Wrist Injuries In Tennis
Published November 03, 2010 12:00
A number of Tennis players are sidelined by wrist injuries. Many of the injuries sustained by professional tennis players are in the non-dominant wrist because of their use of the two-handed backhand, where the non-dominant wrist gets quite a workout. To avoid a wrist injury due to poor stroke mechanics, read the previous topic in our Fitness section: "Stroke Mechanics: Backhand" and profit from Dr. Ben Kibler's Tip for your most successful backhand.
The most common cause of wrist pain in Tennis players is "Tendonitis", an inflammation of the tendon that crosses either the front or the back of the wrist. Repetitive strokes or extreme grips contribute to wrist tendonitis. If you are having wrist pain, talk to your coach and evaluate your stroke mechanics and your equipment including grip size, racket size and weight, and string tension. If you are diagnosed with tendonitis in your wrist, the initial treatment is rest. Physical Therapy plays an important role to decrease the inflammation and restore normal motion and strength to the wrist and upper extremity. Injuries of this nature take approximately 6-8 weeks to heal, although this varies and depends on many factors.
In addition to Tendonitis, other injuries can cause pain and limit your performance on the court:
• TFCC Injuries:
The TFCC, called Triangular Fibrocartilage Complex, is similar to the meniscus of the knee. It is located between the closest bones of the wrist and the ulna (the forearm bone on the little finger side). It can be damaged or torn with improper technique, wrong grip or heavy equipment and may require surgery for repair. A change in technique and equipment analysis with a coach, certified athletic trainer, or biomechanist, will help prevent wrist and TFCC injuries.
• Stress Fracture:
A stress fracture is one type of an incomplete fracture of the bone, which looks like a very small sliver or crack in the bone and is sometimes referred to as a "Hairline Fracture". This injury typically occurs with a fall on the wrist or overuse and is diagnosed with an MRI (Magnetic Resonance Imaging). Initial treatment includes bracing or casting for at least 4 weeks, and is followed by rehabilitation and Physical Therapy.
• Ligament Sprain:
A ligament is tissue that connects bone to bone, stabilizing your joints and preventing the joint from excessive motion (opening or gapping). If the joint is overloaded and the ligament cannot withstand the load, a sprain or overstretch, of the ligament occurs. Depending on the severity of the load, the ligament may rupture. The injury should be assessed by an orthopedic physician who may order an MRI to get an exact diagnosis. The treatment may include bracing during a period of rest (depending on the grade of the sprain between 10 days and 4 weeks) followed by intensive rehabilitation including Physical Therapy.
• Cartilage damage:
Cartilage is a stiff yet flexible connective tissue to protect the bone. Cartilage is found in the joint line on both bones and is stiffer and less flexible than muscle. With overuse, the cartilage can be damaged or torn and surgery may be required to repair the injury. Following the appropriate rest to aid healing, rehabilitation is initiated to restore the range of motion and stability of the wrist after surgery.
Wrist pain tends to be easily diagnosed and typically in the hand and wrist, the location of the pain generally identifies the location of the problem. Unlike other parts of the body, especially in the spine, pain may be referred to many different locations.
Simple tests can be done by a Physical Therapist/Certified Athletic Trainer or a hand specialist to differentiate between Tendonitis, Cartilage damage and a Ligament Sprain. Tendonitis tends to be more of an overuse injury compared with a ligament sprain, which tends to be traumatic and occur during one specific movement.
Get in Front - Prevent!
Here are a few helpful hints to prevent wrist injuries:
1. The arm and wrist are not designed to generate the force needed to hit the ball hard. The force must be generated by the legs and trunk and then transferred to the racket by the arm. Strengthening the core (trunk muscles) as well as the legs can help take the stress off the wrist.
2. Strengthening the muscles around the wrist is done with simple exercises using hand weights or a "spinning ball". Ask your Physical Therapist or Certified Athletic Trainer to recommend some of these exercises.
3. Many Tennis players have stiff elbows and wrists, which cause compensation in other areas, frequently in the tendons. Stretching exercises and manual therapy by a Physical Therapist can increase the range of motion and prevent other compensatory injuries.
4. Talk to your Coach or Certified Athletic Trainer about your technique, specifically about your grip. For most of the weekend "warriors", it is all about the way they hit the ball!
Thanks to Joanna Goldin, MCSP, RPT, Primary Health Care Provider - WTA
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