Background: High-performance tennis exposes players to repetitive high-load strokes and abrupt directional changes, which substantially increase musculoskeletal injury risk. This systematic review synthesized evidence on epidemiology, risk factors, and physiotherapy-led preventive strategies in elite adolescent and adult players. Methods: Following a PROSPERO-registered protocol, MEDLINE, Web of Science, and Scopus were searched (2011–2024) for observational studies reporting epidemiological outcomes in high-performance tennis. Methodological quality was appraised with NIH tools, and certainty of evidence was graded with GRADE. Results: Thirty-seven studies met inclusion criteria: 16 in adolescents, 18 in adults, and 3 mixed. Incidence ranged from 2.1 to 3.5 injuries/1000 h in juniors and 1.25 to 56.6/1000 h in adults. Seasonal prevalence was 46–54% in juniors and 30–54% in professionals. Lower-limb trauma (48–56%) predominated, followed by lumbar (12–39%) and shoulder overuse syndromes. Across age groups, abrupt increases in the acute-to-chronic workload ratio (≥1.3 in juniors; ≥1.5 in adults) were the strongest extrinsic predictor of injury. Intrinsic contributors included reduced glenohumeral internal rotation, scapular dyskinesis, and poor core stability. Three prevention clusters emerged: (1) External load control, four-week “ramp-up” strategies reduced injury incidence by up to 21%; (2) Kinetic-chain conditioning, core stability plus eccentric rotator-cuff training decreased overuse by 26% and preserved shoulder mobility; and (3) Technique/equipment adjustments, grip-size personalization halved lateral epicondylalgia, while serve-timing modifications reduced shoulder torque. Conclusions: Injury risk in high-performance tennis is quantifiable and preventable. Progressive load management targeted kinetic-chain conditioning, and tailored technique/equipment modifications represent the most effective evidence-based safeguards for adolescent and adult elite players.

Introduction: Adults with intellectual disability (ID) have high rates of urinary incontinence, yet objective neuromuscular data are limited. We compared pelvic floor muscle (PFM) activation using surface electromyography (sEMG) in adults with ID versus matched controls. Methods: In this cross‐sectional study, 104 participants were recruited to an ID group ( n = 52) and a matched control group ( n = 52). Perianal sEMG recorded five maximal voluntary contractions following a standardised protocol. Intensity, variability, contraction onset and relaxation times were analysed using t or Mann–Whitney tests, MANOVA and multiple regression. Results: Compared with controls, the ID group showed lower mean activity (5.3 ± 6.0 vs. 8.8 ± 7.2 μV; p < 0.001; d = 0.52), lower peaks, longer onset and greater variability; relaxation parameters did not differ. MANOVA indicated a significant global group effect (Wilks' λ = 0.801, p = 0.003). Regression identified ID as the sole independent predictor of reduced activation. Conclusions: Adults with ID exhibit weaker, less stable and delayed PFM activation, supporting tailored physiotherapy.

Background: Female rugby players are exposed to repeated contact, impact, acceleration, deceleration, and trunk-stabilization demands that may challenge lumbopelvic control and intra-abdominal pressure regulation. Rehabilitative ultrasound imaging can characterize transversus abdominis (TrA) thickness changes during standardized tasks, although these measures should not be interpreted as direct indicators of neuromuscular activation or sport-specific trunk function. This study aimed to characterize ultrasound-derived TrA thickness and thickness change in nulliparous female rugby players and to explore whether these measures, immediate visual feedback, sport-related variables, and body mass index were associated with urinary leakage. Methods: A cross-sectional observational study was conducted with 34 nulliparous female rugby players recruited from two competitive rugby clubs. Urinary leakage was assessed using the validated Spanish version of the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-UI SF), with current urinary leakage defined as leakage reported within the four-week recall period. TrA thickness was measured bilaterally using rehabilitative ultrasound imaging at rest, during the abdominal drawing-in maneuver (ADIM), and during ADIM with real-time ultrasound-based visual feedback. Exploratory analyses were conducted to examine associations between current urinary leakage and ultrasound-derived TrA measures, sport-related variables, and body mass index. Results: Overall, 41.2% of participants reported having experienced urinary leakage at some point, while 20.6% reported current urinary leakage. Among participants reporting leakage type, stress urinary incontinence was the most frequent pattern, and perceived impact on daily life was low. TrA thickness increased bilaterally during ADIM compared with rest. Immediate visual feedback did not produce a statistically significant additional increase in TrA thickness. No significant associations were observed between current urinary leakage and TrA thickness measures, side-to-side differences, weekly training hours, years of rugby practice, or body mass index. Conclusions: In this exploratory sample, ultrasound-derived TrA thickness measures during controlled ADIM tasks were not significantly associated with current urinary leakage. Future studies should include larger samples, direct pelvic floor muscle assessment, respiratory monitoring, body composition measures, and dynamic rugby-specific tasks.

Background: Patellofemoral pain syndrome (PFPS) is a common musculoskeletal condition in physically active individuals. Although quadriceps strengthening has traditionally been the cornerstone of conservative management, hip-strengthening exercises have gained increasing attention because of their potential to improve lower-limb biomechanics. However, the optimal exercise prescription for PFPS remains uncertain. Objective: To evaluate the effectiveness of isolated or combined hip muscle strengthening compared with knee strengthening or no intervention on pain, physical function, and muscle strength in individuals with PFPS. Methods: A systematic review was conducted in accordance with PRISMA guidelines and registered in PROSPERO (CRD420261342475). PubMed, PEDro, the Cochrane Library, CINAHL, and Web of Science were searched from inception to 31 December 2025. Randomised controlled trials comparing hip-strengthening interventions with knee strengthening or no intervention were included. Methodological quality, risk of bias, and certainty of evidence were assessed using the PEDro scale, the Cochrane RoB 2 tool, and the GRADE approach, respectively. Results: Fifteen randomised controlled trials involving 1002 participants were included. Exercise therapy consistently improved pain, physical function and muscle strength. Both hip- and knee-strengthening programmes were superior to no intervention. Programmes incorporating hip strengthening may provide greater reductions in pain and larger improvements in proximal muscle strength than knee-focused programmes, whereas functional outcomes were generally comparable. Combined hip- and knee-strengthening programmes appeared to provide the most consistent overall clinical benefits. The overall certainty of the evidence was moderate for all outcomes. Conclusions: Current evidence supports exercise-based rehabilitation for PFPS, while evidence remains insufficient to determine whether any specific strengthening strategy provides a clear overall advantage. Further high-quality randomised controlled trials are needed to determine the optimal exercise prescription.