Scapular Stabilization

As I promised in an earlier blog, an important topic to cover for injury prevention is the musculature of the upper back. I refer to these muscles as a child's 'shock absorbers'. The repetitive load that is transferred to the dominant arm can cause micro-trauma over time. When a child 'plays up' or practices constantly with older children they are exposed to even greater stress on this kinetic chain. Inflexibility and muscle strength imbalances in the shoulder causes a 'rolling forward' of the shoulders and a posture that is a precursor to injury. Combined with weak posterior musculature, this posture (more common in growing boys than girls) can lead to a breakdown somewhere in the chain (wrist, elbow, shoulder).

The key to your child's health is striking a balance between participation and prevention. Remember that prior to puberty, changes in strength are mainly due to neurological adaptations. In the absence of hormones these changes are hard to maintain. "If you don't use it-you lose it." Prevention is a daily task and the scapular stabilizers are the most important muscle group to attend to.

A quick check to see if your child has proper 'shock absorbers' can be done by having them stand shirtless facing away from you. Have them hold a small soup can in each hand and make a Y with their arms. Inspect whether their scapula 'wing out'. Most young children have winging scapula so don't panic.



The long bone of the arm (humerus) is held in place by two major muscle groups. The rotator cuff is made up of four muscles that originate on the scapula and attach on the humerus. The scap stabilizers (trapezius, serratus and rhomboids) originate on the spine and attach to the scapula. Together these muscles keep the humerus centered in the shoulder joint and provide stability during movement. As stated earlier, the combination of weak posterior musculature, anterior inflexibility and the overuse nature of the sport has created a 'perfect storm' of circumstances that often lead to injury.

The exercises in the video below can be done daily. Light resistance tubing or dumbbells should be used and the athlete should complete 3 sets of 12-15 repetitions. For the mat and ball exercises, sets of 10-20 reps can be done. This routine should be completed after playing tennis and should only take 10-15 minutes. It can be done in conjunction with daily core strengthening as a part of the 'homework' program.

The Road to Cardiovascular Fitness

A frequent question that I receive from parents of young children pertains to cardiovascular fitness and the efficacy of long runs to accomplish this. The question is a simple one but the answer is a little complicated. I will do my best to K.I.S.S.
(Keep it simple, silly).

Children who are growing will have a 70-80% increase in aerobic fitness simply due to the growth and development of their heart,lungs and muscles. So without ever running around the block, on the track, or on the court, your child's cardiovascular (CV) fitness will improve naturally. I don't recommend that you and your child celebrate by sitting on the couch and eating Bon Bons but this is an important fact.

Pediatric exercise research is limited but the results that exist suggest that training at a higher percentage of your child's maximal heart rate (sprints) for short bursts is much more effective at increasing overall CV fitness than long, slow, sub-maximal runs. As long as the volume (amount) is monitored and the child is not having growing pains, this is the desirable way to train young tennis players. The most enjoyable way for children to do sprints is through 'speed play'. Tag, relay races and shuttle runs are all examples of games that accomplish this goal, encourage socialization and are fun!

When I train young athletes I try to use many different footwork drills and vary the time (10-30 sec) it takes to complete each. I then give them approximately 30 seconds of rest. This is not only tennis specific but works with the short attention span most children have. These drills can be completed daily and are best early in the workout when the athlete is fresh. Not only is the child improving their CV health but they are improving their tennis footwork which can be challenged as they grow.

The attached video gives an example of some simple and fun drills.