JOINT MOBILITY

Most of the professional athletes use mobility exercises as part of their warm up. They help to keep your body and all your joints in tiptop shape. They are key to prevent injuries. 

Limitations in movement are the first cause of knee, elbow and lower back

pain. Also remember, these limitations can lead to secondary injuries like knee and

elbow tendinitis. 

Use them as a warm up and you will feel the difference: Choose a joint and move it in every possible direction. Do this slowly, and repeat every movement 10

times. To help you keep track, start by mobilizing the neck, then the shoulder, elbow and wrist, going down through the spine, hip, knee and finishing with the ankle. To get more out of these joint mobilizations, they should be done in the early morning or before tennis practice.

Here is an example of some hip rotation exercises:

MOST EFFECTIVE TREATMENTS FOR A PATELLAR TENDINOSIS 

1. Hands on, hands on, hands on… from my experience it is the only treatment that really helps. A combination of deep tissue massage, mobilization, friction massage. ​​100% of the professional tennis players with patellar tendinosis get a hands on treatment at least once a day.

2. Ice or heat? This is easy. USA=Ice. Rest of the world=heat. My opinion is that unless there is a big swelling the heat is more effective.

3. Thimblex massage. Specially in chronic patellar tendinosis scar tissue and adhesion are present. Thimblex massage is a new therapy I use with my patients and I find it really effective for this injury. Check the the web page www.thimblex.com for more information.

PATELLAR TENDINOSIS

1. How do I know that I have a patellar tendinosis?
1. The easiest way to know if you have a patellar tendinosis is by looking at the location of the pain. The pain is below the patella. Here you can see the exact location. 

1. Second is when and how you feel the pain. The pain occurs mainly when you climb steps up and down. Also while running or jumping (although it can disappear once you warm up and come back once you stop exercising). But it can also come if you sit a long time with your knee bent or when you stand up after sitting for a long time. 

If you don’t have this symptoms then maybe you can have another issue like chondromalacia or a meniscus problem. 

THE KOUROS

In the life of every tennis player, there is a stage where you can say the body is at its

peak. For a time, we all are in prime condition and all our bones, muscles and joints

are working perfectly. This is, more or less, where Roger Federer, with his 16 Grand Slams, and Rafael Nadal, with his nine, are at now. But even the less athletic among us will feel full of vitality, and suffer no aches or pains when your body is in peak form.

The ancient Greeks carved such an image of perfection in marble. A “kouros” is a statue of a young male, standing, arms at his sides, left leg forward, looking straight ahead. It is not the image of a particular youth, but of youth itself.

The kouros then (or any one of us at the time we function perfectly, with no discomfort, weakness or limitation) knows no pain or suffering.

His joints move freely along pre-determined pathways. His cartilage, discs and menisci act like shock absorbers. His muscles trigger contractions and his movements are fluid, agile and effective. All the systems he needs to move around are working properly.

If we take this ancient Greek figure as our starting point, we can explain most of the chronic muscular-skeletal injuries that tennis players suffer in muscles, joints, tendons, bones and ligaments, either due to the passage of time, or from the hours spent on the court.

Any physical decline leads our joints, muscles and fasciae (the connective tissue between muscles) to adapt to our habits or circumstances.

Locked or limited joints will have a negative impact on movement. Shortened fasciae or inhibited muscles can also lead us to move poorly.

All of this can lead to injury, pain and premature decay in some structures such as the surfaces of joints and tendons.

So we get stuck in a tug-of-war: on one side, practice, decay, aging, erosion, discomfort, locking, limitation, weakness; and on the other, willpower, care, diet, maintenance, preventive work and exercises to try and halt the decline due to the passing of time.

Anyone can monitor and influence these adaptations to the body, following the basic principles of training. Cars, motorbikes, bicycles and machinery all need care, attention,

check-ups and maintenance—and so do we. If your body is healthy and well looked

after, you probably will not suffer from tennis- related injuries, and you will get much

more out of your tennis.

To achieve this injury-free state, whether you are a junior or a senior player, you need

to follow a few basics rules:

• Keep your body and all your joints in tiptop shape. Make sure you can move freely,

because limitations in movement are the first cause of knee, elbow and lower back

pain. Also remember, these limitations then can lead to secondary injuries like knee and

elbow tendinitis. Daily movement exercises for every joint are important to prevent tennis- related injuries. Use them as a warm up

and you will feel the difference.

• Check that all your muscles are balanced and firing strong. You have to hit the gym

two or three times a week. Bilateral strengthening exercises of legs and arms are necessary in a sport like tennis, where most of the movements are side to side and asymmetric.

On top of that, core exercises are vital to keep your body balanced.

• Pamper your most valuable organ, your heart. The heart doesn’t like sharp ups and

downs. A proper warm-up and a slow cool down is necessary before and after each

practice. You can warm up 5 to 10 minutes on the treadmill and cool down on a stationary bike, or you can hit easy and gradually increase intensity before you play or

practice, then when finished, do the reverse and gradually step down your hitting

and movement.

 www.injuryrecoverymassage.com

PREVENTIVE STRIKES: How to prevent chronic injuries.

Whether you’re one of the world’s top players or a recreational player

hoping to advance in a local tournament, at some point in your

playing career, you’ll probably get a tennis-related injury. It may not

be serious, but it’s virtually impossible to avoid all injuries, all of the time.

But you can take steps that will reduce your chances of being injured.

On the pro tours, much of the physical work the pros do on a

daily basis is to prevent injuries. Here are some guidelines you can use

to help prevent injuries.

Make Sure You Can Move Freely

You want all of your joints to move freely, and all your movement “patterns”

to be able to take place without limitations or restrictions. To help

prevent the aches and pains that can limit your movement, you should:

- Work your joints every day. It’s simple: Choose a joint and move it in

every possible direction. Do this slowly, and repeat every movement 10

times. To help you keep track, start by mobilizing the neck, then the shoulder,

elbow and wrist, going down through the spine, hip, knee and finishing

with the ankle. To get more out of these joint mobilizations, they

should be done in the early morning or before tennis practice.

- Stretch your joints. To stretch a joint, you have to bring it to the limit of

the movement and stay in this position for 15 seconds. Some joints only

move in one or two directions (knee or elbow), but others can move in

multiple directions (shoulder). To stretch the knee, for example, you have

to bring your heel to the butt (flexion), then in another movement bring

the leg up straight (extension). Stretching exercises should be done after

practice or at night. You can even do these when you’re relaxing in front of 

the TV.

Keep Muscles Balanced and Firing Strong

Any time you play a sport, your body goes through thousands and thousands

of different biomechanical movements, actions and reactions. In

a training session, a tennis player may practice hitting hundreds of forehands—

and the actions and movements required to do so are all fairly

similar. A slight variation, in the form of a weakness or imbalance in the

arm or shoulder muscles, may have a negative impact on the biomechanical

movement. To help keep your muscles working properly, you should:

- Massage your muscles once a week. Massage is one of the most efficient

tools to keep the muscles healthy. From what I see on the pro tours,

every professional tennis player gets massages—many of them up to four

massages a week. Massage is a good way to clean the muscles and to increase

blood flow and improve circulation. A typical massage session lasts

from 50 to 60 minutes and begins with the legs and finishes with the back,

shoulders and arms.

- Keep the muscles toned with isometric contractions. There are many exercises

where you can activate muscles or muscle groups by simply maintaining

a good posture. These exercises will help muscles to stay sharp

and firing well. Isometric exercises can be done before practice. Some of

the simplest isometric exercises are sitting against the wall or maintaining

the push-up position for 30 seconds.

- Work on “bilateral” strengthening. Tennis is a sport that can create many

imbalances and asymmetries. Muscles from one side of the body will

get strong compared to the muscles from the other side. Just look at the

racquet arms of some of the pro players and compare it with their nonracquet

arms. This is why bilateral strengthening exercises such as pulldowns,

push-ups, chin-ups and squats are important for tennis players.

Warm Up & Cool Down

For the best cardiovascular health, you need to do a gradual warm-up and

cool-down before and after every practice session or match. Biking, running

or rowing for about 10 minutes at a medium intensity, for instance,

are good ways to warm-up before tennis. In the same way, after practice or

a match you need to gradually cool down the cardiovascular system. You

can do the same exercises to cool down, gradually lowering the intensity

over 10 or 15 minutes as you go.