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Previously in Tennis Life we have discussed the most common type of ankle injury, the sprain. Part of the recognition and care for an ankle injury is the appreciation and initiation of the appropriate aspects of treatment aimed toward functional rehabilitation.
Joint stability is the primary requirement prior to functional rehab. As stated previously ankle sprain stages one and two are mostly stable and therefore rehab therapy should be started as soon as possible.
Joint range of motion should be positive and then rehabilitation should begin. Initially stretching the achilles tendon in a non-weight bearing scenario is performed by using a towel to stretch the foot, moving your toes toward your head, the heel going away from the body. If this can be performed in a pain free environment for 30 seconds, times three sets and done three times a day, then rehab can progress to a weight bearing stretch of the achilles. Additionally, the ankle range of motion can be performed by moving the foot around the ankle joint and spelling out the alphabet (A, B, C, etc.) This can be done three times a day. After each of these exercises the ankle should be pain free and an ice massage should be performed.
When there is pain free range of motion and joint stability the next phase of rehab is the strengthening phase. This is very important for return to proper function and prevention of re-injury due to joint weakness and instability.
The initial series of exercises are Isometric. This means the muscle action is performed but not with motion. To achieve this, muscle activity occurs against an immoveable object. The foot is pushed and pulled in four directions, up, down, inverted and exerted. There should be no pain in any direction. Once this is achieved then Isotonic exercises may begin. These exercises are performed with various resistance bands and elastic tubes, and later weights are added to achieve dynamic resistance. These motions are performed once again but motion is allowed by the stretching of the bands. Later it may be possible to include toe walking, heel walking and toe raises to further improve strength and balance.
As rehab continues in a progressive direction it becomes timely to institute proprioceptive training. This is important to prepare for return to normal activity and athletic playing condition.
There are therapeutic devices used for this training and should be performed under the supervision of a trained professional. These should include the wobble board and exercising performed on different uneven surfaces. These motions can be performed with the eyes both open and closed, and with and without resistance.
Finally, to achieve complete rehabilitation and return to activity there must be the ability to function in a pain free climate. The stages of this begin with walking, followed by light jogging, then full jogging both forward and backwards, and then pattern running (such as circles, and figure eights).
This represents the final phase of ankle sprain rehabilitation which is essential for stability and good athletic function. The use of ankle braces, orthotic devices and taping are also a part of the care. Their use should be determined by the trained medical professional supervising the rehab care.
Dr. Simon Small is a board-certified sports medicine professional. As a podiatrist and President of Pro Support Systems, Inc. he provides care and orthotics for individual athletes and industrial workers’ needs. Information is available at Prosupportsystems.com.
What do tennis elbow, sore back, weak footwork and inability to maintain good foyoga-1cus have in common? All of these tennis-related issues can be prevented and remedied by yoga practice. As more and more world-class tennis players are taking up yoga to improve their stretching, strength and breathing, perhaps so should you. Yoga practice can improve your game on many levels, most notably working on your flexibility, power, balance, as well as injury prevention and mind control.
Flexibility
This benefit of yoga is usually the first one that tennis players think of. As flexible muscles can aid injury prevention by allowing better extension, it’s no surprise that flexibility is important for tennis. Flexibility also increases your reach and allows you to better turn your back to the ball.
Next time try this simple move before you play tennis: You will need to be next to the fence. Stand a full-arm length away from the fence. Place your palms about eye-height on the fence. Bend your elbows, so that your forearms are parallel to each other. Place your right foot on the fence, with the lower portion of the heel still on the ground. Try to rest the weight of your foot on the fence. Look at your fingers, draw the shoulder blades towards each other and gently drawing the right hip back, sink the weight into your hips. Keep looking at your fingertips and walk your palms up higher for a more intense stretch. You should feel this stretch in the right hamstring and the right calf. Hold for five to ten deep breaths and reverse it, placing the left foot on the fence and doing the move on the other side.
Power
Powerful muscles will help you keep your knees bent throughout the match and will help make sure that your serve and groundstrokes are strong.
In between your tennis matches, try this move, called the chair pose: Make sure your feet and your knees are together. Inhale and strongly bend your knees, while lifting your arms up towards the sky, hands separated. Drop your shoulders down and join your palms together. Look up at your fingertips. This is a great power pose for tennis, because it works on the quadriceps, the leg muscles, the back muscles and the arm muscles, simultaneously. It also increases the back and the shoulder flexibility. Exhale and release the position, falling forward over your legs. Shake your upper body and relax.
Balance yoga-6yoga-3 Good balance equals to a powerful game. If you could maintain a straight posture, no shot would throw you off-balance. Yoga has just the pose for that: the tree pose. Tree pose strengthens the back and the torso muscles. Additionally, it works on the leg muscles for groundstrokes and volleys.
Try this pose anytime you are feeling unfocused or shaky:
While standing, inhale and lift your right knee into the chest. Make sure that your left thigh is lifted and your left leg is strong and active. Exhale and open your right knee to the right, placing the right sole of the foot into the inner side of the left thigh. Imagine a current of energy lifting through your left leg. Lift your pelvic floor in-and-up. Keep your torso straight. On the inhalation, lift your arms in prayer up above your head, with forearms being behind the ears. Keep looking at an unmoving point in front of you. Hold for ten breaths and repeat on the other side.
Injury Prevention
If you follow the above instructions and get a yoga DVD or two, chances are you’ve already decreased any possibility of an injury.
But you can always try this stretch to eliminate and prevent something as common as tennis elbow: Stand straight with your feet, hip-width apart. Lift your arms up. Grab a hold of the right wrist with the fingers of your left hand. Right palm is facing down. Inhale and extend the whole right arm and the right side of the body up. Exhale and keeping your legs in the same position, allow your torso to fall to the left. This stretch works on every arm joint, especially concentrating on the elbow. Don’t fall forwards or backwards. Inhale and come up. Change sides.
Mind Control
Your strong and flexible body isn’t going to win any matches if your mind is imbalanced and preoccupied with worries and thoughts. You can try this yogic breathing anytime: before, after and even during the match:
Sit in a comfortable position. Make sure your back is straight and your shoulders are dropped. Close your eyes. Shift your mental focus to the point in between your eyebrows. Inhale slowly through the nose on the count of eight. Retain the breath on the count of eight and exhale through the nose on the count of eight. If this is challenging, you can try the four counts of breathing. This technique is very calming and centering for the mind. Just what you need to win!
Anastasia Dorohova is an experienced tennis player and a certified yoga teacher. She has produced and starred in a series of Yoga for Tennis DVDs, available at www.tennislife.com. Her yoga for tennis program was featured in multiple magazines and her yoga for tennis show appeared on The Tennis Channel in July. She teaches yoga for tennis workshops internationally.
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