Physiotherapy to fix a forehand

As one of the UK’s leading London physiotherapists, I regularly write about injuries, treatment and assessment techniques.

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15-YEAR-OLD DAN WAS TRAINING TO BE A PROFESSIONAL TENNIS PLAYER WHEN HIS COACHES FIRST SENT HIM TO ME IN 2014.

Despite his putting in plenty of work on court, Dan’s forehand was inconsistent as he struggled to turn his thorax. This problem had a surprising source – his feet!

Using the Integrated Systems Model to assess him, I broke down Dan’s forehand into small tasks, making him move slowly and repeatedly so that I could analyse where the breakdown was occurring.

When you take your racket back for a forehand, you have to twist your thorax. Dan could rotate his thorax perfectly to the left, but not to the right. Bingo! This was why he couldn’t execute a proper backswing. But why couldn’t he rotate?

A common problem for people who rotate poorly is restriction in the thoracic spine and the attached ribs, so I cleared this first: surprisingly, nothing I repositioned in Dan’s upper body made any difference to his ability to rotate. Clearly, the problem was coming from elsewhere.

Looking further down Dan’s body, I noticed that when he rotated to the right, his right hip slid forward in its socket. Not ideal. I investigated further, and noticed that when I kept his hip centred, his thorax rotated perfectly. When he rotated to the right, his right foot appeared correctly balanced – but when he returned to a neutral position, the foot remained in the same place, and didn’t respond to the change in load.

I then tested the effect of facilitating movement in Dan’s feet, and this time he was able to maintain a properly-centred hip and a normal rotation of his thorax.

I treated Dan’s feet for a few weeks – focusing first on releasing the tight muscles under his foot and in his calf. I then helped him to practise using the newly-released muscles to spread his foot under load, enabling him to stabilise and absorb shock effectively – before introducing the new foot movements into his forehand. His technique improved, and his confidence with it.

Dan’s results showed a rapid upturn. He began to move better around the court, and was no longer at risk of developing an injury due to compensating for his stiff feet.

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Many people assume that a stiff or sore neck is an inevitable part of aging. 

I’m here to show you that doesn’t have to be the case!