Risk factors for musculoskeletal injuries in elite junior tennis players: a systematic review

The objective was to systematically review the literature on risk factors and prevention programs for musculoskeletal injuries among tennis players. PubmedMedline, Embase, CINAHL, Cochrane, SportDiscus were searched up to February 2017. Experts in clinical and epidemiological medicine were contacted to obtain additional studies. For risk factors, prospective cohort studies (n > 20) with a statistical analysis for injured and non-injured players were included and studies with a RCT design for prevention programs. Downs&Black checklist was assessed for risk of bias for risk factors. From a total of 4067 articles, five articles met our inclusion criteria for risk factors. No studies on effectiveness of prevention programs were identified. Quality of studies included varied from fair to excellent. Best evidence synthesis revealed moderate evidence for previous injury regardless of body location in general and fewer years of tennis experience for the occurrence of upper extremity injuries. Moderate evidence was found for lower back injuries, a previous back injury, playing >6hours/week and low lateral flexion of the neck for risk factors. Limited evidence was found for male gender as a risk factor. The risk factors identified can assist clinicians in developing prevention-strategies. Further studies should focus on risk factor evaluation in recreational adult tennis players