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Back Injuries

Q. I have a sciatica problem, most likely for not warming up. What do I do now, I can’t play with pain?

A. Gerd, this is a common problem that can be caused by many factors. One of which is poor flexibility. Additionally, lack of core strength, bad or improper tennis mechanics are additional factors. Be sure to have a physician provide a comprehensive examination of your back.

Choose if possible an orthopaedic surgeon or neurologist who has completed a spine fellowship which is specialized training in spine examination and treatment. Additionally, choosing a physician who works with athletes or active individuals is also important.

Simply resting or doing nothing is not good advice in nearly any situation involving sciatica.

Q. My son has had a recurring back injury. The area of compliant is at the L5 level. He has recently been seen by a MD and chiropractor. The MD says “no practice for 6 months, no exercising, and wear a brace. It’s could be a pre-fracture.” The chiropractor says, “Nonsense! He should exercise or forget about his tennis.” Adjustments to the back would not make the condition worse or for that matter, if there was a serious injury as a fracture he couldn't take the adjustment because there would be pain. What would be your advice?

A. I think you need to listen to who has the most sports medicine experience. Your son should be cared for by an orthopedist (MD) who has a specialty in sports medicine and is familiar with the demands of tennis. I recently had this situation occur with a junior athlete and the physician’s orders were followed. The orders were the similar to ones given your son. He should still be trying to exercise as much as he can while remaining pain free, focusing on improving his flexibility in other areas as well as maintaining his cardio-vascular fitness.

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.

A. 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.

Q. I have a 15-year-old daughter who plays Junior competition tennis. She about 5"2 105 pounds. Very strong lower body, smaller frame up top. She plays against girls much bigger. She hangs with them and often beats them. But after playing against a hard hitter she gets back pain from stretching for some returns. Any suggestions to help get stronger or prevent back pain.

A. Core stability is a vitally important part of any athlete’s training program, and in this case it is vitally important to provide stabilization to the lower back. Performing exercises on an exercise ball for example would prove very effective in increasing core stability for your daughter. Sit-ups and arm and leg extensions are only 2 examples of wide range of exercises that can be done on the stability ball.

Research has shown that tennis players of elite level typically have very strong abdominal muscles, but relatively weak lower back muscles. Therefore, exercises such as the superman (lie on the ground on your stomach, and raise both arms and legs off the ground approximately 3-5 inches, hold for 1-2 seconds and return to rest position) can be helpful to provide muscular balance to the back side of the core.

Playing catch with a medicine ball is also very good, especially using a rotation pattern like you would use when hitting a groundstroke. Be sure to use a light medicine ball (4-6 pound ball), as you will want to do a lot of repetitions to build muscular endurance. Finally, consult your local strength and conditioning professional who is familiar with tennis and is skilled at working with tennis players. They will be able to ensure that the exercises your daughter is doing with the balls is safe and effective. Good Luck.

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