How Does Blood-Flow Restriction Alter Forehand Drive Performance and Muscle Recruitment in Tennis Players?

To examine the acute effects of forehand drive (FD) preconditioning with or without blood-flow restriction (BFR) on subsequent forehand performance and muscle recruitment in tennis.

On separate visits, 12 well-trained tennis players participated in 4 randomized trials. Each visit included pretests (maximal muscle-activation capacity or FD performance), a preconditioning phase, and posttests after 5 minutes of rest (ie, similar to pretests). The preconditioning phase involved 5 sets of 10 maximal-effort FD exercises, performed either with (EXP) or without (CON) BFR (50% of the arterial occlusion pressure applied to dominant lower and upper limbs). During the pretest and posttests, either maximal voluntary isometric contraction (MVIC) with surface electromyography recordings of 6 muscles (gastrocnemius, rectus femoris, biceps brachii, anterior deltoid, external oblique, and pectoralis major) or ball velocity and accuracy of 10 crosscourt forehands were assessed.

Peak ball velocity increased from pretests to posttests (+2.3% [2.3%]; P = .004), regardless of the condition (P = .130). Peak ball accuracy remained unchanged (P > .05). From pretests to posttests, increases in electromyography levels for the biceps brachii muscle were larger for EXP (+14.5% [7.4%]; P < .001) than CON (+7.3% [10.3%]; P = .042). During the preconditioning phase, biceps brachii muscle activity was higher for EXP than CON (+7.4% [7.3%]; P = .006) during MVICs. Surface electromyography levels remained unchanged for other muscles.

Executing FD exercises during a preconditioning phase acutely improved FD velocity but not accuracy in tennis, also accompanied by increased recruitment of the biceps brachii muscle. However, adding BFR did not significantly enhance these benefits.