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The impact of tennis injuries can be reduced by careful management of swelling, protection of the injured structures from further injury, and by enlisting the support of one of our Bath chartered physiotherapist or our sports chiropractor or osteopath. Collateral tissue damage can be minimised by following the POLICE or PRICE guidelines, standing for protection, optimal loading/rest, ice, compression and elevation. Current evidence as published by the Association of Chartered Physiotherapists in Sports & Exercise Medicine (ACPSEM) should be followed to minimise collateral tissue damage.
Anti-inflammatories are not recommended in the first 5-7 days after injury, as inflammation is the body’s way of healing. Swelling needs to be managed, but stopping inflammation from occurring at all is not advised. A chartered physio will perform a thorough assessment to evaluate how well joints and muscles are functioning. In addition the physio will assess muscle power, strength and endurance as well as balance, co-ordination and joint position awareness. Injured players will be guided from the initial phase after the injury to the end phase of return-to-play testing. It is important to rehabilitate fully after any injury as failure to do so often leads to re-injury often resulting in a longer period off play. Rotator cuff tear What is it? The rotator muscle complex provides stability and controls movement of the shoulder joint. Tears may be due to overuse or acute trauma. How does physiotherapy treat rotator cuff tears? Acute soft tissue management as evidenced by the PRICE guidelines (above) should be undertaken to reduce secondary damage from swelling. Simple painkillers may be taken but anti-inflammatories should be avoided at this stage. Once again a thorough examination will guide the treatment plan which may include mobilisations, soft tissue techniques, taping, acupuncture and other physiotherapy modalities. The physiotherapist will write a graded rehabilitation plan including return to play testing. Shoulder injuries: famous tennis examples Maria Sharapova had surgery to repair two rotator cuff tears in 2008 and has since suffered other problems with her shoulder. Lower back pain What is it?This is very common among tennis players because of the repetitive nature of the game and the demands of the strokes, especially serving. Acute pain may result from a sudden stretch or fall or ongoing ache may be experienced. Physical conditioning is very important to minimise the risk of low back pain in recreational as well as elite tennis players. How does physiotherapy treat lower back pain?A full assessment of movement control, flexibility, strength and endurance will guide the treatment and rehabilitation plans. Our Team may use hands-on techniques for joints and soft-tissues, taping, acupuncture, exercise prescription, and practical advice. Back injuries: famous tennis examples Roger Federer has suffered long-term issues with his back that he manages with core strength training and by playing fewer tournaments, while Andy Murray underwent surgery last year to address a long-standing problem. Wrist sprain What is it? The wrist contains many small joints and ligaments and has a cartilage structure, TFCC, like the knee meniscus, which can be injured. How does physiotherapy treat wrist sprain?The physiotherapist will follow the PRICE guidelines (above) and may protect the joint with a splint or strapping. A full examination will be undertaken to determine which structures are involved. A graded exercise program, including return to play testing, will be undertaken alongside hands-on treatments. Carpal tunnel syndrome What is it? This condition occurs when the median nerve that passes through the wrist is compressed, causing pain throughout the hand, wrist and forearm. How does physiotherapy treat carpal tunnel syndrome? The first priority is to reduce any swelling in the carpal tunnel region and ensure the forearm muscles are functioning properly. An assessment of the neck and neural system will be done to rule out any problems further up the movement chain. An assessment of racquet grip and tennis stroke may help to identify any technical issues. Wrist injuries: famous tennis examples Juan Martin Del Potro has suffered serious injuries to both wrists that have been reported as career-threatening. Nikolay Davydenko is another player to have struggled with a wrist injury. Patella tendonopathy What is it? This injury involves pain in the tendon that connects the kneecap (patella) to the top of one of the shin bones (tibia) and is usually caused by overuse. It can be either acute or chronic in nature. How does physiotherapy treat patella tendonopathy? Management of inflammation and restoration of movement range and control are key factors in this condition early on then a graded loading rehab programme is key. This condition need not stop a tennis player from playing, but the physiotherapist may suggest modifications to the amount or intensity of play. Medial collateral ligament (MCL) sprain What is it?This ligament limits excessive sideways movement of the inner side of the knee joint. It has close links with the knee meniscus (cartilage) and the anterior cruciate ligament. The Unhappy Triad is the name given when all three structures are injured together. MCL injuries can vary from overuse strains to full ruptures. A ruptured MCL may be managed conservatively or surgically. How does physiotherapy treat medial collateral ligament sprain?Immediate treatment involves the PRICE guidelines (above). Protection may be offered in the form of bracing and / or use of crutches. Painkillers can be used but anti-inflammatories should be avoided in the immediate aftermath of the injury. Restoration of normal range of motion is one of the first targets even if weight bearing is still reduced. Movement control including balance and co-ordination skills will form part of the rehabilitation plan along with hands-on techniques and strengthening. The physiotherapist will guide the patient through graded exercises from squatting and lunging type exercises to jumping, hopping and landing skills. Knee injuries: famous tennis examples Rafa Nadal suffers knee tendonitis that requires ongoing management, while Richard Krajceck battled back from a severe knee ligament injury to win further tournaments. Calf strain What is it?Injuries to the calf complex can affect the deep and superficial calf muscles, the Achilles Tendon and the Plantar Fascia of the foot. How does physiotherapy treat calf strain? Immediate treatment involves the PRICE guidelines (above). Protection may be offered in the form of bracing and / or use of crutches. Painkillers can be used but anti-inflammatories should be avoided in the immediate aftermath of the injury. Restoration of normal range of motion is one of the first targets even if weight bearing is still reduced. Movement control including balance and co-ordination skills will form part of the rehabilitation plan along with hands-on techniques and strengthening. The physiotherapist will guide the patient through graded exercises from squatting and lunging type exercises to jumping, hopping and landing skills. Sprained ankle What is it?The most common injury is a strain to the lateral (outside) ligament but the deltoid ligament on the inside/medial side of the ankle can also be injured. Excessive strain on the ankle where it ‘rolls out’ can cause the lateral ligament to stretch or rupture and medial ligament to compress and get squashed. How do physiotherapists treat sprained ankle?I mmediate treatment involves the PRICE guidelines (above). Protection may be offered in the form of bracing such as a walking boot, and / or use of crutches. Painkillers can be used but anti-inflammatories should be avoided in the immediate aftermath of the injury. Restoration of normal range of motion is one of the first targets even if weight bearing is still reduced. Movement control including balance and co-ordination skills will form part of the rehabilitation plan along with hands-on techniques and strengthening. The physiotherapist will guide the patient through graded exercises from squatting and lunging type exercises to jumping, hopping and landing skills. If you are suffering with any of these injuries or any others just call for help and support getting you back to your best!
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Our team of sports osteopaths, chiropractors and Physios in Bath are experts in dealing with injuries sustained playing football and a host of other sports. Read about some common ones below and give us a call if you are struggling with recovery! Dislocated shoulder What is it?This occurs when a player’s arm is pulled or forced from its joint in the shoulder, most commonly in a fall or a collision with another player. How does physiotherapy treat a dislocated shoulder?The shoulder will be reduced and depending on the severity of the dislocation, can be surgically stabilised. Intensive physiotherapy treatment will follow, working on flexibility, muscle strengthening and confidence, to ensure the shoulder does not dislocate again. How long is the recovery?There are several different types of shoulder dislocation, relating to the direction of the dislocation. Anterior dislocations make up around 95% of all dislocations. Recovery will take around 2-6 months, depending on the severity and whether surgery is necessary. Dislocated shoulder: famous football examples England winger Theo Walcott suffered a series of dislocations earlier in his career, and Chelsea keeper Petr Cech dislocated his shoulder in a Champion’s League semi-final. Groin strain What is it?This is a strain of the adductor muscles on the inside of the thigh and occurs when they are stretched beyond their limits and the muscle tissue tears. This can happen when players are stretching for the ball or side-stepping. How does physiotherapy treat groin strain?Immediate treatment will involve the ‘PRICE’ protocol (protection, rest, ice, compression and elevation). The aim here is to reduce the bleeding and swelling from the injury site. This will also help with pain and can last for around three days. Following this, the rehabilitation period will include gentle stretching, soft tissue work and muscle strengthening. Once properly healed, the player can start football specific drills, including jumping, running and sprinting. For safety and to reduce the risk of re-injury, players should complete rehabilitation under the guidance of a chartered physiotherapist. How long is the recovery?Muscle strains can be categorised into three grades. A grade one adductor strain involves 5-10% of the muscle fibres. This will tend to require 1-2 weeks rest before a player can return. A grade two strain is more extensive, including a greater number of muscle fibres. Players will tend to be out for 3-6 weeks in this case. A grade three muscle strain is a severe tear involving most or all (rupture) of the muscle fibres. These players may require surgery and could be out for 3-4 months. Groin strain: famous football examples former Liverpool and England captain Steven Gerrard recovered from a mild groin injury leading into the World Cup. Hamstring strain What is it?The hamstrings are a group of four muscles found at the back of the thigh. These muscles bend the knee. When they are overstretched the muscle fibres can tear leading to a strain. These muscles tend to tear during explosive or rapid movements such as sprinting. How does physiotherapy treat hamstring strain?Immediate treatment will involve the ‘PRICE’ protocol (protection, rest, ice, compression and elevation). The aim here is to reduce the bleeding and swelling from the injury site. This will also help with pain and can last for around three days. Following this, the rehabilitation period will include gentle stretching, soft tissue work and muscle strengthening. Once properly healed, the player can start football specific drills, including jumping, running and sprinting. For safety and to reduce the risk of re-injury, players should complete rehabilitation under the guidance of a chartered physiotherapist. How long is the recovery?Muscle strains can be categorised into three grades. A grade one hamstring strain will involve around 5-10% of the muscle fibres. This will tend to require 1-2 weeks rest before a player can return. A grade two strain is more extensive, including a greater number of muscle fibres. Players will tend to be out for 3-6 weeks in this case. A grade three muscle strain is a severe tear involving most or all (rupture) of the muscle fibres. These players may require surgery and could be out for 3-4 months. Hamstring strain: famous football examples Michael Owen suffered multiple severe hamstring injuries throughout his career Thigh (quadriceps) strain What is it?This is where a tear occurs in the quadriceps group of muscles found on the front of the thigh that are responsible for straightening the leg, ie, when kicking a ball. How does physiotherapy treat thigh (quad) strain?Immediate treatment will involve the ‘PRICE’ protocol (protection, rest, ice, compression and elevation). The aim here is to reduce the bleeding and swelling from the injury site. This will also help with pain and can last for around three days. Following this, the rehabilitation period will include gentle stretching, soft tissue work and muscle strengthening. Once properly healed, the player can start football specific drills, including jumping, running and sprinting. For safety and to reduce the risk of re-injury, players should complete rehabilitation under the guidance of a chartered physiotherapist. How long is the recovery?Muscle strains can be categorised into three grades. A grade one thigh strain will involve around 5-10% of the muscle fibres. This will tend to require 2-3 weeks rest before a player can return. A grade two strain is more extensive, including a greater number of muscle fibres. Players will tend to be out for 3-6 weeks in this case. A grade three muscle strain is a severe tear involving most or all (rupture) of the muscle fibres. These players may require surgery and could be out for 3-4 months. Meniscus injury What is it?There are two meniscus (a type of cartilage) in the knee. Kidney shaped, they provide a cushion between the upper and lower leg bones and can be pinched and torn under pressure. This tends to happen during twisting movements. There are many different types of meniscal tear, including a ‘bucket handle’, ‘radial’, ‘parrot beak’ and ‘horizontal cleavage’ tear. Each tear will alter the biomechanics of the knee and therefore can cause irritation, swelling and pain. How does physiotherapy treat meniscus injury?Dependent on the severity of the tear, it can irritate or cause the knee joint to lock. Sometimes following the initial swelling symptoms resolve with targeted strengthening work with a physio, and other times surgery is required. In this case, the meniscus is either repaired or trimmed. Following surgery, the player will have intensive physiotherapy in order to control swelling, pain and increase muscle activation. This may include hydrotherapy and anti-gravity treadmill training initially, before starting football specific drills. It is important that the rehabilitation is supervised by a chartered physiotherapist to reduce the risk of re-injury. How long is the recovery?A player may be expected to return to play within 4-6 weeks, depending on the severity of injury and the surgery. Meniscus injury: famous football examples ex Liverpool Uruguayan striker Luis Suarez underwent intensive physiotherapy to get fit in time to knock England out of the World Cup. Anterior cruciate ligament (ACL) injury What is it?This is the supporting ligament in the knee joint that enables twisting and turning movements. It can tear or completely rupture during an awkward landing or fall, or under impact of a tackle. How does physiotherapy treat anterior cruciate ligament injury? Rehabilitation following ACL injury is long and intensive whether the ligament is repaired or a patient decides to manage the injury with rehab. It is a staged process to ensure the repair (graft) does not fail from early stressors if a reconstruction has taken place.. Initial treatment can include hydrotherapy, and graded strengthening Football specific drills will be introduced later, starting with straight line running. Pivoting and quick turns will be introduced towards the latter stages of rehab, as these put the newly repaired ligament under the most stress. It is crucial that the player’s rehabilitation is closely monitored and progressed by a chartered physiotherapist to reduce the risk of re-injury. How long is the recovery? You could expect a player to be sidelined for 9-12 months with an ACL injury. The intensive rehabilitation a player receives may lead to a quicker return than expected. Medial collateral ligament (MCL) sprain What is it?This is the ligament that joins the thigh bone and the shin bone and is found on the inner side of the knee joint. As with the ACL, it can be torn through twisting or impact. How does physiotherapy treat medial collateral ligament sprain?Immediate treatment will involve the ‘PRICE’ protocol (protection, rest, ice, compression and elevation). The aim here is to reduce the bleeding and swelling from the injury site. This will also help with pain and can last for around three days. As the ligaments start to heal, the player will be encouraged to put more weight through the ankle joint. The physio will then work with the player on their balance, co-ordination and muscle strength to get them back to match fitness and football specific drills. They may use bracing techniques to support the joint during rehabilitation. It is important that the rehabilitation is guided by a chartered physiotherapist to reduce risk of re-injury. How long is the recovery?MCL sprains can be categorised into three types. A grade one sprain is categorised as a mild sprain of the ligaments. Grade two is a partial tear of the ligament(s) and may result in some ‘looseness’ at the joint. Grade three is a complete tear of the ligament which results in gross instability and may require surgery. Dependent on the type and grade of sprain, a player may be out for up to 6 months. Calf strain What is it?The calf is at the back of the lower leg and is made up of two key muscles which enable players to push off and run. Like other muscles, the calf can be torn and strained when stretched beyond its limits. How does physiotherapy treat calf strain?Immediate treatment will involve the ‘PRICE’ protocol (protection, rest, ice, compression and elevation). The aim here is to reduce the bleeding and swelling from the injury site. This will also help with pain and can last for around three days. Following this, the rehabilitation period will include gentle stretching, soft tissue work and muscle strengthening. Once properly healed, the player can start football specific drills, including jumping, running and sprinting. For safety and to reduce the risk of re-injury, players should complete rehabilitation under the guidance of a chartered physiotherapist. How long is the recovery?Muscle strains can be categorised into three grades. A grade one calf strain will involve around 5-10% of the muscle fibres. This will tend to require 2-3 weeks rest before a player can return. A grade two strain is more extensive, including a greater number of muscle fibres. Players will tend to be out for 3-6 weeks in this case. A grade three muscle strain is a severe tear involving most or all (rupture) of the muscle fibres. These players may require surgery and could be out for 3-4 months. Sprained ankle What is it?A sprained ankle occurs when there is soft tissue damage to the ligaments in the ankle joint. Around 70-85% of ankle sprains are ‘inversion’ sprains. This occurs when you roll the ankle outward and the sole of the foot faces in and up. This can happen during a tackle, by running on uneven ground or landing awkwardly. How do physiotherapists treat sprained ankle?Immediate treatment will involve the ‘PRICE’ protocol (protection, rest, ice, compression and elevation). The aim here is to reduce the bleeding and swelling from the injury site. This will also help with pain and can last for around three days. As the ligaments start to heal, the player will be encouraged to put more weight through the ankle joint. The physio will then work with the player on their balance, co-ordination and muscle strength to get them back to match fitness and football specific drills. It is important that the rehabilitation is guided by a chartered physiotherapist to reduce risk of re-injury. How long is the recovery?Ankle sprains can be categorised into three types. A grade one sprain is categorised as a mild sprain of the ligaments. Grade two is a partial tear of the ligament(s) and may result in some ‘looseness’ at the joint. Grade three is a complete tear of the ligament which results in gross instability at the ankle joint and may require surgery. Dependent on the type and grade of sprain, a player may be out for around 3-6 months. Broken metatarsal What is it?This is a bone in the foot that can be broken through contact, excessive rotational force or simply overuse. How does physiotherapy treat a broken metatarsal? Initially the player will be encouraged to take weight off the foot by wearing an aircast boot. Once the medical team are happy that the bone has healed sufficiently, the player will gradually return to play. The physiotherapist will specifically work on maintaining fitness, muscle strength/length, balance and co-ordination. How long is the recovery?Dependent on the severity of the injury, recovery can take between 4-8 weeks. If surgery is required, this could be longer. Broken metatarsal: famous football examples David Beckham and Wayne Rooney suffered high-profile metatarsal injuries before major tournaments for England, although both went on to play in the 2002 and 2006 World Cups respectively. Rooney has suffered the injury on three occasions. |
AuthorPhysioimpulse Chartered Physiotherapists Archives
June 2024
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