ihre Stammdaten auf den aktuellsten Stand bringen können. Außerdem finden Sie einen Hinweis auf aktuelle Änderungen in den Anti-Doping-Regularien.

Mit freundlichen Grüßen,
Frank Wechsel und Dr. Wolfgang Schillings, GOTS-Pressesprecher

Verletzungen und Überlastungsschäden im Tennissport

Der Tennissport erfreut sich seit vielen Jahren einer weltweiten Beliebtheit. Die langgezogene Grand-Slam-Saison mit den Turnieren in Melbourne (Januar), Paris (23. Mai bis 6. Juni 2010), Wimbledon (21. Juni bis 4. Juli 2010) und New York (30. August bis 12. September 2010) erlaubt wenig Ruhephasen, zumal viele weitere ATP-Turniere und der Davis Cup ebenfalls ihren festen Platz im Terminkalender haben.

Mit 0,08 Verletzungen pro 1.000 Stunden Sportausübung gehört Tennis nicht zu den verletzungsintensiven Sportarten. Akute Verletzungen sind selten und betreffen fast ausschließlich die unteren Extremitäten. Als Folge der im Tennissport häufigen plötzlichen Stopps und schneller Dreh- sowie Abbremsbewegungen kann es durch Umknickereignisse zu Verletzungen des Kapsel-Band-Apparates am Sprung- oder Kniegelenk kommen. Hier kommt dem Bodenbelag eine besondere – auch prophylaktische – Bedeutung zu. Auf Aschenplätzen springen die Bälle in der Regel langsamer ab, was für den Spieler eine etwas längere Reaktions- und Vorbereitungszeit bedeutet. Außerdem rutscht der Schuh auf Asche besser und bremst den Fuß nicht unvermittelt ab, so dass die Umknickhäufigkeit deutlich geringer ist als beispielsweise auf Kunststoff- oder Teppichboden.

Tennisellbogen bei Profis selten
Während der Tennissport im Volksmund mit der Epicondylopathia humeri radialis, dem sogenannten Tennisellbogen, in Verbindung gebracht wird, findet sich diese Überlastungsreaktion beim Profi äußerst selten. Die Medical Commission der Tennis-Association beschreibt in ihren Statistiken Verletzungen und Überlastungsschäden in der Ellenbogenregion nur mit einer Häufigkeit von sechs Prozent und damit weit unter der anderer Körperregionen (siehe Tabelle). Dies ist dadurch erklärbar, dass der Anfänger häufig „aus dem Handgelenk“ schlägt, wie zum Beispiel beim Tischtennis, wodurch insbesondere die Handgelenksstrecker, die am Ellenbogen ihren Ursprung haben, chronisch überlastet werden. Der Profi führt im Gegensatz dazu seine Schläge aus dem Arm mit muskulär stabilisiertem Handgelenk durch. Außerdem kommen Griffstärke und Bespannungshärte eine gewisse Bedeutung in der Entstehung der Epicondylopathie zu. Bei Anfängern sollte die Bespannungshärte 26 bis 27 kp nicht überschreiten, der Griffumfang dem individuellen Abstand von der Handflächenmittellinie bis zur Spitze des Mittelfingers entsprechen.

Wiederkehrende Mikroverletzungen
Am häufigsten taucht in den Verletzungsstatistiken der Profis die Schulter auf mit einer Häufigkeit von über 20 Prozent, gefolgt von Wirbelsäulen- und Oberschenkelproblemen (siehe Tabelle). Es handelt sich dabei weniger um akute Verletzungen als um Folgen wiederholter Mikrotraumata, die mit der sportspezifischen Belastung dieses Überkopfsportes einhergehen. Aufschläge erreichen mittlerweile sowohl bei Damen als auch bei Herren Geschwindigkeiten von über 200 Stundenkilometern (Weltrekord: Andy Roddick mit 249,4 km/h). Durch die extreme Außenrotation im Schultergelenk kommt es auf Dauer zu einer Überdehnung der vorderen Gelenkkapsel, die als Folge zu einer Fehlbelastung anderer Weichteilstrukturen wie der Sehnen der Rotatorenmuskulatur oder der Schulterlippe (Labrum) führen kann. Hier kommt der Prophylaxe durch gezielte Dehn- und Kräftigungsübungen bei muskulären Ungleichgewichten sowie einem guten Aufwärmprogramm vor Beginn des Aufschlag- und Schmetterballtrainings eine wichtige Rolle zu.

Wegen des oft sonnigen und warmen Wetters bei vielen Turnieren muss der betreuende Arzt zusätzlich zu seinen sonstigen Aufgaben beratend tätig werden bezüglich entsprechender Schutzkleidung und ausreichender und auch regelmäßiger Aufnahme von Flüssigkeit und Elektrolyten – nicht nur zwischen den Spielen, sondern auch beim Seitenwechsel.

Tabelle: Verletzungsstatistik beim Tennis (Verletzungen und Sportschäden bei 290 männlichen Tennisprofis nach Körperregion, Quelle: ATP Medical Commission)

Schulter: 58 (20,9 %)
Wirbelsäule: 43 (14,8 %)
Oberschenkel: 40 (13,8 %)
Fuß 34: (11,7 %)
Becken/Hüfte: 21 (7,2 %)
Knie: 21 (7,2 %)
Ellenbogen: 18 (6,2 %)
Hand/Finger: 6 (2,1 %)

Dr. Hans-Gerd Pieper, Zentrum für Schulterchirurgie, Arthroskopische Chirurgie und Sporttraumatologie, Roland-Klinik am Werdersee in Bremen

Neues von der WADA

Für das Jahr 2010 hat die WADA die sogenannte Blood-Spinning-Methode, d. h. die Verabreichung von PRP (Platelet Rich Plasma), ACP und ähnlichen Zubereitungen (z. B. Orthokin), genauer spezifiziert. Dies muss mit einer Erklärung zum Gebrauch bei der NADA angezeigt werden, die Anwendung wird jedoch grundsätzlich möglich sein. Die intramuskuläre Verabreichung der Präparate bleibt allerdings weiterhin verboten, lediglich die lokale Anwendung wird unter die Anzeigepflicht gestellt. Diese Regelungen gelten lt. WADA-Verbotsliste seit dem Jahresbeginn.
Prof. Dr. Holger Schmitt

In eigener Sache: Sind Ihre Kontaktdaten aktuell?

Liebe GOTS-Mitglieder,
sind wir auf dem aktuellen Stand? Bitte prüfen Sie Ihre persönlichen Daten, die in der GOTS-Datei auf der Website www.gots.org hinterlegt sind. Mit Ihrer E-Mail-Adresse haben Sie den Zugang.

Herzlichen Dank,
Ihre GOTS-Geschäftsstelle
Petra Enderlein

GOTS erwartet das 1.000 Mitglied

Die Gesellschaft für Orthopädisch-Traumatologische Sportmedizin (GOTS) wurde 1986 von Orthopäden aus Deutschland, Österreich und der Schweiz gegründet. Die schnell wachsende Anzahl von Mitgliedern aus Universitäten, Kliniken, Ambulatorien, Praxen, Sportverbänden und Vereinen, die für eine Diagnostik, Therapie und Rehabilitation sorgen, machte die GOTS nach der „American Orthopaedic Society for Sports Medicine“ (AOSSM) zur größten und bedeutendsten sportorthopädisch-traumatologischen Gesellschaft der Welt.

In Kürze wird die GOTS ihr 1000. Mitglied herzlich willkommen heißen. Zu diesem besonderen Anlass wird dieses Mitglied eine Einladung zum nächsten GOTS-Kongress erhalten.

Der GOTS-Vorstand

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  62. {Tôi đã khá hài lòng khám phá trang này. Tôi cần cảm ơn bạn {vì đã|dành thời gian cho|chỉ vì điều này|vì điều này|cho bài đọc tuyệt vời này!! Tôi chắc chắn đánh giá cao từng một chút nó và tôi đã đã lưu vào mục ưa thích để xem những thứ mới trong trang web của bạn.|Tôi có thể chỉ nói rằng thật nhẹ nhõm để tìm thấy một người mà thực sự hiểu họ là gì đang nói về trên mạng. Bạn chắc chắn hiểu cách đưa một vấn đề ra ánh sáng và làm cho nó trở nên quan trọng. Nhiều người hơn nữa phải kiểm tra điều này và hiểu khía cạnh này của. Tôi đã ngạc nhiên bạn không nổi tiếng hơn cho rằng bạn chắc chắn sở hữu món quà.|Xuất sắc bài viết. Tôi chắc chắn đánh giá cao trang web này. Cảm ơn!|Thật khó đến những người hiểu biết cho điều này, nhưng bạn có vẻ bạn biết mình đang nói gì! Cảm ơn|Bạn cần là một phần của một cuộc thi dành cho một blog trực tuyến tốt nhất. Tôi sẽ khuyến nghị trang web này!|Một hấp dẫn chắc chắn đáng giá bình luận. Tôi tin rằng bạn cần viết thêm về chủ đề này, nó có thể không là một điều cấm kỵ vấn đề nhưng thường xuyên mọi người không thảo luận chủ đề như vậy. Đến phần tiếp theo! Cảm ơn rất nhiều!|Xin chào! Tôi chỉ muốn đề nghị rất to cho thông tin xuất sắc bạn có ở đây trên bài đăng này. Tôi sẽ là quay lại trang web của bạn để biết thêm thông tin sớm nhất.|Sau khi tôi ban đầu bình luận tôi có vẻ như đã nhấp vào hộp kiểm -Thông báo cho tôi khi có bình luận mới- và từ bây giờ mỗi lần được thêm vào tôi nhận được 4 email cùng chính xác một bình luận. Có một phương pháp dễ dàng bạn có thể xóa tôi khỏi dịch vụ đó không? Cảm ơn bạn.|Lần sau nữa Tôi đọc một blog, Tôi hy vọng rằng nó sẽ không thất bại nhiều như bài này. Rốt cuộc, Tôi biết điều đó là sự lựa chọn của tôi để đọc, dù sao thì tôi thực sự tin bạn sẽ có điều gì đó hữu ích để nói về. Tất cả những gì tôi nghe được là một loạt phàn nàn về điều gì đó mà bạn có thể sửa nếu bạn không quá bận tìm kiếm sự chú ý.|Đúng với bài viết này, tôi thực sự tin rằng trang web này cần nhiều hơn nữa sự chú ý.

  63. {Tôi khá hài lòng khám phá trang web này. Tôi muốn cảm ơn bạn {vì đã|dành thời gian cho|chỉ vì điều này|vì điều này|cho bài đọc tuyệt vời này!! Tôi chắc chắn thực sự thích từng một phần nó và tôi cũng đã đã lưu vào mục ưa thích để xem điều mới trong trang web của bạn.|Tôi có thể chỉ nói rằng thật nhẹ nhõm để tìm thấy một cá nhân mà thực sự hiểu họ là gì thảo luận trên internet. Bạn chắc chắn hiểu cách đưa một rắc rối ra ánh sáng và làm cho nó trở nên quan trọng. Nhiều người hơn phải đọc điều này và hiểu khía cạnh này câu chuyện của bạn. Thật ngạc nhiên bạn không nổi tiếng hơn vì bạn chắc chắn nhất sở hữu món quà.|Tốt bài đăng. Tôi chắc chắn đánh giá cao trang web này. Tiếp tục làm tốt!|Thật khó tìm những người hiểu biết trong chủ đề cụ thể này, nhưng bạn nghe có vẻ bạn biết mình đang nói gì! Cảm ơn|Bạn cần là một phần của một cuộc thi dành cho một trang web trên internet hữu ích nhất. Tôi chắc chắn sẽ Rất khuyến nghị trang web này!|Một hấp dẫn chắc chắn đáng giá bình luận. Tôi tin rằng bạn cần viết thêm về chủ đề này, nó có thể không là một điều cấm kỵ vấn đề nhưng nói chung mọi người không nói về chủ đề những điều này. Đến phần tiếp theo! Chúc mọi điều tốt đẹp nhất!|Xin chào! Tôi chỉ muốn cho bạn một rất cho thông tin tuyệt vời bạn có ở đây trên bài đăng này. Tôi đang quay lại blog của bạn để biết thêm thông tin sớm nhất.|Sau khi tôi ban đầu để lại bình luận tôi có vẻ như đã nhấp vào hộp kiểm -Thông báo cho tôi khi có bình luận mới- và bây giờ mỗi lần được thêm vào tôi nhận được 4 email cùng chính xác một bình luận. Có lẽ có một phương tiện bạn có thể xóa tôi khỏi dịch vụ đó không? Cảm ơn rất nhiều.|Lần sau Tôi đọc một blog, Hy vọng rằng nó không thất bại nhiều như bài này. Rốt cuộc, Tôi biết điều đó là sự lựa chọn của tôi để đọc, dù sao thì tôi thực sự tin bạn sẽ có điều gì đó hữu ích để nói về. Tất cả những gì tôi nghe được là một loạt phàn nàn về điều gì đó mà bạn có thể sửa nếu bạn không quá bận tìm kiếm sự chú ý.|Đúng với bài viết này, tôi thành thật cảm thấy trang web tuyệt vời này cần nhiều hơn nữa sự chú ý.

  64. {Tôi rất hài lòng khám phá trang này. Tôi muốn cảm ơn bạn {vì đã|dành thời gian cho|chỉ vì điều này|vì điều này|cho bài đọc tuyệt vời này!! Tôi chắc chắn thưởng thức từng một phần nó và tôi cũng đã đã đánh dấu trang để xem những thứ mới trong trang web của bạn.|Tôi có thể chỉ nói rằng thật thoải mái để khám phá một cá nhân mà thực sự biết họ là gì đang nói về trực tuyến. Bạn thực sự biết cách đưa một vấn đề ra ánh sáng và làm cho nó trở nên quan trọng. Nhiều người hơn nữa cần phải xem điều này và hiểu khía cạnh này câu chuyện của bạn. Tôi đã ngạc nhiên bạn không nổi tiếng hơn vì bạn chắc chắn sở hữu món quà.|Rất tốt bài đăng. Tôi hoàn toàn yêu thích trang web này. Tiếp tục làm tốt!|Thật khó tìm những người có học thức trong chủ đề cụ thể này, nhưng bạn nghe có vẻ bạn biết mình đang nói gì! Cảm ơn|Bạn nên tham gia một cuộc thi dành cho một blog trên web tốt nhất. Tôi sẽ Rất khuyến nghị trang web này!|Một cuộc thảo luận thú vị chắc chắn đáng giá bình luận. Không còn nghi ngờ gì nữa rằng bạn nên viết thêm về chủ đề này, nó có thể không là một điều cấm kỵ chủ đề nhưng thường xuyên mọi người không nói về chủ đề như vậy. Đến phần tiếp theo! Chúc mọi điều tốt đẹp nhất.|Xin chào! Tôi chỉ muốn đề nghị rất cho thông tin tuyệt vời bạn có ngay tại đây trên bài đăng này. Tôi đang trở lại trang web của bạn để biết thêm thông tin sớm nhất.|Sau khi tôi ban đầu bình luận tôi có vẻ như đã nhấp vào hộp kiểm -Thông báo cho tôi khi có bình luận mới- và từ bây giờ mỗi lần được thêm vào tôi nhận được bốn email có cùng nội dung. Có một phương pháp dễ dàng bạn có thể xóa tôi khỏi dịch vụ đó không? Cảm ơn bạn.|Lần sau nữa Tôi đọc một blog, Tôi hy vọng rằng nó không thất bại nhiều như bài này. Ý tôi là, Tôi biết điều đó là sự lựa chọn của tôi để đọc, tuy nhiên tôi thực sự tin bạn sẽ có điều gì đó hữu ích để nói. Tất cả những gì tôi nghe được là một loạt rên rỉ về điều gì đó mà bạn có thể sửa nếu bạn không quá bận tìm kiếm sự chú ý.|Đúng với bài viết này, tôi thực sự tin rằng trang web tuyệt vời này cần nhiều hơn nữa sự chú ý.

  65. {Tôi đã háo hức để tìm thấy trang web này. Tôi muốn cảm ơn bạn {vì đã|dành thời gian cho|chỉ vì điều này|vì điều này|cho bài đọc tuyệt vời này!! Tôi chắc chắn yêu thích từng một phần nó và tôi cũng đã đánh dấu để xem thông tin mới trên blog của bạn.|Tôi có thể chỉ nói rằng thật thoải mái để khám phá một người mà thực sự hiểu họ là gì đang nói về trực tuyến. Bạn chắc chắn hiểu cách đưa một rắc rối ra ánh sáng và làm cho nó trở nên quan trọng. Nhiều người hơn nữa phải kiểm tra điều này và hiểu khía cạnh này của. Tôi đã ngạc nhiên bạn không nổi tiếng hơn vì bạn chắc chắn có món quà.|Xuất sắc bài viết trên blog. Tôi chắc chắn đánh giá cao trang web này. Tiếp tục làm tốt!|Thật khó đến những người có học thức cho điều này, nhưng bạn nghe có vẻ bạn biết mình đang nói gì! Cảm ơn|Bạn cần là một phần của một cuộc thi dành cho một blog trên internet có chất lượng cao nhất. Tôi sẽ Rất khuyến nghị trang web này!|Một hấp dẫn chắc chắn đáng giá bình luận. Tôi tin rằng bạn nên viết thêm về chủ đề này, nó có thể không là một điều cấm kỵ vấn đề nhưng nói chung mọi người không nói về chủ đề như vậy. Đến phần tiếp theo! Cảm ơn rất nhiều!|Chào buổi sáng! Tôi chỉ muốn cho bạn một rất to cho thông tin tuyệt vời bạn có ở đây trên bài đăng này. Tôi sẽ là quay lại blog của bạn để biết thêm thông tin sớm nhất.|Sau khi tôi ban đầu để lại bình luận tôi có vẻ như đã nhấp hộp kiểm -Thông báo cho tôi khi có bình luận mới- và từ bây giờ mỗi lần được thêm vào tôi nhận được bốn email có cùng nội dung. Có một phương pháp dễ dàng bạn có thể xóa tôi khỏi dịch vụ đó không? Cảm ơn bạn.|Lần sau Tôi đọc một blog, Tôi hy vọng rằng nó sẽ không thất bại nhiều như bài này. Ý tôi là, Tôi biết điều đó là sự lựa chọn của tôi để đọc, dù sao thì tôi thực sự tin bạn sẽ có điều gì đó thú vị để nói về. Tất cả những gì tôi nghe được là một loạt rên rỉ về điều gì đó mà bạn có thể sửa nếu bạn không quá bận tìm kiếm sự chú ý.|Đúng với bài viết này, tôi hoàn toàn tin rằng trang web tuyệt vời này cần nhiều hơn nữa sự chú ý.

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