PLEASE NOTE: The medical opinions in USTA.com's Ask the High Performance Lab are responses intended for the average player. Please consult with your primary physician before beginning any new exercise program.
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The answers in this week’s column are presented by Michele McCoy, athletic trainer and strength and conditioning coach for USA Tennis High Performance. Michele joined the USTA staff earlier this month and comes with a background in working with elite level athletes. She earned her Master’s degree in Sport Psychology from San Diego State University in 1995 and her Exercise Science/Athletic Training degree in 1993 from Appalachian State University. Michele also competed as a junior tennis player in Florida and played on the Appalachian State University tennis team for two years.
Q: I am a woman in my mid-40s who plays tennis up to four times per week. I have been relatively injury-free up to now but have a concern over a developing problem, a feeling of stiffness and soreness in my knees. This pain is apparent when I first get up in the morning as well as after I play. I play tennis almost exclusively on hard courts. What can I do in terms of warm-up exercises, shoe inserts, etc. that can help stop this problem from becoming worse?
McCoy: The pain you are describing could be from a number of things including tendinitis or arthritis. Playing exclusively on hard courts forces your knees to take quite a beating. Either way your problem likely has to do with inflammation around the joint causing the stiffness you feel in the morning. You can stretch your quadriceps out regularly during the day (hold for at least 30 sec) as well as before and after you play. It is also beneficial to warm-up gradually before starting high level play.
The USTA has developed a DVD of warm-up exercises that tennis players can perform to help get the body ready for tennis.
Taking some anti-inflammatory medication, like ibuprofen (Advil), before you play may help alleviate some post-activity soreness as well. On the days that you are already sore, I recommend decreasing your playing time or rescheduling and immediately icing after you get off the court. Stretching, ibuprofen, and icing should help alleviate your symptoms.
Check with your doctor to verify why you are feeling pain, and as always, check with a physician before starting or changing medications.
Q: I have been experiencing shin splints for the last month or so. The pain mostly occurs 3-5 hours after playing and more so the next day. Rarely does it hurt while I am playing. I have been stretching, emphasizing my calves, but it has not made a significant difference. The shin splints began to occur at a time when I was playing more but also I had switched sneakers. I have tried switching sneakers (and then back) but the pain persists. I am unsure if it is the shoes, amount of playing time (4-6 hrs per week), both, etc. Please advise of any cause/ prevention/ treatment/ exercises etc. that you are aware of.
McCoy: There are many different theories to the actual cause of “shin splints” or “anterior pain syndrome”. It’s been speculated that muscle tightness, strength imbalance or weakness can cause this problem as, well as training or equipment errors. Players who hyperpronate (flat feet) are also at a great risk of developing this injury. When you stretch your calves, make sure you stretch the much forgotten soleus muscle – this lies beneath the bigger gastrocnemius muscle that you see in your calf.
To stretch the soleus you need to stretch your calf with the knee slightly bent. Make sure your ankles are strong by doing heel raises and tubing exercises that work the foot in all directions. Immersing your shins in ice buckets after playing will help decrease the inflammation that occurred with the workout. If you are still sore the next day, ice again before you play. If you try these and you are still bothered by them, go to the local drug store and get some Dr. Scholl’s inserts. Your arches may need some extra support.
Q: What tennis elbow brace is the best? There are so many to choose from. Has your organization done any surveys or studies to see which brace has the best result?
McCoy: In my experience, most tennis elbow braces are similar in how they perform. The best brace to get is the one that you feel comfortable in and the one that you will wear.
Q: I have a problem with bruised toes caused by sudden stops on the court. Do you have any recommendations?
McCoy: You need to buy a shoe with a wider toe box. Perform your tennis movements in the store before you purchase the shoes to make sure that your toes have adequate room.
For more helpful health & fitness-related advice from our team of experts, visit the USTA High Performance website.