Tennis Elbow and Beyond: A Closer Look at Tennis Injuries

shutterstock 181769753 Tennis Elbow and Beyond: A Closer Look at Tennis InjuriesThe 2014 US Open starts today. One of the major stories prior to the start of the tournament is that Rafael Nadal is sitting this one out due to injury. At only 28, Nadal has already won 14 Grand Slam singles titles but his aggressive playing style has taken a toll on his body. Nadal has suffered from many different injuries — mostly to his knee and wrist — over his career; this is the fifth tournament in his career where he has been sidelined due to injury. It leads many to wonder if Nadal would be the greatest tennis player of all time if he could only get his body to cooperate.

Whether you are a professional tennis player or you play for fun, injuries can always occur and ruin your game. In honor of the US Open, let’s take a closer look at tennis injuries and how they can be prevented.

Common Tennis Injuries

Overuse is the most common reason for tennis related injuries. Approximately two-thirds of all tennis injuries occur because of overuse. The other third is due to sudden injury or an acute event.

Tennis Elbow

You know an injury is common when it is named after the sport where it frequently occurs. Lateral epicondylitis or tennis elbow, is a strain of the muscles and tendons in the elbow through repetitive motions. Tennis players can get tennis elbow by practicing their backhand swing repeatedly.

Shoulder Injuries

Swinging a tennis racket and firing off a powerful shot can put a great deal of stress on your shoulders. Tennis players often suffer from shoulder injuries.

Rotator cuff injuries are common. The rotator cuff helps position your shoulder in the socket. If you have a weak rotator cuff, it can cause irritation in the socket tissues as it moves around. This can lead to inflammation in the tendon or the bursa (Shoulder Bursitis), causing pain when you swing your racket overhead.

Lower Limb Injuries

Tennis is a full body workout and players must sprint from one side of the court to the other. The sudden pivot as a player takes off can put stress on the knee joints, tendons and ligaments resulting in knee injuries.

Any sport that requires running has the risk of ankle injuries. A sprained ankle is one of the most common tennis injuries. Even the greats like Roger Federer and Andrew Murray have suffered sprained ankles.

Preventing Tennis Injuries

With any sport, proper training and condition is crucial to injury prevention. This means warming up before a match as well as maintaining your fitness even in the offseason. Tennis is a fast paced sport that requires not just muscle strength but also endurance. You need to be able to sprint back and forth, backwards and forwards, throughout the match.

When strength training, focus on the shoulder muscles to help prevent rotator cuff injuries. Strengthen and stretch the wrist and forearm muscles to prevent tennis elbow, as these tend to absorb the most impact from the ball hitting your racket. Work on your core and back to further reduce the chance of injury.

For tennis, technique is extremely important not just to win but also to extend your career by reducing the risk of injury. Make sure you have the proper form for each type of swing. That said; try not to repeat the same swing too many times in a row. Mixing it up helps prevent overuse injuries but is also more in line with how a match will be played.

In addition, make sure you have the right equipment. Pay attention to the grip size of your racket. Make sure your footwear is supportive. If you are experiencing even minor pain, consider taping the area or wearing a brace for added support.

Sources:

http://www.stopsportsinjuries.org/tennis-injury-prevention.aspx

http://www.physioworks.com.au/Injuries-Conditions/Activities/tennis-injuries

Cheerleading: The Most Dangerous Sport

shutterstock 61626283 Cheerleading: The Most Dangerous Sport

When you think of sports injuries, full contact sports like football probably come to mind. However, one of the most dangerous sports in terms of serious injury is not football, soccer, or basketball…it’s cheerleading.

Cheerleading has become so much more than shouting encouraging phrases from the sidelines. Modern day cheerleading features amazing feats of gymnastics and flexibility along with dance and of course, stunts. A basket toss can send a cheerleader flying 20 feet in the air, only to land in the arms of her teammates, if everything goes right. It’s not hard to see how cheerleading can be dangerous.

Even with human pyramids, choreographed gymnastic passes and more, some might not even consider cheerleading a true sport; in fact the National Collegiate Athletic Association (NCAA) does not even include it in their list of sponsored sports. But it doesn’t change the fact that from 1980 to 2013, cheerleading injury rates went up 440%. While compared to other sports, the overall number of injuries is actually low. However, cheerleading injuries are often much more severe, making up 50-66% of catastrophic injuries in female athletes. A catastrophic injury is defined as a severe injury to the spine (including the spinal cord) or brain and may also include skull or spinal fractures.

Most Common Injuries

Cheerleading injuries affect all areas of the body. The wrists, shoulders, ankles, head, and neck are most commonly injured.  Sprains account for more than half of all cheerleading injuries. While ankle sprains are most common, sprains can also occur in the knees, wrists, neck and back.

Back injuries are also common in cheerleading, largely from tumbling and stunts. Back injuries can be caused by twisting and rotating in stunts or tumbling passes and from lifting, catching, or falling during stunts.

Concussions are also becoming increasingly more common in cheerleading. With more evidence of the damage head injuries like concussions can cause, there has now been a heightened awareness of cheerleading related injuries overall.

Prevention

Some of the causes for cheerleading injuries are lack of training (especially with stunts) lack of conditioning and that there is no protective gear for the sport. The best way to avoid injury is to prevent them from happening.

Stunt restrictions

It’s no surprise that stunting causes the most serious injuries in cheerleading. Stunting accounts for 42-60% of all cheerleading injuries. In addition, 96 percent of concussions and head injuries in cheerleading are caused by stunts. Without the proper training on how to toss and catch the flyer, along with practice, these injuries will continue to occur.

Other stunting restrictions include height restrictions in human pyramids to keep them level and increasing the number of spotters during aerial stunts. Mats should always be used during practice, as cheerleading is one of the only sports where more injuries occur during practice than in competition.

Trained coaches

The lack of recognition of cheerleading as a sport has lead to a lack of qualified coaches. Often, coaching is done by a member of the school’s faculty who may not have any experience with cheerleading, or at least not some of the more physically demanding aspects of it. At a minimum, a cheerleading coach should know proper stunt technique, should always supervise practice and should be able to identify the symptoms of serious injury like concussion.

Conditioning

Like any other sport, proper training and conditioning can help prevent injury. First and foremost, stretching before practice and competition can loosen the muscles and help prevent strains, sprains and pulls. Yoga or Pilates can also help cheerleaders improve flexibility.

Strength training can also help prepare muscles for lifting either your body weight or a teammate during stunts. Special attention should be paid to strengthening the back and shoulders are well as the core muscles to help reduce the risk of injury.

Sources:

Jumper’s Knee

We take this opportunity to have Dr. Kevin McIntyre of Burlington Sports Therapy introduce Jumper’s Knee.

Jumpers knee is a common term used to describe an overuse injury to the patellar tendon.  The technical term for this tendon injury is patellar tendinosis or patellar tendinopathy and is estimated to affect 45% of elite volleyball players.

So how do we apply our newest understandings of “Jumper’s Knee” to the athlete at risk? If a coach or trainer notices any of the above findings in one of their athletes they should be urged to try a soft landing technique, bending both the ankles and knees as much as possible to absorb the force of landing. If symptoms are present, frequency and intensity of jumping may need to be reduced. Of course, we always recommended that you consult with a doctor so that your condition can be diagnosed prior to any treatment.

patellar tendon image2 250x307 Jumpers Knee

According to the most current literature, patellar tendinosis is largely due to the eccentric load placed on the patellar tendon. That is, the tendon is lengthened under load when lowering for a jump and when bending the knee upon landing. (For an explanation of “eccentric contraction” please refer to our previous post about the prevention of hamstring strain). According to a study published in the British Journal of Sports Medicine, athletes who experienced patellar tendinosis had a tendency to land with a lesser degree of ankle and knee joint flexion on initial impact. That is, they didn’t bend their knees or ankles during landing to the extent of other athletes. The study also found that the rate at which the knee is forced into flexion upon landing may be a risk factor in the development of patellar tendinopathy.

ACL Injury Prevention

Here’s a great article we found on ACL Injury Prevention from Dr. Kevin McIntyre of Burlington Sports Therapy.  What makes this article great is it concisely describes common causes of ACL injuries, who is most likely to suffer from an ACL injury, and tips to prevent an ACL injury.

Last June we posted an entry on the prevention of anterior cruciate ligament (ACL) injuries. In that article, we learned that muscular co-contraction was very helpful in preventing an acute tear of this ligament. Today’s blog is going to review some of the more current understandings in sports medicine with respect to ACL injury and prevention, including some practical ways that coaches, parents and players can help identify those athletes at risk.

Most ACL injuries are non-contact, occurring during deceleration, landing or pivoting. In soccer, 58% of injuries are non-contact.  Athletes who run and change direction in a more upright position are at more risk of ACL injury.

Females are 4 to 6 times more likely to injure their ACL (some of the points below will help to explain this difference).  Hormonal changes have been shown to influence ligaments (like the ACL).  Such hormonal changes occur during monthly cycles and growth spurts.

Having “loose” joints can predispose you to ACL injury. For example, a positive measure of knee hyperextension increases the odds of anterior cruciate ligament injury status five-fold.  Greater knee laxity and increased general joint laxity are more prevalent in girls.  As boys get older there is a trend toward decreased joint flexibility and ligament laxity. Relative to boys, girls show more joint flexibility and ligament laxity with age.

A trend toward knee valgus (pictured below) has been well established in the literature as a risk factor of ACL injury.  Females tend to land from jumping in a more valgus position than males.  They also tend to land harder, suggesting less muscular recruitment and thereby less stabilization of the knee.

Prevention of ACL injuries would significantly reduce the chances of arthritis in adulthood. There is an estimated ten fold increase (incidence) after ligament injury.

Active and passive flexibility training may be contraindicated for preventing ACL injuries. Flexibility training does not provide protective effects from injury as has been previously reported in the literature.

Prevention works.  According to a recent study of 1435 female varsity soccer players, those who did the proper preventative exercises showed a 3 fold reduction in non-contact ACL tears.  There is a growing body of research validating ACL prevention programs.

valgus knee1 ACL Injury Prevention

Prevent ACL Knee Injuries


Protect knees from sports injuries

In an article on CNN’s website, Dr. Melina Jampolis, a physician nutrition specialist, offers some great advice on how athletes can protect their knees from sports injuries.  The preventative technique she recommends focuses on teaching athletes improved awareness of injury risk as well as promoting proper motion patterns and muscle strengthening to minimize injury.  This program is called the HarmoKnee Preventative Training program and she summarizes the program as follows -

1. Warm-up: This phase involves jogging, backward jogging on the toes, high-knee skipping and two zigzagging and sliding exercises.

2. Muscle activation: This phase involves four-second contractions of major muscle groups in the lower body, including calves, quadriceps, hamstrings, hip flexors, groin, and hip and lower back muscles to help athletes increase awareness of individual muscle groups.

3. Balance: These exercises, which require careful form — including straight-line hip-knee-foot posture, shoulder-width apart, controlled landing on flexed knees, maintaining a low center of gravity, contraction of stomach and buttocks — should be performed slowly. They include backward and forward, single- and double-leg jumps lasting approximately 30 seconds each.

4. Strength: This phase, which requires similar form to the balance phase, including walking lunges, hamstring curls and single-knee squats with toes raised.

5. Core stability: The final phase also encourages proper form and includes sit-ups, plank on elbows and toes, and bridging (an exercise where your hips are lifted toward the ceiling and the position is held).

Dr. Jampolis notes this summary is just an outline that includes key components of a comprehensive knee injury prevention program and recommends you work with a coach or personal trainer to develop a similar program that works for you.

Click here to read Dr. Jampolis’ complete article on protecting knees from sports injuries.