Net Gains

Wagmag.com—December 27, 2011

When professional tennis players hit the court, they have a lot on the line.

They are fighting for their rankings, their reputations – and in most cases, their livelihoods.

When an amateur picks up a racket, the stakes are usually not as high. But the risks to one’s health can be the same the pros face, Joshua Dines says.

Joshua Dines, an orthopedic surgeon who’s a physician for the United States Davis Cup team, says players of all skill levels encounter a lot of the same issues when it comes to playing – and staying – healthy.

Dines is more than a keen observer of play both professional and amateur. He has come in contact with countless professional athletes through his work. Besides being a member of the Sports Medicine Service at Hospital for Special Surgery in Manhattan, Dines is also a consultant for the Los Angeles Dodgers and a team orthopedist for the Long Island Ducks, a minor-league baseball team

Dines – whose father, David Dines, is the medical director of the Association for Tennis Professionals – has treated everyone from former No. 1-ranked Andy Roddick to the weekend warrior headed to the country club to the high school student striving for a tennis scholarship. He has seen the pro game volley into high gear with a more aggressive style of play, as exemplified by Novak Djokovic and Rafael Nadal, the current No. 1 and No. 2, respectively.

“The pro game has become so much more physical,” Dines says. Players, he says, are simply bigger and stronger, often reaching 6-foot-4 and topping 200 pounds. “They could play any sport, but chose tennis.”

And that play is intense, no matter who’s serving.

“It’s faster… They hit the ball harder than 10 years ago,” he says. “As soon as the bar is raised, it trickles down to the amateur level, as well.”

Amateurs are not only mimicking the style they see, they’re having some of the same issues with injuries to their knees, ankles, elbows and shoulders.

“From that perspective, we do see more injuries, even at the amateur level.”

Two sets of challenges

Dines says when it comes to amateurs, there are basically two kinds.

The weekend warriors are those who might simply play a casual match or participate in a weekly league.

“In that group, injuries are still an issue. In the winter, you see a lot of problems.”

“We’re seeing a lot more overuse injuries, especially in the younger age group. I see that in baseball players as well.”

Younger players are more prone to ankle sprains and knee injuries. As intensity progresses, these turn into rotator cuff concerns and tendonitis, affecting both the knee and elbow.

“Doing things with incorrect technique or form predisposes you to injury.”

The most common problems include rotator cuff tears, shoulder dislocations and anterior cruciate ligament (ACL) tears. Dines has a particular interest in joint replacement, shoulder surgery and tendon injuries.

Should surgery be warranted, he can avail himself of the latest research and most cutting-edge techniques – no pun intended – in less invasive, arthroscopic approaches to shoulder, elbow, knee and ankle problems.

A love of the game

Dines enjoys working with the world’s top athletes.

“There’s cachet there. It’s fun. It’s celebrity.”

“If you’re treating the most elite athletes, it helps in treating the people who don’t have to get to that level.”

After all, if Dines can say he counseled Roddick to sit out a tournament, then it gives him credibility when telling future Federers that a break may be warranted.

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