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Ask the Lab: Leg Injuries & Hydration

May 25, 2008 12:25 PM

Originally published June 18, 2007

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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    From Denise Ashworth of Fountain Hills, Arizona:

    My 60-year-old husband is a very good tennis player. He is rated 4.5 and plays several times a week. He works out regularly and is in very good shape.

    He seems to be re-injuring his legs in various places over the past few years. First his in-step, then Achilles, then both of his calves and now the thigh muscles.

    A physician friend of ours said it is because he is accumulating scar tissue and not getting rid of it. He said that he should have intense physical therapy to get rid of the scar tissue buildup in his legs.

    Do you have any suggestions? Thank you!

    Dr. Riewald: Denise, the pattern you describe sounds very much like a kinetic chain based pattern of injuries. What I mean by this is that the segments of the body are linked together like the links in a chain and every part of the body is linked to every other part.

    In the case of your husband, an initial foot injury could have forced him to compensate in some way (e.g. running slightly differently) and this placed added stress on the calves/ Achilles tendon. This injury then forced another adaptation that places added stress on the knee, and so on.

    It is not uncommon for tennis players to suffer an injury in one part of the body and then to quickly get injured somewhere else because they changed their technique or made some adaptation that placed additional stress on another part of the body.

    There are several things to consider in addressing this problem:

    • First, have the problems evaluated by an orthopedist to get to the root of the injuries and get any physical therapy the doctor recommends (this would include breaking up scar tissue if that is in fact what is contributing to the problem).

    • Strength and flexibility (or more accurately a lack of strength and flexibility) often contribute to breaks in the kinetic chain. Most players benefit from regular stretching and injury prevention exercises. Unfortunately, most traditional exercises do not target the muscles that need to be strengthened in tennis player.

    • Work with a tennis pro to evaluate your husband’s technique. Poor technique and injuries often go hand in hand.

    • A lot starts with the feet. Have an evaluation to assess if your husband would benefit from wearing orthotics.

    • Make sure you allow adequate time, and follow all instructions, to recover from an injury before starting intense play again.

    Would drinking two cups of coffee before you play tennis on a hot day be detrimental to your body? Would drinking beer or wine the night before a tough tennis match on a hot day be harmful to your body?

    Dr. Riewald: Harold thank you for your questions. As to your first question, there are a couple of schools of thought on caffeine.

    For many years caffeine has typically been thought of as a diuretic - a substance that causes the body to increase urine output which leads to a loss of fluid from the body/ dehydration.

    Consequently, sport scientists and nutritionists have advised athletes away from drinking caffeinated beverages. However, several recent studies suggest that caffeine does not result in significant fluid loss/dehydration.

    Caffeine also has a mild stimulatory effect that could actually benefit tennis performance, depending on how far in advance of your match you consume it. However, since it is a stimulant it can also increase heart rate and may also affect blood pressure.

    Be sure to check with your physician to determine the effect caffeine will have on your health and performance.

    Regardless of whether you drink coffee the morning of your match or not, you should plan to have a hydration strategy for when you step on court. Follow the recommendations put forth by the USTA Sport Science Committee in the USTA’s Hydration Guidelines.

    As for alcohol consumption, anyone who has consumed a few alcoholic beverages knows that it does in fact increase urine output and can lead to dehydration. Also, drinking alcohol after a match or practice will delay recovery, as the body’s first priority is to break down the alcohol before replenishing muscle glycogen/ energy stores.

    With that said, if a legal-aged adult consumes one alcoholic beverage the night before a match is that going to compromise his or her performance? Probably not. However, to try to offset any dehydration that may occur, be sure to drink two glasses of water with that drink.

    Again, be sure to follow good hydration practices leading up to, during, and after your match.

    About the Author:

    The answers to this week's column come from Scott Riewald, PhD. Dr. Riewald was the USTA Administrator of Sport Science, reporting to Paul Lubbers, Director of Coaching Education. Dr. Riewald worked with the Sport Science staff and with Coaching Education to provide information to the coaches of top American players through seminars, workshops and newsletters.

    Past Riewald Columns:
    Knee Problems & Tennis Elbow
    Strength & Flexibility Exercises
    Playing in the Sun & Jumping Rope
    Banned Substances & Youth Strength Training

    From Harold Schnitzer of East Amherst, NY:



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