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GOTS: Verletzungen im Tischtennis

GOTS: Verletzungen im Tischtennis

GOTS – Newsletter vom 12.09.2009

Sehr geehrte Damen und Herren,

am Sonntag beginnt in Stuttgart die Tischtennis-Europameisterschaft 2009. Auch im Spiel mit der leichten Kugel drohen Verletzungen – weitere Informationen finden Sie in diesem Beitrag.

Alle Beiträge dieses Newsletters sind zur weiteren Veröffentlichung freigegeben.

Mit freundlichem Gruß,
Frank Wechsel, GOTS-Pressesprecher

Verletzungen im Tischtennis

Vom 13. bis 20. September findet in der Porsche Arena Stuttgart die Tischtennis-Europameisterschaft 2009 statt. Neben dem Mannschaftswettkampf wird die Einzel- und Doppel-Europameisterschaft ausgespielt. Die Erfolge der deutschen Männer bei den vergangenen zwei Europameisterschaften mit gewonnenen Titeln sowohl im Mannschafts- als auch im Doppel- und Einzel-Wettkampf geben berechtigte Hoffnung auf weitere sportliche Erfolge.

Tischtennis ist eine sehr komplexe Sportart und gehört zu den schnellsten Rückschlagspielen. Es treten Spitzengeschwindigkeiten des Balles zwischen 170 und 190 Stundenkilometern auf. Dem Athleten bleibt lediglich eine Reaktionszeit zwischen 0,07 und 0,25 Sekunden, um seine nächste Aktion durchzuführen. Nicht nur eine schnelle Reaktionszeit, sondern auch eine gute Sehkraft wird benötigt, um den rotierenden Stempel des Zelluloid-Balles mit Rotationen von bis zu 3000 Umdrehungen pro Sekunde erkennen zu können.

Tischtennis gehört zu den Intervallsportarten mit Belastungen von 3 bis 5 Sekunden und einer Pause von etwa 7 Sekunden. In der Aktionsphase findet der Stoffwechsel ausschließlich anaerob-alaktazid, über das ganze Spiel gesehen aerob statt. Ein Match dauert 20 bis 40 Minuten. Über einen Turniertag verteilt können schon mal vier bis sechs Spiele mit Belastungspausen von 10 Minuten bis zu 4 Stunden auftreten. Während der Spiele werden Pulswerte von 80 bis 170 Schlägen pro Minute erreicht. In den Spielunterbrechungen sinkt die Herzfrequenz um 20 bis 40 Schläge ab.

Zu den Voraussetzungen von Tischtennisspielern gehören insbesondere Schnelligkeit, Schnellkraft, Ausdauer, Koordination und Beweglichkeit sowie die Fähigkeit, sich zwischen den einzelnen Spielen schnell zu regenerieren.

Muskuläre Verletzungen
Beim Tischtennis kann es an allen Extremitäten zu Muskelverletzungen wie Zerrungen, Prellungen bis hin zu Muskelfaserrissen kommen. An den Armen werden vor allem der Bizeps- und Trizepsmuskel durch die hohen Beschleunigungskräfte bei Topspinschlägen beansprucht. Gerade das Spiel eines Angreifers gegen einen Abwehrspezialisten erfordert von diesem eine vermehrte Muskelarbeit infolge längerer Ballwechsel sowie den Rückschlägen des stark rotierenden/angeschnittenen Balls.

Muskelverletzungen an den Beinen im Adduktorenbereich sind auf schnelle Richtungswechsel und Ausfallschritte zurück zu führen. Gerade im ansatznahen Bereich der Schambeinfuge kommt es zu chronischen Sehnenansatzverletzungen oder Muskelfaserrissen.

Instabilitäten
Instabilitäten können im Bereich der Lendenwirbelsäule in Form von Gleitwirbeln auftreten. Die nach vorne gebeugte Grundhaltung im Tischtennis, das Kurzspiel über der Platte und die einseitige Belastung durch die Rotation bei der Ausholbewegung begünstigen den Entstehungsmechanismus.

Zahlreiche Spieler zeigen eine gewisse ventrale Instabilität der Schlagarm-Schulter. Dies führt zu wiederkehrenden Sehnenansatzverletzungen im Bereich des großen und kleinen Brustmuskels sowie zu Impingementerscheinungen durch Kompression der Sehne des Supraspinatus-Muskels im so genannten subacromialen Raum. Auch Schleimbeutelentzündungen in diesem Bereich kommen häufig vor.

Traumatische Verletzungen
Traumatische Verletzungen sind beim Tischtennis eher selten. Am häufigsten sind Umknickverletzungen des Sprunggelenks bei Ausfallschritten oder Seitwärtsbewegungen mit dadurch bedingten Läsionen des Kapsel-Band-Apparates. In letzter Zeit sind zudem Distorsionen des Kniegelenks mit Riss des vorderen Kreuzbandes durch schnelle Vorwärts-Rückwärtsbewegungen gehäuft aufgetreten. Als Verletzungsursache kommt hierbei der Kontakt mit der Seitenbegrenzung mit multiplen Prellungen in Frage.
Verletzungen an der Schlaghand treten nach erfolgtem Kontakt mit dem Tisch während der Schlagausführung auf. Hier sind besonders Hautverletzungen und Blutergüsse unter der Fingernagelplatte zu nennen.

Prophylaxe
Nicht nur regenerative Maßnahmen in Wettkampfzeiten und Trainingslagern stehen im Vordergrund der Verletzungsvorbeugung, sondern auch die Statik des Skeleto- und Myofascialen-Systems. Hierbei sollten die für den Sport spezifischen Anpassungserscheinungen, wie zum Beispiel eine gewisse Hypermobilität des unteren Sprunggelenks bei Sidestep-Bewegungen, nicht aufgehoben werden. Langfristig sind gezielte Therapien der „Problemzonen“ und muskulären Dysbalancen anzugehen. Durch den gedrängten Turnierplan mit vielen Wettkämpfen und damit verbundenen Reisen ist eine dauerhafte Therapie und prophylaktisches Training nur eingeschränkt möglich.
In diesem Zusammenhang sind auch allgemeine Fitnessvoraussetzungen von zunehmender Bedeutung. Sowohl in der Saisonvorbereitung als auch in der laufenden Saison sollte daher neben einem regelmäßigen Krafttraining auch ein gutes Grundlagenausdauerniveau angestrebt werden. Dies schafft die Voraussetzungen für eine erhöhte Belastbarkeit in den Trainingsmaßnahmen sowie eine verbesserte Regeneration zwischen den wiederholten Wettkampfbelastungen insbesondere im Rahmen von großen Turnieren wie den anstehenden Europameisterschaften.

Medizinische Betreuung
In der Wettkampfbetreuung sind akute regenerative Maßnahmen wichtig. Die Pausen zwischen den Spielen müssen dafür optimal genutzt werden. Häufig kommt es durch das viele Reisen in teilweise sehr unterschiedliche Klima- und Zeitzonen zu Erkältungen. Während einer Europa- oder Weltmeisterschaft besteht das medizinische Betreuerteam aus einem Mannschaftsarzt und zwei Physiotherapeuten. Der Arzt hat disziplinübergreifende Aufgaben und muss neben der Akutversorgung von kleineren Blessuren während der Wettkämpfe auch die allgemeinmedizinisch-internistische Versorgung, beispielsweise von Infekten und Magen-Darm-Problemen, vor allem in den Regenerationsphasen zwischen den Wettkämpfen absichern. Insbesondere durch die überschaubare Größe d es Teams bedarf es einer guten interdisziplinären Zusammenarbeit und einem perfekten Zusammenspiel des gesamten Betreuerteams. Nur eine optimale Versorgungsstruktur im Umfeld ermöglicht es dem Athleten, seine optimale Leistung abzurufen und ist damit eine wichtige Voraussetzung für den Erfolg einzelner Athleten wie auch des gesamten Teams.

Autoren: Cand. med. Martin Ulrich, Physiotherapeut der deutschen Tischtennis-Nationalmannschaft, Mitglied der deutschen Olympiamannschaft 2008 in Peking, medizinischer Unterassistent in der Rennbahnklinik Basel (Dr. L. Weisskopf Dr. B. Segesser), und Dr. Bernd Wolfarth, leitender Oberarzt der Abtlg. Präventive und Rehabilitative Sportmedizin am Klinikum rechts der Isar der TU München, Olympiaarzt des Deutschen Olympischen SportbundesDr. Wolfgang Schillings

Die GOTS-Geschäftsstelle

Bitte notieren Sie die neuen Kontaktdaten der GOTS:
GOTS-Geschäftsstelle
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E-Mail: info@gots.org

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