Tag Archive: Tennis injuries

1. What does Jack Wilshere have in common with a Dinosaur?

   4th December 2014 3:13 pm 4 Comments

   They both suffer from stress fractures!

   Poor old Jack Wilshere will be watching the Champion’s League Final from the comfort of his own home this week.

   Could he have helped Arsenal get to the final if he hadn’t suffered from a stress fracture in training?

   Physiotherapist Sarah Marshall looks at what we know about stress fractures and how to prevent them.

   The human problem

   Stress fractures in the human population were first reported in military recruits in the 19^th century. A stress fracture is an incomplete fracture and caused by a repeated overload to a focal point of bone.

   These injuries can occur in virtually any bone in the body but they are more commonly seen in weight bearing bones amongst runners and footballers e.g. tibia and metatarsals.

   There are many predisposing factors which can contribute to a stress fracture such as:

   • poor mechanics
   • muscle weakness / imbalance
   • training errors
   • poor footwear / training environment
   • inadequate nutrition (Vitamin D deficiency)

   Getting the diagnosis

   Stress fractures are often difficult to diagnose. Many athletes will have continued with their sport for many months before seeking medical attention. Some key things to consider are:

   • Pain will be localised to the fracture site and specifically tender on palpation.
   • Pain will be aggravated by the precipitating activity, becoming severe towards the end.
   • Swelling or bruising is not commonly seen.
   • An x-ray appearance is often normal although signs of repair can be seen at times.
   • MRI and CT scans are the investigation of choice.

   5 things to consider in management of a stress fracture

   1. Relative rest is the initial treatment of all stress fractures. If the stress fracture occurs in a weight bearing bone complete rest and / or a cast or walking boot may be prescribed for up to 8 weeks (or longer in more severe cases).
   2. The amount of recovery time and degree of rest will vary on the location, severity and healing response of the individual.
   3. Return to sport and activity must be a gradual process to enable the bone to adapt to an increased load again.
   4. Further use of investigations are not useful during this rehabilitative phase as they can be deceptive i.e. the fracture site can still be visible even when the bone itself has fully healed.
   5. Healing is best assessed clinically by the absence of tenderness on palpation and a pain free precipitating activity.

   What have Dinosaurs got to do with it?

   A study was published by Bruce Rothschild and other palaeontologists back in 2001 which studied and confirmed the presence of stress fractures in Theropod dinosaurs.

   They were able to conclude that Theropods probably sustained these overuse injuries in the lower end of their third metatarsals whilst holding struggling prey with its feet.

   Don’t train like a Dinosaur (Or Jack): Follow a correct training programme (see here)

   Always seek medical advice before commencing a running regime if you suffer from an illness or have a musculo-skeletal disorder or injury.

    Sarah Marshall 

2. Rafael Nadal Tennis Injury

   29th January 2010 9:24 am Leave a Comment

   So Rafael Nadal has withdrawn injured from a Grand Slam tournament – again. Andy Murray marches on to the final, relatively injury free.
   This isn’t the first time that the trainers and physios have had an impact on the outcome of an important match, this report from last year’s U.S. Open:

   INJURY DAY:

   Juan Martin del Potro ran into a wall. Gilles Simon tweaked his knee. Jose Acasuso had left knee pain. And when Rafael Nadal flopped to the ground to receive treatment on his abs, his opponent, Nicolas Almagro, figured he’d call the trainer, too. Injuries ran rampant at the U.S. Open on Sunday. None appeared to be too serious.

   Simon and Acasuso each retired from their matches while trailing. Del Potro was fine _ just a little flesh wound _ while Nadal, who missed Wimbledon with bad knees, said he was getting sick and tired of talking about injuries, but that the strained abs that have been bothering him since last month won’t keep him out.

   I saw Rafa call, so I prefer to call at the same time, Almagro said of the dueling injury timeouts in Ashe Stadium.

   Trainers came out and worked on his back and 20,000 fans got to watch both tennis players laying on the ground, getting massages.

   What a difference a rubdown makes?

   My tennis was the same, before the trainer, after the trainer, Almagro said.

   This year’s Australian open also showed that the 5 set epics such as this one: can also be decided by the trainer.

   Potential causes of this could be:

   • poor scheduling of the tournaments
   • players playing when already injured due to financial pressures
   • tournament sponsors wanting their pound of flesh with big names having to attend
   • poor conditioning- lack of foundation training from an early age
   • gamesmanship- the opportunity to halt momentum and refocus mentally

   The male tennis player Grand Slam champions of the future could be the ones that manage to remain injury free, the ones with staying power. This makes Roger Federer’s recent accomplishments all the more remarkable.

   Read our Guide to Tennis Injuries Here