Tennis injuries, past and present, and their cure

I really don't think this applies to me! :-)

The book I use as a reference for most of the injuries I get is this one by Allan Levy but I see that he also has one specific to tennis. As well as the book I use the previously mentioned Primal Pictures at Anatomy TV, and have bought my own set of CD's.

So as mentioned in my last blog here is a list of all present and past injuries, from head down, the cause where known and the treatment I undertook. In a later blog I describe my approach to treating injuries.

• Torn contact lens

I wear glasses for short sight when not playing tennis after wearing contact lenses full time for many years. Since I switched to glasses I started using disposable daily contact lenses for tennis, since in the UK, in winter, I have not found how to prevent glasses misting up when playing. Disposable contacts are thinner and more fragile than regular contacts, and shortly after I started using the disposables I had a lot of difficulty in getting them out.One time I ripped one in half leaving half in the eye which promptly disappeared under the eyelid. Hospital eye nurse got it out.

• Cricked neck

Past injury. Think I did this serving and it lasted several months. Performed neck stretches, rotations and shouder rolls until it cleared.

• Sore inflamed shoulder

Past injury, well maybe. Shoulder problems started when I started to use the same Prince Warrior racket as Pat Rafter. Great racket but I ended up with a sore shoulder caused by serving with a strain of the deltoid muscle and subscapularis and eventually tendonitis of the biceps tendon. This lasted a couple of years, even after I stopped using the Warrior racket.I started doing shoulder strengthening exercises, experimented with changing my service action and it eventually cleared. In fact, interestingly, it cleared soon after I had a coaching session with Brad Langevad, and the main thing he did was to correct my grip when serving.

Update: having suffered from a chronic sore shoulder caused by serving, I eventually sought some help. The physio told me that since there are several muscles involved with shoulder movement: lifting, rotating, abduction, etc, it is usually best to get the specific muscle or tendon injury diagnosed before starting a course of rehabilation. In my case I had a sore supraspinatus and there is a specific exercise for that: stand with arms down at side, rotate arm so that the thumb points into the side, now lift the arm - not straight in front or out to the side but at 45 degrees using a weight or band to provide resistance. That used to hurt! Other useful exercises for me are the so called pendulum as a warm up and internal and external rotations. I now do all of these as part of a general exercise routine.

• Tennis elbow

Past injury. It was a couple of years after I first started playing that I got tennis elbow. I had it for 2 or 3 years and tried lots of things to get rid of it. It was tolerable after doing regular strengthening and stretching exercises, and playing with a grip slighly larger than I would normally choose, but always present. I changed rackets twice. Eventually I found more by chance than anything that playing with a head light racket was the answer, and ever since I have always used a head light racket and no longer suffer from tennis elbow. I still keep up with the exercises though.

The usual suspect for tennis elbow, if the above things don't apply, is poor technique on the backhand. Usually hitting the ball with a bent wrist. See your local pro for advice.

Interesting articles on tennis elbow treatment that I have found amonsgt the many out there on the Internet: Introductory, introductory with exercise recommendations, a report on the use of NSAID's, steroid injections and physical therapy, and an in depth report that includes all of them including Acupuncture, Extracorporeal Shockwave Treatment, Magnetic, Orthotic, Physical and other forms of treatment.

Try using an EpiSport CLASP. I found it definitely helps and is much better than many of the softer braces.

• Golfers elbow

Past and new injury. I have spoken about this before and described it in more detail here. I think I'm on the mend again, using an older head light racket that weighs 11 ounces which is heavier than my usual racket. It's the extra weight that helps with this injury, or the use of a not too stiff graphite racket.

The usual suspect for golfer's elbow, if the above things don't apply, is poor technique on the forehand, especially a topspin forehand with western or semi-western grip. See your local pro for advice.

The reports I link to under the section on tennis elbow apply here too.

Try using an EpiSport CLASP. I found it definitely helps and is much better than many of the softer braces.

• Wrist fracture

Past injury. I fractured the trapezium in the wrist from a clash of rackets playing doubles. It was a hairline fracture that was not initially detected by x-ray. My wrist was not put in a plaster cast but a plastic splint for four weeks. I could not hold a racket for 6 weeks, and had pain serving after 8-10 weeks, before it eventually settled down. I did intensive hand and wrist physio, strengthening and stretching, and the last thing to hurt before it finally cleared was the wrist snap associated with serving.

• Wrist tendonitis

Current injury. This comes and goes almost at will. Since I use a computer a lot I've switched to using the mouse with my other hand, that helps. Also I do not use a mouse-pad or trackpoint that comes with most laptops or IBM Thinkpad's, and instead I use a proper mouse. At the moment I strap my wrist every time I play using cohesive strapping.

• Wrist ganglion

Current injury, probably associated with the wrist tendonitis. I have a ganglion on one of the flexor tendons in the forearm. It sometimes impacts the Palmar Carpal Ligament and affects the whole hand. I'm waiting to see if it subsides before seeking medical treatment.

• Hand blisters

Past injuries. I'm sure everyone gets blisters when they play or practise a lot. My own prevention is to ensure I have a good padded grip that's not too worn, file down excessive hard skin calluses, and use surgical spirit to toughen the skin. I always remove the grip from a new racket and file down the edges of the octagonal frame-grip. Why do they make rackets like that? I don't remove the octagonal shape but do remove the corners.

• Hand soreness

Past injury. Strange pain in the the back of the hand where the little finger bone runs. Never satisfactorily diagnosed, but I think it was caused by the racket slippping or twisting when serving, especially when trying to get a kick topspin serve.

• Finger ganglion

Past injury. Had two ganglions in the past on the forefinger knuckle joint, both caused by violent racket twist on forehand volley of a hard shot. At the time I found partial loose taping of the forefinger to the next finger would add some support. These ganglions were around for several months before subsiding.

• Lower back pain

Past injury, but recurs. For 45 years I never had any back trouble, until the day I hurt it serving. I always had a very twisting arched back serving motion, and eventually I damaged something. At the time I had the classic symptoms, sciatica, couldn't bend, muscle spasm, difficulty turning over in bed, difficulty getting in and of the car, and so on. When it's acute you have to rest, in fact you can't do anything else because of the pain and stiffness. I personally have not tried an osteopath or chiropracter but have tried physio. I also tried Pilates but did not find that useful, although I hear lots of success stories. I started stretching exercises, also stomach and back strengthening, and now it's mostly under control. Oh yes I bought a recliner chair for home instead of slouching in a sofa or couch, and regularly hang by the hands from a chin bar, just hang for 30 seconds or so, no chins-ups.

• Jumpers knee

Past injury. Patella tendonitis, This came on insiduously. At first I just noticed pain going downstairs the morning or day after playing. Eventually it got so bad I couldn't play. I don't really know what caused it. Maybe because my right leg is the main push off leg. I rested it for 6 weeks and had physio but it came back. I started knee strengthening exercises to balance the muscles around the kneecap, stopped jogging and cycled instead for aerobic exercise, and swam regularly. Eventually it cleared, and I think it was the cycling that helped. Now I'm back to jogging but keep up the knee strengthening exercise.

Interesting report on Jumpers knee here and a further discussion on treatment here.

• Sore achilles

Past injury, but recent recurrence. This was probably my first injury after I took up tennis well into middle age. When I started I dug out an old pair of plimsoles (plimsolls) from the early 70's that I had managed to hang on to all these years. Sure enough my feet started hurting but most especially the right achilles tendon. I soon realised I needed proper tennis shoes for the hard courts I was playing on and everything got better. A few months later, and some new tennis shoes and the achilles soreness was back. I had it for quite a while until by chance I added some soft heel supports to the shoes, because of a heel problem, and the achilles problem was cured. These days I always add one or two heel cushions in addition to a full length Sorbothane sole to any new trainer, details in previous blog, as well as slitting the back support with a sharp knife as shown in the photo.

• Sore heel

Past injury. Felt like a bruised heel at the bottom of the heel bone. Added extra heel cushioning to my tennis shoes.

Luckily I have never had plantar fascia for which treatment is described here and stretching exercises here. Update: I suffered symptoms of plantar fascitis this year that wasn't bought on by tennis but was quite unpleasant with a sore arch on one foot. I iced it regularly, stretched, and started using Sole ultra footbeds, which provide arch support, in my normal day shoes. The tricky bit is finding a level of support that helps without irritating an already sore arch, and I did notice, but didn't try, the Scholl gel arch support comes with a range of three differerent grades of support that you can choose to suit your need. My condition cleared after about 2-3 weeks.

• Ankle sprain

Past, but lingering injury. I turned my ankle over on the outside stepping on something. At the time it didn't hurt much, but there was a lot of fluid swelling, and still is several months later. It gets stiff sometimes, but mostly I ignore it. That's the main reason I bought the wobble board in my previous blog. I expect it will have cleared completely in another six months. Oh to be young again when these things cleared up in days or weeks. An alternative to the wobble board is standing on one leg for several minutes at a time. Try starting with just 5 minutes and you'll be surprised how tough that might be for the lower leg/ankle muscles.

• Big toe
  

Bruise:
Past injury. I'm sure many of us have done this or something similar: I walked into a doorframe in bare feet! Hurt like hell at the time but then I discovered I couldn't play tennis either. Tennis is very harsh on the feet with the constant changes of direction and stops and starts; and the toes, especially the big toe take a lot of the stress. Lucky I didn't break the toe.

Sore (Hallux Rigidus):
Possibly a sign of old age in my case, the main big toe joint started playing up when I walked a lot in my normal day shoes. Nothing to do with tennis. Eventually the pain got so bad I googled it and found it's a well known condition 'Hallux Rigidus'. The fix is to get a new pair of shoes with a stiffer sole, and it worked. Easy. I now ensure there's plenty of firm support under the front part of the foot in all my shoes, including tennis shoes.

• Groin injury

Present injury, and new for this year. I hurt something in my groin area for the first time this year, and it's been off and on since then. I don't really know for sure what it is, my guess is the Adductor longus or Iliopsoas. When it flares up it hurts to bend or lift the leg to go up the stairs. I think it was caused by the rotation from an open stance forehand and not bringing the right leg round as part of the follow through. At the moment it's OK and I just try to take care off it by taking small steps when playing with no lunges or stretches. If it continues to flare up I will have to investigate some stretching and strengthening exercises in that area.

• Collar bone

I sufferered a muscle pull in the front of the chest where the muscles attach to the collar bone as described in this blog entry.

Tags: sports injuries
tennis elbow