Am I through with top level Tennis-Injury Explained-Help requested

Discussion in 'Health & Fitness' started by Mick3391, Nov 10, 2012.

  1. Mick3391

    Mick3391 Professional

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    I started playing Tennis after a long Hiatus about 8-9 months ago to train my then 11 year old son.

    I'm 38 and have never had injuries, not real injuries. First I ripped my plantaris muscle, incredible pain. Then I ripped my second one. Then my neck, then in the emergency room with a pulled tendon in my ankle/foot.

    That's all gone, but one thing has stayed, and I simply can't play high performace Tennis. About 3-4 months ago, on the opposite side of my elbow I had pain/weakness. I mean to hit the ball hurt bad each time, sometimes just picking up the racquet hurts. So unlike my other injuries I actually did give it a rest for a week. But once playing again it came back, so after 3-4 months it's still with me.

    Anyone know how to fix this? It's not just pain, but weakness. It's like a dull pain, sharp when I hit the ball.
     
    #1
  2. Red Sunset

    Red Sunset Rookie

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    It's likely due to horrendous technique.
     
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  3. Say Chi Sin Lo

    Say Chi Sin Lo Legend

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    And/or the misconception of what injuries are. Clearly, "ripping" plantaris muscles and going to the emergency room for a hurt ankle are not injuries. You just went for a tune-up.

    You sure you didn't play with an "injured" elbow and pushed it to the point of no return?
     
    #3
  4. LeeD

    LeeD Bionic Poster

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    "top level" tennis?
    Are you sure you know what that is?
    And yes, you're through with "top level" tennis.
     
    #4
  5. Mick3391

    Mick3391 Professional

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    Thanks for your help guys, clearly love is in your heart.
     
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  6. Sabratha

    Sabratha G.O.A.T.

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    What's your definition of "top level tennis"?
     
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  7. F. Perry

    F. Perry Banned

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    You earned it.
     
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  8. Mick3391

    Mick3391 Professional

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    Just playing as good as I can, not "Top" as in "Top", top for me. I play horrible with this arm.

    Would be great if anyone knew something about this condition, surely it can't be unique to me. It hurts to dry my hair with a towel and hasn't gone away for a long time now.
     
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  9. Crispvolley

    Crispvolley New User

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    Honestly, if it hurts that badly and you have insurance, go see a respected Orthopaedic surgeon - preferably one that specializes in elbow/arm issues. They will be able to give you a proper diagnosis and treatment plan to hopefully resolve the issue.

    I am 36 and like you never had any injuries to speak of, until recently when I had some issues that I thought were symptoms of golfers elbow. It got to the point where I could not straighten my arm, so I went in and had it looked at. 15 minutes later I was told my issue was really triceps tendonitis, given a treatment plan, and within two weeks I was back on the courts. Your issue could be more or less serious than mine, but you really won't be able to know until have it looked at by a professional so you get the right diagnosis and recovery plan.
     
    #9
  10. dak95_00

    dak95_00 Professional

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    Go to a sports medicine clinic where you can see an athletic trainer or other sports injury person. Nearly all high schools have an AT. Your son's school might have one. Ask around. You'll get better advice from someone who can actually see you.

    If they can't figure it out, they'll refer you to a doctor and might anyways.

    I don't know why you haven't sought the advice of someone in medicine or athletic or physical training yet anyways.
     
    #10
  11. ramos77

    ramos77 Semi-Pro

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    1. Take a break for a couple months and get treatment.

    2. Get rid of the kfactor and the NXT strings.

    3. Get an arm friendly racquet, (Volkl, Pro Kennex) and use natural gut strings.
     
    #11
  12. NLBwell

    NLBwell Legend

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    Go to a good doctor.
     
    #12
  13. WildVolley

    WildVolley Legend

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    I had to look up what a plantaris muscle is. Never heard of it before.

    You need to stop playing tennis for a while, perhaps see a doctor, and slowly start doing some rehabilitation work. I've become a believer in weight training for tennis, especially for people who are aging. Likely you've lost a lot of strength and even a basic strength routine will help build muscles and strengthen tendons.

    Once you feel healthy enough to start playing again, see a good coach or perhaps video tape your performance and look for technique errors. Start slow and work your way back into it. I see guys in their 80s still playing tennis, so I think it is easily in the reach of most guys to play through their 50s assuming no degenerative diseases.
     
    #13
  14. charliefedererer

    charliefedererer Legend

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    I'm not sure where the pain is.

    Looking at the photos below, is it in the areas of tennis or golfer's elbow? [yes, tennis player's also get golfer's elbow.]

    [​IMG]
     
    #14
  15. Chas Tennis

    Chas Tennis Hall of Fame

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    Of course after an injury you need to have a Dr's diagnosis and advice.

    From the number of your injuries and their type - probably tendon injuries - you sound as if your lifestyle has gotten you out of shape with too many tight/short muscles. ?

    See reply #12 especially for short/tight muscles and life style issues.
    http://tt.tennis-warehouse.com/showthread.php?t=419850

    Exercises or stretches when injured might cause farther injury. Only do them only after a Dr has said that they are OK.

    You might talk to your sports medicine Dr about having your posture and ranges of motion for your joints measured with the purpose of correcting any tightness or weakness issues.

    To research tennis elbow, search and read the many TE & Golfer's Elbow threads to find some useful information. See a Dr for a diagnosis of your unknown elbow injury. Don't stress the injured elbow with extreme tennis stroke forces that probably injured it in the first place.
     
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  16. Mick3391

    Mick3391 Professional

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    Wow yea that's awesome all of you:)

    Yea the thing is it sounds I'm like you, I get a pain and just go on, let it work itself out, but yea time to see a Doctor, this is rediculous. By the way I've heard that before (Golfers Elbow), it's clearly on this inside, the muscles exact opposite side of the elbow bone, they just burn all the time, now it can hurt with stupid things (Picking up a towel or other light things)
     
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  17. Mick3391

    Mick3391 Professional

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    The strange thing is that I have alot of muscle, I believe in working out with weights also.

    Yea man I have just fell apart, it's almost funny because I never really had any injuries except for small stupid things.

    The Plantaris my doctor told me is in the calf, FIRST SERVE back I fell to the ground, evidentelly as strange as it sounds it rolls up and dies, at least that's what my doctor said. So yea incredible pain, playing with one leg and pain pills, then my other one goes out, then in the hospital with a torn tendon in the foot ankle area, then neck, man...........and at only 39, well 38 and 12 1/2 months:)

    I can see how the Nadals of the world can be in so much jeopordy as they are full speed all year. I'm not even in first gear compared to him!
     
    #17
  18. Mick3391

    Mick3391 Professional

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    Because I'm stupid, or at least my son says I'm not that smart to keep playing through pain. My leg cleared itself, same with every other injury I've had, figured this would just go away.

    By the way to my friend who suggested a more arm friendly racquet, to pick up a racquet hurts sometimes:)
     
    #18
  19. charliefedererer

    charliefedererer Legend

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    You have lived long enough to realize that the vast majority of aches and pains, even if initially severe, usually get better on their own.

    Vast majority of aches and pains - but not all.


    You also have observed that most superficial wounds heal in about a weak - hence it is understandable that you took a week off and expected to see an improvement.



    But from your response to WildVolley I assume you have pain in the area consistent with "golfer's elbow".




    Golfer's elbow, just like tennis elbow that occurs on the other side of the forearm near the elbow, involves either one, or more commonly many, small tears in the tendon:

    [​IMG]




    Tendon is very dense protein that almost resembles a strong rope.


    The way the body repairs a tendon is by the process of "inflammation and repair".



    Inflammation means that white blood cells are attracted to the site of the injury.
    The white blood cells make chemicals (cytokines) that attract the type of cell (fibroblast) that will make the protein to repair the tear.



    The trouble is that the protein strands that are made by these cells are incredibly small. It takes millions of these little strands to bind together to heal the tear.



    These little protein strands resemble the protein strands that make up a spider's web.

    [​IMG]

    From the Spiderman movies we all know that a spider's web is stronger than steel, ounce for ounce.

    But we also all know that to break up a spider's web, we only need to wiggle our finger in it.




    It takes many weeks for these isolated strands to become "crosslinked" and form a strong tendon again that is as strong as rope or cable.

    [​IMG]





    What you are doing by continuing to play is break down the protein strands as you forcefully swing your racquet - this force is way more than the force of a finger in a spider's web breaking down thin, healing protein strands.




    Every time you break these protein strands down, the body has to start all over to heal the area.

    You elbow area is living the same problem over and over day after day, like in the movie Groundhog Day.




    And why the continued pain?

    The inflammation phase usually lasts just long enough for the white blood cells to recruit the cells that make the protein (fibroblasts) to the the injured site.
    Again, they recruit the protein building cells by secreting chemicals (cytokines) to the area.
    The main job of the chemicals is to attract the protein building cells there, but a side effect is that these chemicals are that they irritate nerve endings - hence pain.

    Because you have broken down these healing areas so often, there is a much larger number of white blood cells making a lot more chemicals at the site to finally make enough protein strands to heal the area.



    [Be warned: if the inflammation goes on too long, the chemicals will actually start to break down surrounding tissue, resulting in degeneration/fibrosis of the tendon, and it will never go back to normal.]:







    So do yourself a favor and REST.

    Go see that doctor who can give you individual care based on exactly what is wrong for you, and can outline a gradual increasing amount of physical therapy.




    A few words on physical therapy.

    The first sessions of "exercise" are not to strengthen the muscle/tendon area.

    They are just to keep the tendons sliding past one another in a normal fashion.

    Otherwise the process of inflammation ends up with tendons and muscles "glued together" by all those excess protein strands, so the tendons and muscles don't glide smoothly any more.

    Only when almost all the pain goes away can actual strengthening begin.

    And if there is a return of pain, you have hod off on exercise for a time, then begin again.



    I hope this helps!
     
    #19
  20. charliefedererer

    charliefedererer Legend

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    Your exercise may have worked against you.

    Most exercises involve flexion and extension, not the rotational forces so prevalent in tennis.


    Therefore your strong muscles were able to pull on your tendons with more force than if you hadn't exercised, but your tendons were not ready for the excess rotational forces.

    This devise really works the forearm muscles in a rotational fashion, so that your foream/elbow will later be ready for tennis.


    Therefore, it is likely that your physical therapy will involve initially using a red, and much later, a green flexbar.
    Thera-Band FlexBar Video Demonstration http://www.youtube.com/watch?v=zB3TVb8a5mk




    Later, I would urge you to do all of the Thrower's ten exercises to help prevent shoulder and wrist (as well as elbow problems), as these exercises bring muscles through all the different directions (including rotational) that tennis playing involves.
    Thrower's Ten Exercises: http://www.muhlenberg.edu/pdf/main/athletics/athletic_training/throwers10.pdf



    [It's not that you are 38.

    It's that you are bringing your strong muscles explosively through ranges of muscle that they have not been prepared for in your exercise program.]
     
    #20
  21. charliefedererer

    charliefedererer Legend

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    Guess you hadn't heard of "tennis leg".


    "An isolated injury to the plantaris tendon or myotendinous junction has been described as "tennis leg." Powell first described this clinical entity in 1883.4 While there has been controversy in the orthopedic literature as to whether the clinical entity of plantaris tendon rupture really exists,5 surgically confirmed cases of plantaris tendon rupture have been well documented.6 Tennis leg may be seen in young athletes or in sedentary older individuals. A tearing sensation or pop is often reported, with pain increasing over one to two days and with tenderness and swelling found at the calf.

    The plantaris muscle is of questionable physiological importance. It is thought to be a vestigial structure and is absent in 7% to 10% of the population. Despite these facts, injuries to the plantaris are a not uncommon cause of patient pain, and can present with a confusing clinical picture, thus making an understanding of plantaris anatomy and related pathology important to those who utilize and interpret MRI."
    - http://www.radsource.us/clinic/0608

    [​IMG]
    PL = Plantaris muscle/tendon
     
    #21
  22. Mick3391

    Mick3391 Professional

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    That's great and clearly you put alot of work in it, I truly appreciate that. It also explains why my Psoriasis has come back a bit, a boost in my already overactive immune system
     
    #22
  23. Mick3391

    Mick3391 Professional

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    Yea, it's a "Pop and drop":( Very painful, see how that muscle goes down all the way of the leg, that's where the pain is. Yea it's better of course, my doctor said, and this sounds weird, but that it "Rolls up and goes away", whatever that means:)
     
    #23
  24. LeeD

    LeeD Bionic Poster

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    Can you still play if you dial it back some, maybe 70%, use new cushy shoes, and generally play with less ferocity?
    Maybe you don't know your body's limits, and still think you're 14 years old....in a 30 year old body.
     
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  25. charliefedererer

    charliefedererer Legend

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    The plantaris is really a puny little muscle with that long tendon.

    It is so small that many consider it a remnant of a muscle that was bigger in some prehistoric relative.

    "In human beings, the plantaris tendon is a rudiment of a large muscle, which in some of the lower animals is continued over the calcaneus and inserted into the plantar aponeurosis. In cows and sheep, the plantaris is a major muscle, from which most xenograft material is obtained."
    - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC152834/

    In fact it is considered so unimportant, that if a tendon elsewhere in the body is too severely damaged to be repaired, surgeons will remove the plantaris tendon from the leg, and use it as a living transplant to replace the injured tendon elsewhere in the body, most commonly for injured hand tendons.

    "The plantaris tendon is an extremely tensile structure used for flexor tendon replacement in hand surgery, and it is not too thick for revascularization at the graft site."
    - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC152834/

    But it even can be used to replace a torn heart valve!

    "We now put forward a hypothesis, extrapolated from hand surgery, for use of the plantaris tendon in heart valve repair.This proposal, if implemented, would increase the supply of autogenous donor tissue for valve repair, thereby enhancing the surgeon's armamentarium. The report describes a novel technique that in our judgment warrants future clinical development. "
    - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC152834/




    But despite how small and unimportant the plantaris muscle/tendon is, if you pop it, it really hurts.


    [By the way, I developed inflammation in the plantaris muscle about 10 years ago.
    I had to pick up my daughter after a class she was taking at a nearby university.
    I had an hour to kill, so I practiced serving every day for much of that hour.
    I kept trying to get into a bigger and bigger bow shape to increase power.
    When it started hurting behind the knee, I mentioned it to a physical therapist who works with a lot of tennis players. She said it sounds like "tennis leg" involving the plantaris.
    With some rest and a return to a less insane amount of serving practice it has never bothered me again.]
     
    Last edited: Nov 14, 2012
    #25
  26. charliefedererer

    charliefedererer Legend

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    Most of us tennis players are pretty stubborn.

    If we weren't, we never would have made much progress, stopping for every little ache or pain.

    But once a real overuse injury occurs, I think if we can understand what is going on, we can take some time off knowing it is the only way we can make progress to eventually get back to the sport we love.


    Also, I would really encourage you to add in the Thrower's Ten to your weight lifting regimen to prevent future injuries.

    You also might be interested in looking at this site to modify your current off court training. The rotational movements of the core on the legs are not ones that are targeted by most weight lifters. By incorporating more of the exercises like lunges, and the use of medicine balls, you can help prevent back, hip and knee injuries that seem to crop up in too many players.

    The Elite Approach to Tennis Strength Training http://www.sport-fitness-advisor.com/tennis-strength-training.html



    Best wishes for as speedy a recovery as possible!
     
    Last edited: Nov 14, 2012
    #26
  27. Mick3391

    Mick3391 Professional

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    Exactly, that's what it's like, I "think" I can do things maybe I can't anymore. I do dial it back when hurt, just hit with my son and train, then forget and go for it. Lately I'm too paranoid to jump on it as I'm afraid something will give. I had the honor of playing with the great Justin Bower a week or so ago and jumped on the gas, was exhausted for lack of training, so tired I was hyperventalating an hour after, you know numb face.

    I'm going to rest for awhile, arms, legs, everything, heh, I have to teach my son a serve, maybe I'll just talk, it's hard though when you LOVE Tennis.
     
    #27
  28. Mick3391

    Mick3391 Professional

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    Thanks, yea I'm going to rest. If you saw me, I "Look" in great, well good shape, but it's like I'm "Mr. Potatoe Head", one thing falling off at a time. Trust me I'm no whiner, but I've been on pain killers out of necessity on and off for 8 months, feel like I'm 90!
     
    #28

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