Timely Tips for Tennis Types

Lloyd Nesbitt, DPM

THE PHYSICIAN AND SPORTSMEDICINE - VOL 26 - NO. 5 - MAY 98

Tennis players of all skill levels can improve their health along with their game by using some simple measures for conditioning, technique, injury prevention, and equipment.

Conditioning and Skills

To improve your heart and lung conditioning, consider a running program. Running three to five times a week will help you sustain the stamina for a top level of play through long matches.
Get expert instruction in both conditioning and technique. The pros will not only help you with technique, but also provide you with a fitness program to suit your physical condition and level of play.
Work on all-around flexibility and strength. Consider consulting a sports physiotherapist or medical professional who can recommend a program to suit your body type.

Preventing Injury

Warm up before starting to play, without fail. And remember that a warm-up means getting warm. Start with brisk walking or easy jogging to get your muscles warm, then stretch for several minutes. Consult a qualified instructor and develop your own warm-up routine, centering on muscles that come into play during a tennis match.
If you are prone to ankle sprains, tape up with the proper athletic product, or consult a sports shop or healthcare professional for an ankle brace designed for tennis. (For advice on other injuries common in tennis, see "Court Trials: Coping With Common Tennis Injuries" below.)
Calf muscles can get tight in tennis. Do lots of runner's stretches before, between, and after matches (figure 1). These are especially good for women who spend time in high- heeled shoes.
Drink lots of water before, during, and after your match. Avoid caffeine, alcohol, and drinks that are high in sugar.
Ongoing sore feet or legs in tennis may be a result of a mechanical foot imbalance. This can often be corrected by taping, an off-the-shelf orthotic insert, or a custom-made orthotic device prescribed by a healthcare professional.

Equipment

Wear tennis shoes for stability and cushioning (see "Selecting Tennis Shoes," below). Don't wear running shoes, which are designed for forward motion and don't protect as well against an ankle sprain.
Socks have improved. Try those for tennis that wick away perspiration and reduce friction. Reduced friction can help you avoid blisters.
Choose the right racket (1). Your arm should not get tired swinging it. Mid-level string tension will absorb shock but give good power. And as you grasp the handle, a finger's width should separate the tip of your middle finger from the crease at the base of your thumb.
Keep a couple of small adhesive bandages in your bag in case you need them for foot or hand blisters.

Game Point

Tennis is a great way to get muscles working, enjoy time with a friend or three, and test your ability. The tips provided above can help you ace the sport without double-faulting on your body.

Reference

Harding WG III: Elbow pain in young tennis players: selecting the right racket, learning good technique. Phys Sportsmed 1991;19(9):135-136

Selecting Tennis Shoes

Wear shoes that are designed specifically for racket sports and support your feet well. Replace worn-out tennis shoes. Patches or other repairs are temporary at best, and excessively worn shoes can affect both your feet and your playing style. Never play in improperly fitted or borrowed shoes.

When buying shoes, look for those that support the arch firmly and allow room to move your toes. At the store, try tennis shoes on and practice some on-court moves to make sure they fit and feel comfortable. As a rule, more expensive shoes are of better quality, but not always. Look for:

Reinforcement at the toe to protect your foot and minimize wear when the toe drags on the court;
A well-padded sole at the ball of the foot, which is where most pressure is exerted;
Sturdy sides of the shoe for stability during side-to-side motions;
A well-cushioned heel for absorbing jarring forces;
Ample room in the toe box to prevent blisters; and
A firm and well-padded heel counter (back and sides of heel) for support.

Court Trials: Coping With Common Tennis Injuries

Even if they take precautions to avoid injury, tennis players sometimes get hurt. Here are pointers on how to deal with some of the most common tennis problems.

Corns and calluses. Corns and calluses indicate pressure, friction, and imbalance of the foot. If you have calluses, place 1/8-inch or 1/4-inch moleskin or felt on each side of the callus to reduce pressure until you can get proper medical help. Do not use commercial acid corn "cures," because they can lead to skin irritation and infection.

Because most corns and calluses are signs of some underlying mechanical problem, they cannot be eliminated permanently until the problem itself is corrected. Seek professional attention. Simple corrective procedures can relieve disabling problems.

Tennis leg. Sudden movements of the foot and leg may result in "tennis leg," or a muscle tear deep within the calf. Never play with calf muscle pain. Seek medical help.

Tennis elbow. Bending the elbow during a backhand swing, an improper racket, and weak muscles can all contribute to pain in the elbow (1). If you have persistent elbow pain, take a break from tennis for a few weeks. Icing can also help. If the pain continues, see a physician, who may prescribe an elbow strap, strengthening exercises, and other measures.

Tennis toe. Tennis toe is characterized by severe, throbbing pain beneath the toenail. Symptoms include vague swelling of the toe and purple discoloration under the nail. The discoloration is from bleeding, which may appear as vertical streaks beneath the nail.

The condition usually affects the big toe or the one next to it. Tennis toe is often caused by modern tennis shoes, which give such good traction that the foot is forced to the front of the shoe during sudden stops, thus traumatizing the nail. Shoes should have a finger's width of room in front of the toes.

Initially, you can use cold packs and painkillers like aspirin to provide relief if the pain is severe. Placing a 1/8-inch-thick felt pad on the skin behind the base of the nail can help you prevent or cope with the problem, as can trimming the nail. Medical care can also help.

When to stop, when to resume. Swelling, stress, and strain won't necessarily mean you have to stop playing altogether. You may just have to scale back. Assessment and treatment by a medical professional can pave the way to pain-free playing.

Don't try to return to full tennis activity immediately after an injury or other forced layoff. Return gradually, and slow down if you feel pain. Get professional advice if you're unsure of how to resume your program.

Reference

Case WS: Acing tennis elbow. Phys Sportsmed 1993;21(7):21-22

Remember: This information is not intended as a substitute for medical treatment. Before starting an exercise program, consult a physician.

Dr Nesbitt is a podiatrist in private practice in Toronto.

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