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Ask the High Performance Lab - April 24

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.

Todd Ellenbecker, Chairman of the USTA Sport Science Committee. Todd is a physical therapist and clinic director of Physiotherapy Associates Scottsdale Sports Clinic in Scottsdale, Arizona.
All answers to this week's "Ask the High Performance Lab" column are provided by Todd Ellenbecker, Chairman of the USTA Sport Science Committee.

Todd is a physical therapist and clinic director of Physiotherapy Associates Scottsdale Sports Clinic in Scottsdale, Arizona. He received his degree in physical therapy from the University of Wisconsin-LaCrosse in 1985 and a master's degree in exercise physiology from Arizona State University in 1989.

In addition, he is a certified sports clinical specialist, an orthopedic clinical specialist by the American Physical Therapy Association, and a certified strength and conditioning specialist. He is also a certified USPTA tennis teaching professional.

From Wayne Mikell of Ocala, Florida: My daughter has played competitive tennis for ten years, about four months ago she complained of right hip pain after a hard match. We tried physical therapy with no results and we saw a second orthopedists who diagnosed her with sacro-illiac rotation. We have been seeing a chiropractor with somewhat better results.

It is no longer a goal to get my daughter back on the court but to just get her to be pain free. Do you have any suggestions for me? Do you know of any one who specializes in this treatment. Any suggestions would be greatly appreciated.

Todd Ellenbecker: Regarding your daughter, injury to the lower back and sacro-illiac region is a common occurrence in high performance players.

Typically, the best treatment involves decreasing the initial pain and inflammation, and then most importantly, developing a comprehensive program of core stability training to support the lower back and pelvis through specific exercises and stretching. This program initially must be set up by a knowledgeable sports physical therapist and continue to be carried out to ensure that optimal stability is provided by these muscles.

The chiropractor may be placing the lumbar spine and sacro-illiac segments into proper alignment, hence the better recent result, however, if your daughter is rather hyper mobile or extremely flexible in these areas, this treatment alone without the proper core stability training would likely not completely address the problem. Core stability training is a very important part of treatment and prevention of sacro-illiac and lumbar spine injury.

From Cheryl of Austin, Texas: I recently started playing more tennis and now all of a sudden I have wrist soreness. It doesn't happen during the match or practice but later in the day it's sore and it doesn't totally go away. I'm left handed and it's my left wrist. It hurts even while typing or writing or other non-tennis wrist uses. I've never had prior wrist soreness. Is this over use or tennis technique and what can I do to correct it. I love playing tennis.

Todd Ellenbecker: Cheryl, you likely have tendonitis of your wrist, and fortunately, you are in the beginning stages of it. You likely are experiencing low levels of inflammation which is why it doesn’t really hurt while you play tennis but only after.

The most important thing you can do is to have your technique checked by a certified tennis teaching professional. Often tendonitis in the wrist is caused by improper loading or technique, most specifically, using the wrist and elbow segments to produce the power behind your strokes rather than the entire kinetic chain (legs, hips and trunk).

Treatment usually consists of ice, rest, and sometimes in the more severe cases formal physical therapy to decrease the pain and inflammation with ultrasound and electrical stimulation. Also important is to increase your arm strength. Doing very light weights with multiple sets of 15 repetitions for wrist curls with the palm up and palm down are a good start. Additional exercises and specific guidance can be given by a sports physical therapist or athletic trainer.

While this seems like a lot of advice, it shows how all aspects of care are important – checking your technique, decreasing inflammation and finally increasing arm strength – good luck.

If you would like to submit a question that may be answered by our Health & Fitness team or want to share an idea for a future column, please click here.

Click here for USTA.com's Health & Fitness Archive.

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