title: Injury rates in recreational tennis players do not differ between different playing surfaces.
abstract: OBJECTIVE
  The aim of this study was to determine whether there is a difference in the prevalence of tennis injuries between the four most common court surfaces in the Netherlands, including hard court, clay, sand-fill artificial grass and red-sand-fill artificial grass. Natural grass was not included in this study.
  
  
  METHODS
  This was a repeated cross-sectional study over 6 months, involving members of the Royal Netherlands Lawn Tennis Association (KNLTB). A monthly questionnaire was sent to a random sample of 20 000 KNLTB members, stratified by their club's playing surface. The questionnaire included questions on court surface, tennis exposure and physical complaints, using the Oslo Sports Trauma Research Centre questionnaire on health problems.
  
  
  RESULTS
  A total of 3656 (18%) of the 20 000 invited members completed at least one of the monthly questionnaires [mean age 49 years (15)]. A total of 4047 injuries were reported by 1957 respondents. Of these injuries, 3246 (80%) were overuse and 801 (20%) were acute. There were no statistically significant differences in injury prevalence between groups who played primarily on any one of the four court surfaces. However, players who played on multiple surfaces had a higher injury prevalence, particularly of overuse injuries, than those who primarily played on one court surface. Compared with the other court surfaces, there was a higher prevalence of lower limb overuse injuries when playing on hard court.
  
  
  CONCLUSIONS
  There is no significant difference in the overall prevalence of injury on clay, hard court, sand-fill artificial grass and red-sand-fill artificial grass.
authors.affiliation: Department of Sports Medicine, Royal Netherlands Lawn Tennis Association, Amersfoort, The Netherlands.|Amsterdam Collaboration on Health and Safety in Sport, Department of Public and Occupational Health & Amsterdam Movement Sciences, VU University Medical Center, Amersfoort, The Netherlands.
authors.forename: Babette M
authors.initials: BM
authors.lastname: Pluim
authors.affiliation: Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Clarsen
authors.affiliation: Amsterdam Collaboration on Health and Safety in Sport, Department of Public and Occupational Health & Amsterdam Movement Sciences, VU University Medical Center, Amersfoort, The Netherlands.
authors.forename: Evert
authors.initials: E
authors.lastname: Verhagen
mesh_terms: D000328:Adult; D001265:Athletic Injuries / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D012090:Cumulative Trauma Disorders / Q000453:epidemiology; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000293:injuries; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D000072264:Sports and Recreational Facilities / Q000145:classification*; D013715:Tennis / Q000293:injuries*
keywords: Epidemiology; Injury prevention; Overuse injury; Tennis