ONS on Spring Training

An article by  Tanya Kalyuzhny, DPT, MDT, director of physical therapy at ONS in Greenwich, was published recently in the Greenwich Sentinel.   Greenwich Physical Therapy

In Spring Training is Not Just for Pros, Tanya stresses the importance of building strength and flexibility before staring up seasonal activities to avoid many of the painful injuries that can crop up.  In the March 16 issue, she writes:

If you’re like me, you’re chomping at the bit for spring to arrive so you can tie up your sport shoes and head out in the sun with your racquet or golf club in hand.

Not so fast!

If you haven’t been using the muscles necessary for your sport in the past few months, you’ll need to start slowly and make sure you have the strength and conditioning needed to play before the season is underway.

A simple pre-season program using light weights or an exercise band can help protect against back strain, arm pain and worse. Start with daily stretching exercises, held for a minute, and move on to two sets of weight bearing or resistance exercises of 15 repetitions three to four times a week.

Avoid Golf and Tennis Injuries

Common golf and tennis injuries are usually the result of muscle strain and fatigue, muscular imbalance, overuse, or any combination of the three. As with any physical activity, core muscle strengthening is essential to train your pelvis, lower back, hips and abs to work together to give you power, better balance and stability. Without core strength, the muscles in your back, neck and extremities will be strained taking you through your motions.

Beyond the core, your shoulders need to be ready for the demands of the repeated overhead, rotating motions required in tennis and golf. Conditioning that area is not only important to prevent tendinitis and rotator cuff problems, weakness in the joint’s surrounding muscles can also lead to pain elsewhere in your arm when smaller muscles are forced to overcompensate.

To avoid painful shoulder injuries, it’s important to strengthen the peri-scapular (shoulder blade) muscles as well as the four muscles that make up the rotator cuff. The rotator cuff helps stabilize the upper arm within the shoulder socket and manage the speed of your swing and follow through.

You can strengthen and increase flexibility in this region of your body by using light weights or an exercise band.

In general, exercises that involve the internal and external rotation of the shoulder are good for the rotator cuff. You can work on external rotation by alternating arms to rotate the band away from your body, starting with your arms waist level and forearms parallel to the floor.

For internal rotation exercise, tie your band to a door knob and hold it in one hand across your shoulder. Start with your arm bent at 90 degrees as though you are waving hello, and slowly stretch the band downward until your forearm is parallel to the ground. Slowly return to your starting position and switch arms.

It’s also important to keep your pectoral muscles and those in the back of your shoulder supple. A corner stretch is great for the pecs. Lean into a corner of a room with each of your forearms resting on the adjacent walls and hold the stretch.

Cross body stretches, achieved by moving your extended arm across your chest, will help prevent and reduce any tightness that may occur in the back of the shoulder.

These exercises will also help reduce the risk of elbow conditions such as tendinitis and golf and tennis elbow. Elbow injuries can occur because the wrist muscles, which originate in the wrist but attach at the elbow, become overused or lack proper strength to match the demand of each sport.

Exercises to help thwart this from happening involve wrist flexion and extension while holding a light weight. First, sit while you hold a weight, palm facing down. Raise the weight by pulling the hand upward, bending at the wrist. Next, rotate your arm so the palm of your hand is facing the ceiling and bend your wrist to move the weight upward.

Common sports-related lower extremity injuries, including calf strains and ankle sprains, can be avoided if the musculature is strong enough to support the acceleration and deceleration involved in walking, running and jumping. Ankles are particularly vulnerable to quick changes in direction. Single leg balance exercises are the best way to protect against ankle and calf issues. Try standing on one leg on a balance board, standing on one leg with your eyes closed, or standing on one leg on a pillow. Single leg heel lifts from the edge of a step, and slowly lowering the heels below the step are also good calf exercises.

When you do head out to the court or the greens, start slowly and be sure to warm up. Don’t play an 18-hole round of golf without a few days swinging at the driving range. Immediately before play, start with 5-10 min warm up with a light jog or walking briskly in place. When you’re done for the day, cool down and gently stretch your muscles.

My last piece of advice is to have a professional evaluate your technique and equipment. An improper grip, ill-fitting racket or club, and/or faulty body mechanics can lead to an injury no matter how fit you are.

 

 

Racquet Sports & Golf: Wrist and Elbow Injury Prevention and Treatment

If you love golf and racquet sports you’ll want to know how to keep your swing in motion and avoid the common hand, wrist and elbow injuries that arise while playing these sports. Specialists from the ONS Hand and Upper Extremity Center, David Wei, MD and Matt Cantlon, MD will discuss the warning signs, causes and treatments for conditions such wrist sprains, golf and tennis elbow, among others.  They’ll help you understand the symptoms that should be seen by a doctor, and offer practical advice for injury prevention. Free. Register by calling 203-863-4277 or register online.

Treatments for Tennis Elbow

ONS Dr. David Wei Talks on Treatment for Tennis Elbow.

Tennis season is in full swing and so are the risks of overuse injuries such as Tennis Elbow.

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Tennis Elbow typically happens when a repetitive swinging motion pulls on the extensor tendons that connect the muscles in the forearm to the elbow, creating microscopic tears. Despite its name, there are many types of activities that can injure these tendons, especially those involving repetitive wrist motion. Although it continues to be a mystery as to why some patients develop Tennis Elbow while others are not affected, we do know that the end result is an abnormal change in the quality of the tendon itself, called angiofibroblastic hyperplasia.

Typical symptoms are pain along the outer side of the elbow with wrist motion and with gripping. The pain can be especially exacerbated by activities involving lifting objects with your elbow extended and the palm of your hand facing downward.

Recent data suggests that nearly all cases may resolve spontaneously, and the mainstay of treatment always begins with non-operative options. Avoiding aggravating activities or modifying the way you perform them can help decrease pain. For instance, lift things closer to your body, with your palms up. A splint or a counterforce brace can also help by relieving the strain on the tendon. In some cases, a physical therapy program and possibly injections will help the condition.

Most people don’t require surgery for Tennis Elbow. If, however, non-operative measures fail and the pain persists beyond six months, it may be time to consider surgery to repair the damaged tendons. Recovery time from surgery is relatively fast, but the tendons need time to regenerate, requiring approximately six to eight weeks.

Dr. Wei discusses tennis elbow in greater detail in this video.

 

Get a grip on Tennis Elbow

Physical therapist Tatyana Kalyuzhny, DPT does therapy to relieve symptoms of tennis elbow.

 

Physical Therapist stresses strength building, flexibility and good mechanics

Along with the fun and friendly competition of a great game of tennis, comes the potential for tennis elbow, a degenerative condition of the tendon fibers which anchor the arm muscles used to extend or lift the wrist and hand. Those who suffer from tennis elbow will tell you that it can result in an abrupt end to your tennis season. Below, Tatyana Kalyuzhny, DPT, of ONS Physical Therapy offers the following precautions and tips on conditioning before you even make your first serve.

Tennis elbow

Symptoms of tennis elbow often include persistent pain on the outside of the elbow. It usually begins with mild pain and can continue for weeks or months. The pain can be increased by pressing on the outside of the elbow or by a gripping or lifting motion. In severe cases, minimal movement of the elbow joint can send pain radiating into the forearm.

The first line of treatment for tennis elbow is usually rest, ice and anti-inflammatory medication. After an evaluation, a doctor may prescribe a physical therapy program to stretch and strengthen the muscles in forearm.

Players who lack proper conditioning are the ones who are most vulnerable to most injuries including tennis elbow. Even if you’re a great player with a beautiful swing, if you lack proper conditioning and core strength, you are putting your body at an increased risk for injury. Proper mechanics plays a crucial role in avoiding injuries. The slightest amount of improper alignment can place added stress on tendons and ligaments. You may not notice the ill effects initially, but damage may be cumulative and build to a problem over time.

Conditioning for tennis should include exercises in core and hip strength in multi-directional planes, exercises to strengthen the rotator cuff and elbow and eccentric strengthening, which involves contracting the muscles while simultaneously elongating them to help the body absorb shock. In addition to strengthening, players need to maintain flexibility of their calves, hips and shoulders for proper mechanical efficiency.

A good warm-up for a tennis player should include light stretching followed by a gentle, five- to ten- minute rally session on court that employs some lateral and forward shuffles. Warm-up should be gradual and should aim to slowly increase your heart rate and get the muscles ready for play. You should avoid walking onto the court and swinging with full power at the ball.

 Six tips for preventing injuries

  •  Use proper technique. Have your swing and overall technique evaluated periodically by a professional.
  •  Incorporate a proper strengthening and conditioning program off the court.
  •  Maintain flexibility by stretching after play.
  •  Use proper equipment. Play with a racket that is the correct size, grip and weight for you.
  •  Wear proper footwear designed for tennis and not worn out.
  •  Avoid making sudden radical changes in your technique unless instructed by a professional.