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Recognizing Warning Signs – Listen to Your Body!

September 23, 2003 02:49 PM

by Jim Brown, Ph.D.

The ability to recognize injury “warning signals” is essential to athletic performance and longevity. Tennis players who are disciplined enough to act on those signs avoid some injuries and recover quickly from others. Those who don't know what to listen for or who push the exercise envelope in spite of what their bodies tell them are destined to spend as much time recovering as competing.

We asked physicians and therapists to tell readers how to know when to push, when to pull back, when to train, when to rest, and when to get medical attention from a professional. Limb by limb, here is what they said:

The Foot and Ankle
Donald Baxter, M.D., Clinical Professor of Orthopedics at the University of Texas, begins with an obvious but often ignored principle. "If a pain in your foot or ankle gets worse as you run, that is not a good sign. If it hurts less as you run, it probably means that the exercise is moving fluid and swelling out of the area. You can exercise, but don't overdo it."

"We conducted a study in which 100 persons with heel pain exercised while a control group with the same problem did nothing. The group that participated in a walking program recovered sooner than the non-exercise group. That doesn't mean that more exercise on an injured foot is necessarily better. Walking a mile might be appropriate; walking five miles could make an injury worse."

"Some injuries," continues Baxter, "may not feel as bad as they actually are. For example, stress fractures at the top of the arch can cause a dull ache rather than acute pain. However, if exercise causes the stress fracture to develop into a complete fracture, multiple surgeries might be needed to correct the problem."

"Athletes can help themselves by having some knowledge of anatomy. With an Achilles tendon problem, for example, the sheath around the tendon may be irritated. By stretching the tendon and reducing the intensity of exercise, the person can probably continue to work out without making the situation worse. If the condition is tendinosis (the tendon is actually damaged), exercise could cause an Achilles tendon rupture. If you are not sure, get professional advice."

The Knee
"You can tell a lot about a knee injury by the circumstances under which it occurred," says William Greenwood, M.D., an Atlanta orthopedic surgeon. "If you can remember a specific time or traumatic event that caused significant pain, you probably ought to stop exercising and see a physician. This is especially true if the pain is accompanied by swelling, popping, locking, instability, or an inability to extend the leg fully. There is a good chance that ligament damage has occurred."

"Some knee injuries have an insidious onset. There is no direct trauma; the pain just hangs on or gradually gets worse. If the symptoms persist for several days, see a sports medicine physician."

Greenwood advises extreme caution in determining exercise volume following an injury. "With X representing exercise, don't exceed X divided by 2," he says. "Listen to your body and determine the lowest level of activity that seems reasonable. Then cut that level in half. Take it easy. Mornings are a good time to decide what your knee can do. If it feels pretty good after you've been up and around for 20-30 minutes, it's okay to do a ridiculously little amount of exercise."

One additional suggestion: The cartilage of a meniscus (the crescent-shaped pad between the bones of the knee joint) may be damaged when the knee is twisted. If the meniscus is simply irritated, it will usually heal and the pain will subside with prescribed exercises and anti-inflammatory drugs. If the meniscus is torn, it will probably not heal because the circulation to that part of the knee is very poor. In either case, see a physician. An MRI will tell both of you the nature of the injury.

Next Column: The Shoulder and Elbow

© HMS Publishing, Inc.

Jim Brown will be contributing new content to this site on a monthly basis. If you have a question for Dr. Brown please feel free to email him at sportsmed@mindspring.com.

 

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