Sports injuries and how to prevent them

Over 600,000 people in England play racket and mallet sports every month. Many players will experience a sport-related injury at some stage, regardless of playing level.

This article identifies the most common injuries associated with tennis, squash and croquet, and provides advice on how to prevent their occurrence and what to do if you do sustain an injury.

What are the most common injuries?

Tennis

Rotator cuff tendinopathy and impingement
The ‘rotator cuff’ is made up of 4 muscles whose purpose is to secure the shoulder joint and move the arm. Repetitive actions such as serving or returning a tennis ball can put strain on these stabilising muscles. Overtraining, inadequate warm-up or technique can weaken their tendons causing pain in or around the shoulder. Symptoms may include sudden or gradual increase in pain around the shoulder, difficulty lifting the arm out to the side, raising the arm above the head or placing the arm behind the back.

Tennis elbow
‘Tennis elbow’ or ‘lateral epicondylitis’ is a common injury causing pain to the outside of the elbow and upper forearm. It is commonly caused by repetitive extension (bending back) of the wrist against resistance, such as when hitting a ball with a racket, painting or using a screwdriver. It may also be caused by poor backhand technique, racket strings that are too tight or a grip that is too small. Symptoms can include pain when pressing on outside of the elbow approximately 2cm from the bony point, pain when extending the wrist or fingers against resistance and weakness when doing normal activity such as opening door handle or shaking hands with someone.

Squash

Tennis elbow
‘Tennis elbow’ or ‘lateral epicondylitis’ is a common injury causing pain to the outside of the elbow and upper forearm. It is commonly caused by repetitive extension (bending back) of the wrist against resistance, such as when hitting a ball with a racket, painting or using a screwdriver. It may also be caused by poor backhand technique, racket strings that are too tight or a grip that is too small. Symptoms can include pain when pressing on outside of the elbow approximately 2cm from the bony point, pain when extending the wrist or fingers against resistance and weakness when doing normal activity such as opening door handle or shaking hands with someone.

Ankle Sprains
Ankle sprains are commonly caused by planting the foot on the ground and performing excessive twisting or bending motions at the joint. The most common movement causing and ankle sprain is inversion (rolling in of the ankle). This is common in tennis and squash, where fast changes of direction are required.  Symptoms may include a sudden onset of pain with lateral movement, swelling, bruising, heat and difficulty standing or walking. In some cases, there may be an audible popping sound.

Lower back muscle strain
Sports such as squash and tennis require twisting, bending and jumping movements, which test both the strength and flexibility of muscles. Strains can occur when tight, weak or overused back muscles are required to work beyond their capability. Symptoms may include a sharp twinge on activity and restricted movement due to spasm. The most high risk movements for sustaining this type of injury are flexion (bending forward) and rotation of the lower back.

Croquet

Wrist sprains
Although croquet is one of the safer games, wrist sprains can occur when the force of the mallet hitting the ball pushes the wrist into extension.  This could be reduced by adjusting or loosening your grip – regardless of style (Standard, Solomon or Irish).  You may also benefit from using a mallet with a wider diameter. Symptoms may include a sudden onset of pain, swelling, bruising, heat and difficulty bending or putting weight through the wrist.

How do I prevent injuries?

Introduction
The old saying goes ‘prevention is better than cure’. Sports-specific activity should be complemented with a variety of cardiovascular, strengthening and stretching exercises, such as cycling or weight-training. Every activity should be started with a ‘warm-up’ and ended with a ‘cool-down’. This will improve overall physical fitness and reduce the likelihood of becoming injured.  Find example ‘warm up’ and ‘cool down’ exercises here.

Warm-up
The ‘warm-up’ is essential to prepare your body for exercise and can be achieved by jogging, running or cycling. This ‘cardiovascular’ exercise increases your heart-rate and breathing, pumping blood and oxygen to the muscles in your arms and legs. Once your muscles are warm, you can then do some gentle stretching exercises. These will increase the flexibility of your muscles, tendons and ligaments, reducing the likelihood of receiving an injury.  Think of your warm up as a way of preparing your body for activity.

Cool-down
Cooling down after your game has been shown to reduce amount of muscle soreness after activity. The ‘Cool Down’ consists of gentle cardiovascular exercise (such as jogging, slow cycling) and stretching. This time, your heart and breathing rate gradually returns to normal, transporting blood and toxins (such as lactic acid) away from the muscles.

Technique and equipment
When participating in sport-specific activity it is advisable to seek advice regarding technique (even if you have been playing for a long time)!  Coaches at your club will be able to advise you on the best grip and stance to take for different shots. They may also be able to provide advice on weight/size of racket or mallet.

A good sports shoe can not only cushion the foot, but can reduce injuries by supporting your foot according to your ‘foot type’. Good shoes include a flexible forefoot, a firm heel counter and shank. Podiatrist can assess your ‘gait’ (walking) and advise on the correct shoe to minimise injury and maximise performance. If additional support is required a Podiatrist can prescribe customised orthotics (insoles).

I’m injured, how can Physiotherapy help?
Physiotherapists will be able to assess your injury and give a time-frame for recovery. Depending on the type of injury, treatment may include advice to manage your pain, a home exercise plan, soft tissue massage, mobilisation techniques or acupuncture. We provide personalised treatment plans and work with you to achieve your goals. Our aim is to provide a high quality service, exceeding your expectations and assist in your return to activity as soon as possible.

 

Our thanks to Crystal Palace Physio Group for supplying this article.  Click here for further information: Crystal Palace Physio Group