Shoulder Management and Assessment Serving High performance (SMASH) – A cohort study of risk factors for injuries in adolescent competitive tennis players


Tennis is one of the largest individual sports in Sweden. In the ages 13-18 years are 2716 licensed tennis players according to the Swedish Tennis Association. From an injury perspective, tennis is stressful for muscles, tendons and joints, and it is reasonable to assume that a balance between training load, competition and recovery is important.


We are investigating how our adolescent competitive tennis players train, compete and recover. In addition, the association to injuries in the shoulder and/or spine is investigated.


During the 2018 spring-season, 301 tennis players, (176 boys and 125 girls) in the age 12-19 were included in the baseline screening (baseline questionnaire regarding training volume, previous injuries, years playing tennis and a clinical screening to test isometric/eccentric strength, range of motion in the shoulder and range of motion in the thoracic spine. Weekly follow-up was then conducted for 52 weeks.


SMASH is a prospective study, therefore we believe and expect the results will most likely in a better way identify causal relationships between load and injury, if present.

Research Principle

Karolinska Institute


Swedish Naprapathic Association, Scandinavian College of Manual medicine and Sophiahemmet foundation.


Profile image

Fredrik Johansson

Affiliated to Research
Profile image

Eva E. Skillgate

Visiting Professor
Content reviewer:
Anna Frantz