Table 2 Rehabilitation program for RA injuries in tennis players.

Stage	Tasks
1. Control of pain and inflammation, and protection	Rest is the hallmark of this stage – avoid any participation in tennis
	Cryotherapy on painful area (20 min every 2–3 h)
	Physical therapy
	Evaluation of entire kinetic chain and core stability
2. Isometric strengthening and stretching	Start isometric contractions in a supine position, with the knee and hip flexed (3 sets of 10–20 repetitions, twice a day)
	Progressive passive stretching, starting with the supra‐umbilical portion of the RA
	Conditioning of uninjured links (shoulder, hip, and knee) of the service kinetic chain and core stability training
3. Concentric strengthening	Common abdominal exercises with the hip and knee flexed (“crunches”), and sets of 20–30 repetitions, progressing to more dynamic exercises (eg, bent knee sit‐ups)
	Increase time of stretching position to 7–20 s
	Add strengthening exercises for oblique abdominal muscles (fig 6) and the lower RA muscle (eg, “reverse crunches”, “hanging knee‐up”), and core stability training
	Tennis practice can be allowed, avoiding overhead shots (service, smash, high ground strokes and volleys)
4. Eccentric strengthening and plyometrics	Declined plane exercise (low speed) (fig 7) with the emphasis on proper downfall control
	Progression to faster movements, alternating with weights and, finally, moving on to fast exercises with light to moderate weights
	Start hitting second services and overhead ground strokes, and start playing matches
	Technical correction of service motion errors that predispose to this type of injury: too high ball toss, lumbar hyperextension, excessive top spin shot, etc.
	Throwing exercises with free weights and medicine balls (fig 8), and multiarticular movements
	Plyometric training (final phase of the rehabilitation programme) – exercises with appropriate shortening‐stretching cycle times (similar to the service cycle), with sets of 6–8 repetitions, progressing to maximum power (figs 9 and 10)
	Tennis service practice (interval – full)
	Return to competition
5. Maintenance and re‐injury prevention	Keep up exercises of phases 3–4 during the competitive period, 2–3 times per week