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Ask the High Performance Lab - Oct. 31

May 25, 2008 12:25 PM

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.

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 has 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 wondering what you recommend for the prevention and care of blisters both during and after a tournament. My 15 year old has been experiencing problems with blisters that develop during a tournament. How do you care for them to allow continued play and prevent them in the future?

-- Nancy Kennedy in Colorado Springs, Co

McCoy: To prevent blisters, I have several suggestions. First, don’t wear new shoes during a tournament. Break them in slowly by alternating new shoes with older ones during practices. Make sure the brand of shoe fits properly and is not too tight. Another suggestion is to try wearing 2 pairs of socks during play. Also, make sure the foot stays dry (change socks, use powder regularly) and aired out as much as possible (for example: change into sandals immediately after a workout). Finally, keep calluses shaved down as much as possible without exposing new skin by using a pumice stone or file.

Q: I'm a 50 year old weekend warrior who is in good shape, but doesn't always stretch. Over Labor Day I over did it and developed tendonitis in both Achilles tendons. You can imagine the pain and agony. I went through physical therapy and rehabilitation. I'm pretty much pain free, but still feel a little stiffness in the morning. Is it okay to get back on court with my pro and have feed me balls just to work on stroke, technique, etc? I'm dying to do something.

-- Jose Maldonado in Brooklyn, NY

McCoy: Yes, because you said that you are pain free you can begin your workouts again SLOWLY. However, also recognize that the tendonitis probably developed from a number of factors (shoes, training, foot biomechanics, weight gain/loss) and not from a lack of stretching/ flexibility. So keep that in mind. As you get back into tennis, take the time to warm-up before you play - 10 to15 minutes, until you break a sweat. Then, continue to gently stretch your calf. Lean against the net post with your foot behind you and the leg straight, hold for 30 secs and then bend your knee slightly and hold for another 30 secs. Perform 3-5 times.

Q: I recently suffered a broken ankle and was wondering if you had any suggestions for exercises or other activities that will help speed the recovery time.

-- Eric Nace in Spring Grove, PA

McCoy: Your ankle will heal faster and better with exercise, but without being able to see you or your medical report it is difficult to prescribe exercises. My suggestion is to seek the help of a physical therapist in your area and you should probably be seeing the PT 3-4x’s a week. You should be focusing on regaining your strength and balance. Some exercises that the PT will most likely recommend are: heel raises, single leg balance drills, lunges, mini-squats and step-ups.

Q: My daughter is 14 and has grown 6 inches in the last 12 months. She plays USTA and varsity tennis for her high school. She has been experiencing pain in the tendons in her knees. I have been icing and giving her Advil. Is there a recommended routine or exercises that she can I do help strengthen her knees. I was planning on hiring a personal trainer to work with her in her off season. What do you recommend?

-- Sherry Fox in McHenry IL

McCoy: It sounds like a typical growth spurt. Our bones grow faster than the muscles do, so the muscles are continually being stretched by the attached tendons during these times of rapid growth. You have been doing things properly. I would just add some thigh and hip flexor stretches to your routine to help maintain/improve flexibility. Strengthening the muscles around her knee will help some as long as the exercises don’t hurt her while she is performing them. She should definitely avoid seated leg extensions and lunges which will aggravate the already stressed tendons.

Q: The junior tennis player in our family has incurred a stress fracture in her lower back. We are consulting with a specialized sports medicine doctor about her stress fracture, but I would like an opinion on what type of technique issues might generate potential stress on the lower back such as a kick serve etc. that should either be eliminated or altered from her tennis game? Her training has been consistent over the past year. No one traumatic injury occurred, so to me it would suggest a technical issue to be addressed.

-- Sarah in Massachusetts

McCoy: Stress fractures result from chronic wear on the bone. It may not be just a technical issue, but also a quantity of tennis issue. How much tennis is she playing per week while her body it still having to adapt to growing demands? Without knowing exactly where the fracture is located, I hesitate to suggest any technical adjustments.

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