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TENNIS
Opinion of the expert in sports health



Tennis

TENNIS From a sports medicine, orthopedic surgery standpoint, the shoulder, elbow, back, ankle and Achilles tendon are the usual cause of complaints in tennis. 

In shoulder injuries usually the dominant side will develop shoulder bursitis or even muscle tears due to serving. The cause of the problem can be found in inadequate warm-up as well as a poor serving technique. It is always advisable to stretch the shoulder muscles following warm-up prior to playing. In this way it is possible to prevent muscle injuries. After lessons with a professional, the correct series of movements should be practiced with a gradually increasing hitting force.  If injury develops a specialist should be sought as the healing of complaints consists of complex therapy in all cases. So-called tennis elbow is the most common elbow complaint in tennis. Its prevention is easier than its cure. The development of this problem can be prevented by choosing the appropriate racket geometry and string stiffness for player experience. Often neck vertebrae displacement is in the background thus the basis of fast healing is a trip to a specialist as soon as possible. Causes of back injuries in tennis can be sought in the basic movements of the sport. The sport itself is associated with stress on only one half of the back. The deep muscles of the serving side become much stronger than the other side. This can lead to a disbalance in the muscles supporting the spine. To avoid this, swimming front and back crawl are suggested.

 

Ankle sprains often occur in tennis as well. These can be prevented by sliding out at the end of running. This means that they can be avoided by using good quality shoes that are especially designed for tennis, and are appropriate for the kind of court. For ankles that have already been injured, I suggest using high-cut shoes. Of course it is possible to get good results with ankle-stabilizing exercises as well.

 

Finally, a bit about tears of the Achilles tendon. This frequent injury of tennis players in the 40-50 age range is also the „bogeyman” of orthopedic-trauma surgeons. The overused tendon with a poor blood supply often tears in cases of over stretching. Complications of wound healing are not rare and may go on for months. For this reason prevention should be a primary goal. Compulsory warm-up and stretching should be done for those in this age category. This should also be performed in between long sets. A problematic Achilles tendon can be protected against tearing with a silicon heal wedge. This should be placed under both heels. As I read these lines I realize that I have painted a grim picture. I apologize for this but I am examining this from a medical standpoint. On the other hand with a bit of prevention we can guarantee years of happy tennis enjoyment.


Tennis elbow:

TeniszkönyökTennis elbow is practically an epidemic in the active population. I would like to outline the causes, therapeutic possibilities, opera-tive treatment, and preventive strategies of this illness in a few words. This problem usually arises from the overuse of the finger flexor muscles whose place of origin is on the outside of the el-bow. The basic cause of this is overexertion during tennis. In the majority of cases the patient will present him/herself to the sports specialist after using a new racket with a different geometry, or with tighter strings. The symptoms of other illnesses may also present in this way. Often pressure on the nerves and chronic in-flammation caused by arthritis of the neck vertebrae can act as a causal factor. It may occur that elbow joint degeneration or a small piece of broken off joint cartilage can cause complaints.

 

This problem doesn’t spare housewives either. Persistent pain can develop after load carrying. Looking at the causes of this illness, the reader can see that many roads can lead to tennis elbow. For disease prevention, cessation or decrease of the causal factors are the most obvious steps. In cases where pain develops it is best to see a doctor. This in part helps to determine the cause of the problem as soon as possible and also treatment can be started quickly. Conservative treatment modalities dominate, so we can see the doctor without qualms. The longer complaints persist, the longer the therapy will take. The first steps are rest, icing, massage, drug therapy, physiotherapy, stretching and strengthening of the affected muscle groups. Therapeutic aids (elbow bands) may help but in my experience well-organized con-servative therapy usually gives the expected result. Long-term and persistent complaints may be caused by an inflammatory fo-cus elsewhere in the body. An inflamed tooth, tonsil, or chronic inflammation of the lesser pelvis may be symptom-free, but even a small stress on the elbow can cause unrelenting pain. The fil-tering out of these is the job of the specialist. Patients will often ask for injections claiming that their acquaintances had the same problem and the injections ceased the complaints. Usually these are not the primary mode of treatment, partly because these in-jections contain steroids which can cause tissue degeneration and only three should be injected in a region per year due to other side effect as well. The use of these substances must be regis-tered prior to drug testing! If all these treatments are ineffective, surgery can be performed. This routine procedure can be done within the framework of one-day surgery. The principle of this is that the detachment of the muscle insertions at one point will heal and fixate over a larger area. Following surgery, there is a strict resting period until wound healing and then physiotherapy for weeks. Complete healing can be expected 6-8 weeks later. This illness is not deadly but healing is sometimes long and requires the concern of the patient.