title: Wrist injuries in nonprofessional tennis players: relationships with different grips.
abstract: BACKGROUND
  Recent advances in tennis teaching techniques have been applied in nonprofessional tennis players to develop a more effective play. Hits with enormous amount of top-spin and lower technical and physical training are responsible for most wrist injuries in nonprofessional tennis players.
  
  
  OBJECTIVE
  The use of different grips (Eastern, Western, semi-Western) determines the pattern of wrist injuries in nonprofessional tennis players.
  
  
  METHODS
  Cross-sectional study; Level of evidence, 3.
  
  
  METHODS
  Between January 2006 and August 2007, we evaluated 370 nonprofessional division III and IV tennis players. The screening consisted of a questionnaire appropriately prepared to investigate wrist injuries. Medical records of players who reported a wrist injury were reviewed. Body mass index, years of practice, weekly hours of training, racket weight, grip (Eastern, Western and semi-Western), kind of strings, injury type, time out of competition, and therapy (medical or surgical) were recorded. Statistical analysis was performed to assess the association of different wrist injuries with these variables.
  
  
  RESULTS
  A total of 320 players reported no injuries in their activity; 50 (13%) reported injuries to the wrist. Medical records of these players were reviewed, and 30 extensor carpi ulnaris lesions, 3 lesions of the extensor tendons, 5 injuries to the flexor carpi radialis, 6 de Quervain diseases, 5 triangular fibrocartilage lesions, and 1 intersection syndrome were found. Ulnar-sided injuries were more frequently associated with Western or semi-Western grips while radial-sided injuries were associated with Eastern grip (chi(2) = 20.7; P < .001). Average time out of competition was 69 days; 4 players underwent surgery; the others received medical and rehabilitative therapy. No differences were observed regarding body mass index, years of practice, weekly hours of training, racket weight, and strings.
  
  
  CONCLUSIONS
  In nonprofessional tennis players with wrist injuries, different grips of the racket are related to the anatomical site of the lesion: Eastern grip with radial-side injuries and Western or semi-Western with ulnar-side injuries. Knowledge of this relationship may influence training, prevention, diagnosis, and therapy of wrist problems in nonprofessional tennis players.
authors.affiliation: University of Genova, Italy. atagliafico@sirm.org
authors.forename: Alberto Stefano
authors.initials: AS
authors.lastname: Tagliafico
authors.forename: Pietro
authors.initials: P
authors.lastname: Ameri
authors.forename: Johan
authors.initials: J
authors.lastname: Michaud
authors.forename: Lorenzo E
authors.initials: LE
authors.lastname: Derchi
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Sormani
authors.forename: Carlo
authors.initials: C
authors.lastname: Martinoli
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D019876:Sports Equipment; D011795:Surveys and Questionnaires; D013715:Tennis / Q000293:injuries*; D014954:Wrist Injuries / Q000209:etiology*; D055815:Young Adult