Serving Up Pilates Andy Murray, Serena Williams and Pat Cash all swear by it, so with Wimbledon upon us, Lawn Tennis Association coach and qualified Pilates Foundation teacher Vivian Gabb discusses the injuries that can occur during a tennis player’s serve and explains how Pilates can help. I know from my experience as a tennis player and coach for 30 years that tennis at a high level puts the body under enormous strain. After I played a gruelling first ‘futures’ tournament match some 27 years ago, I came off the court barely able to move. I was in a lot of pain. The tournament physiotherapist diagnosed the beginning of a prolapsed disc. She warned me that if I didn’t change my serve action, I would not be playing tennis for very long. Other tennis injuries followed. I didn’t realise how fit I needed to be to play competitively, and overuse injuries occurred. I hardly left time for my body to heal. It went from small nagging aches to debilitating injuries and eventually operations. After one operation for a knee meniscal tear, the surgeon suggested I should try integrating Pilates into my fitness routine. After doing some research, I found some of Pat Cash’s testimonials about Pilates: ‘I was amazed at how gentle, yet totally effective the exercises were. With … Pilates, I was able to continue playing tennis at the top level and the exercises remain a key part of my exercise programme.’ In recent years Pilates has become part of the fitness routine of players including Serena Williams and Andy Murray. During his 2012 ATP World Tour Finals preparation, Andy Murray was reported in The Daily Express as saying, ‘I started doing Pilates a few weeks ago which has already helped. I did three or four Pilates sessions and my body feels good compared to the last few years … I have practised well the last few days and not been waking up with soreness or stiffness.’ Serena Williams tried Pilates when she wanted to lose weight. ‘I wanted to get really fit ... I’ve been doing Pilates and yoga, trying to lean out my body so I won’t be bulky … Pilates gave me results within a week.’

The serve: how it works According to Bette Pluim and Marc Safran in From Breakpoint to Advantage, the serve’s main component is ‘the instant in which the racket meets the ball at peak height … meaning the dominant arm is at full stretch above the head. At this stage all the muscles are working to discharge the energy that has been stored within each cell toward the ball.’ If the ball is accurately served into the receiver’s court, the point is in play. If however, through some muscular imbalance, the ball is over-hit or put into the net, a second serve is allowed. In the loading phase, the player prepares, visualising the service action and where they want to direct the ball. This could be repeated 300 times in a set, so rhythm, coordination and fluidity are crucial. The sequence is initiated by knee flexion. The player’s arm extends into the ball toss. In a right-handed player, the racquet arm moves to the right side of the body and the trunk follows. This trunk rotation starts the coiling effect to the body. When Serena Williams serves, she transfers her weight back as she pushes into the ground for power. Her knees bend. She moves her racquet into ‘the throwing’ position. Her spine goes into hyperextension. Her feet begin to leave the ground.

Serena’s dominant shoulder and elbow are in external rotation. She prepares to extend up to the ball. Her accumulated power, generated by what Joseph Pilates calls the ‘dynamic kinetic chain’, is released. Then comes the explosive acceleration phase. Serena goes to the maximum elevation of her body. Her trunk and shoulder are into internal rotation. She is in the air. She hits the ball. (Her strong core muscles prevent her upper body from collapsing.) The power started from ground reaction forces is now transferred from the legs to the hips/pelvis/trunk through the middle and upper back, then into the shoulder, arm, wrist and

ultimately to the racquet and ball. She follows through. She lands on her left foot inside the baseline. Her racquet arm and shoulder decelerate. The dynamic kinetic chain is complete. The explosive nature of the serve means that a player can be vulnerable to injury. Andy Murray’s fastest serve at Wimbledon last year was 133 mph. Serena William’s fastest serve was not far behind at 123 mph. With this sudden burst of energy from the serve, it is not surprising that this particular tennis action is the most likely stroke to cause injury. Strains that the serve puts on the body and how Pilates reduces injury risks Here are some typical injuries that occur with the serve and how Pilates exercises may promote core strength, flexibility and more muscle control. Knee injury Knee pain can occur when extending during the service action or when landing on one leg after hitting the ball. The knee can be vulnerable if it lacks the strength and flexibility needed to transmit the energy and absorb the impact. Injuries may be caused by repetitive wear and tear or by an imbalance in the muscles of the leg. Pilates exercises: To correct this imbalance of the muscle in the legs, the following exercises can be used: On the Reformer: The footwork series to strengthen the back and the front of the leg. Foot and ankle joint motion and control exercises. On the Wunda Chair: Calf raises for calf strengthening and flexibility and hamstring stretches. Abdominal strain After a long match, abdominal strain would not be surprising. The abdominal muscles are stretched when the back is in hyperextension. When the stored energy is released, the abdominal muscles contract powerfully, leading to a high risk of abdominal strain. Pilates exercises: Abdominals are key to the Pilates concept of ‘powerhouse’ and ‘core strength’ and there are many exercises to strengthen the abdominals. Mat work: Hundreds Oblique lifts Single leg stretch Double leg stretch On the Reformer: The lunge Rowing to increase abdominal control, flexion and extension. On the Cadillac: Swan dive Integrated roll-up Graham sit-up The Spine

During the serve, the spinal column has to go from rotation to hyperextension to flexion. This repetitive motion could be done 300 times in a match and can cause distress in the lower back. Lack of rhythm and precision in this repetitive action could lead to straining muscles and back pain. Pilates exercises: On the Wunda Chair: The Mermaid with rotation, which should increase flexibility and strength in the trunk. On the Cadillac: The Integrated Roll-up is an effective exercise to strengthen the muscles of the back and abdominals. Shoulder injuries Strain on the shoulder occurs at the acceleration phase because high forces act on the shoulder joint to pull the arm forward. The shoulder is the most mobile joint of the body, but also the least stable. The repetitive pulling of the rotator cuff tendons, particularly the superspinatus muscle, may lead to inflammation, pain and a tear. The tell-tale symptom for this condition is usually the pain caused by bringing the arm away from the body. Further symptoms may be weakness of the shoulder and the inability to lift the arm above the shoulder. Small arthroscopic rotator cuff repair with subacromial decompression may be required. Pilates exercises: On the Reformer: Side arm preps kneeling to strengthen the rotor cuff and enhance scapular stabilisation and strengthen the wrist. On the Cadillac: Hug a tree Circles which increases the range of motion in the glenohumeral joint. Elbow injuries With the serve, the elbow comes under an excessive load and stress during the point of contact or during the acceleration phase. Cubital Tunnel Syndrome is a disorder in the elbow and arm which causes pain on the inner side of the elbow. The symptoms can be numbness and tingling in the hand. This could be caused by loose ligaments at the elbow or nerve pain inside the elbow. Posterial impingement syndrome of the elbow occurs, when the ulnar bone of the forearm is jammed into the end of the humerus (causing cartildge damage). The telltale symptoms: pain and tenderness at the elbow, swelling of the elbow, stiffness and an inability to straighten the elbow. With a high-speed serve movement, the elbow goes from flexion into extension. The muscles of the arm need to be strong to support the elbow joint with the sudden release of energy into the serve. Pilates exercises: On the Reformer: Rotator cuff exercises – elbow abduction/adduction and medial/lateral rotation Drawing a sword Side bend Both arms with trunk rotation Mid-back series

The Wrist In the serve, we can find that the wrist is not quite balanced. Strengthening the wrist would help prevent injuries. Wrist pain is usually felt when contact is made with ball. The range of motion with the wrist during the serve is an arc of approx 90-100% flexion/extension. The repetitive movement can caused over stretching. Strengthening the elbow will also help to prevent injuries. Pilates exercises: Kneeling salute is an effective exercise to strengthen elbow extenders and shoulder abductors. Combination of stretching exercises plus hand/wrist strengthening exercises like squeezing a tennis ball is effectice. Rolling a flexiband on a pole Conclusion It started with an instinctive love of tennis. Competitions, wear and tear and experience slowly made me aware of the amazing complexity and intelligence of the body. The discovery of Pilates gave me a second love that improved my tennis and my quality of  life.