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Spring Is Here...Racquet Sports Are Great But Be Aware Of The Risks. So Get Prepared.

By Dr Colin Crosby, Sport & Exercise Medicine Consultant

Sports such as tennis, badminton, squash and racquet ball all require a high degree of both cardiovascular and muscular endurance.  They have much in common.  They are all multi-sprint activities with short bursts of high intensity play, many changes of direction and rapid acceleration and deceleration, all of which put considerable stress on your muscles and joints.  Repeated high speed overhead movements when you serve and smash also pose significant risks to the upper limbs in particular.

Spring is here so there is a great temptation to rush onto the courts with minimum preparation - but doing so can lead to disaster.  While your upper limbs are obviously at risk of "over use" or Repetitive Strains Injuries (RSI) to wrist, elbow and shoulder, your pelvis and lower limbs still have to cope with recovering balance and moving your body quickly into the right position to play the next shot.  This can lead to groin strains, knee ligament and cartilage injuries, calf and Achilles Tendon tears and ankle inversions (inward twisting ankle - sprains).  Even your neck and back are not immune, with over extension in the serve being a particular danger.

What can you do about all of this?  Most of your problems will be due to over-doing it without adequate preparation and so it is very important that you put yourself through a fitness programme prior to getting on to court.  You should include general cardiovascular conditioning using, for instance, a cycle, step machine, cross trainer or running. Interval training with multiple sprints will improve your ability to move rapidly around the court and strength training for both your upper and lower limbs is essential for both endurance and power.  Then there is core stability training for your lower back, pelvis and abdomen...all vital to provide a strong central body in order to control arm and leg position when making shots.  Jumping and hopping (plyometric) work helps develop springiness in your legs which is necessary for rapid changes of direction.  Lastly, flexibility training for your shoulders, back and legs helps prevent them being damaged by repeated intense movements. 

You should also put some time aside, before and after playing for warm up and cool down sessions.  Many injuries are caused by arriving on court at the last minute, going straight into the game so as not to waste any of your "booked time" and you should remember that the knock-up period is for practising hand/eye co-ordination, assessing the surface, the racquet and the playing conditions.  Don't confuse it with warming up...you should have done this before arriving on court.  When a professional knocks-up before a match he/she will have already completed about an hour's preparation of massage, light cardiovascular exercise and stretching beforehand!

Other injuries are caused by changes in pattern of play, increasing your intensity against younger, fitter opponents, or even a sudden increase in the frequency of the matches you play such as in a tournament or tennis weekend abroad.  New racquets usually have high string tension which can lead to elbow and wrist problems, as can differences in the size of the grip.  As a rule of thumb, your grip size should be about equal to the distance between the large skin crease in the middle of your palm and the tip of your middle finger.  If your racquet is significantly smaller than this it will lead to elbow problems, such as "Tennis Elbow", and if it is too large your wrist will be affected.  These sorts of problems can usually be sorted quite simply by a visit to the Club professional, but if you should see an expert if your injury persists.  It's only like to get worse if you continue to "play through the pain" !

Most minor injuries can be dealt with by resting and possibly a short course of anti-inflammatory medication.  More persistent problems may need sports physiotherapy and a discussion with your coach about technique, particularly your serve (shoulder/ wrist), backhand (elbow/ wrist) and top spin forehand (wrist).  Sometimes an expert opinion from a specialist in Sport and Exercise Medicine (SEM) is required and you may need an injection of cortico-steroid under local anaesthetic.

One last piece of advice; if you do need to see a Specialist, remember that only 5% of all sports injuries require surgery so it makes far more sense, in the first instance, to see a Sports Specialist rather than an Orthopaedic Surgeon.  Dr Colin Crosby, Consultant in Sports and Exercise Medicine, practises here at The Medical Chambers Kensington.  Here is a link to his profile.