What you need to know about physiotherapy and podiatry.
Physio&SoleClinic Physiotherapy September 13 2020
1. Tennis Elbow
Lateral epicondylgia, commonly known as tennis elbow, refers to the irritation and pain of the tendons joining the forearm muscles to the outside of the elbow. It is also known as tendinopathy of the common wrist extensors.
This condition is similar to golfer’s elbow, but it occurs on the tendon located at the outside of the elbow rather than the inside.
Tennis elbow is often the result of overuse. While it commonly occurs among athletes who play tennis and other racquet sports, it can also occur in non-athletes who have occupations that require repetitive movements of the hand and upper limb. Symptoms of tennis elbow include pain or burning sensation on the outside of the elbow, or weak grip strength. You may find that the symptoms are worse with exerting force during repeated upper limb or forearm activity, especially during prolonged tennis sessions or the morning after playing tennis.
2. Shoulder impingement syndrome
Shoulder impingement syndrome is a condition where your shoulder’s bursa and/or rotator cuff tendons are intermittently trapped and compressed during repetitive shoulder overhead movements during tennis. Shoulder impingement can be very painful. Persistent shoulder impingement may cause painful inflammation of the bursa in the shoulder, or cause a structural injury to your rotator cuff tendon (see point 3). Symptoms include:
3. Rotator Cuff tendinopathy and/or tears
The rotator cuff comprises four muscles and tendons that come together to provide stability and mobility to the shoulder. The rotator cuff can get irritated with persistent shoulder impingement and can develop a tear gradually. It can also be a result of overuse from intense tennis, or with age due to degenerative changes. Symptoms of a rotator cuff tear can present similar to shoulder impingement. However, most patients with a tear will present with specific weakness in the shoulder and have difficulty lifting the arm overhead.
4. Stress Fractures in the Back
During tennis serves, a combination of back hyperextension, side-bending and trunk rotation is required. If your body is not conditioned appropriately, the motion of a tennis serve may put excessive stress on the lower back, and can eventually cause stress fractures in a portion of the vertebra called ‘pars interarticularis’. Stress fractures are not always painful, but it can result in pain in the lower back that gets worse with activity. This can eventually result in a more severe condition called spondylolisthesis, in which the vertebra shifts forward. When spondylolisthesis occurs, there may also be symptoms such as numbness and weakness in the lower limbs. A medical consultation is important for this injury.
5. Patellar Tendinopathy (aka Jumper’s Knee)
The patellar tendon attaches the kneecap to the shinbone and is connected to the quadriceps muscle via the quadriceps tendon. The patella tendon plays a role to help move the leg and support our weight when walking and jumping. High load activity such as jumping can put excessive strain on this tendon. Sports that require repetitive jumping can result in microscopic tears and overuse injury to the patellar tendon. Patellar tendinopathy can present with localised pain and swelling, and it is often aggravated with jumping, kneeling, squatting and walking up and down stairs.
6. Ankle Sprains
In a fast paced game such as tennis, it is very common for players to suffer from ankle sprains. Sudden sideways motion can cause the ankle to twist, stretching out or damaging the ligaments in the ankle. An acute sprain can cause pain, difficulty walking, stiffness, bruising and swelling in the ankle. The ankle is often unstable and recurrent ankle sprains are common if the player does not undergo a complete rehabilitation program to restore ankle range, balance and strength.
How can Physiotherapy help?
Through a thorough examination, a physiotherapist can identify the injury and the contributing factors resulting in your condition. The treatment plan will be customised depending on the stage and severity of your condition. You may be advised to seek medical consultation for further tests and management. Mostly, physiotherapists will be able to provide immediate advice on activity modification, sports taping, pain relief methods, as well as prescription of specific exercises to assist in your recovery to play tennis again.
Lan Danlin Esther
Principal Musculoskeletal Physiotherapist
Physio & Sole Clinic