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webbeing 01-06-2013 10:17 AM

when can one returns to competition after an injury?
My son injured his lower back (may be the ejector spinae or psoas muscles) while stretching and late hitting an above the shoulder ball on the forehand. After a week of rest and rehab he regained full motion in all of his exercises and stretches without pain. The stretch that took the longest recovery time to do pain free was bending over and touch the ground with finger tips while standing straight up with no knees bend.

Anyway, after two successful (pain free) practice (2hours each) sessions, he played a set against another kid and reinjured his lower back at the same spot. This time due to an outstretched two handed backhand hit.

Did he return to competition too early? If yes, how does one knows when to return to competition after an injury especially when full motions are regained.

A great many thanks!

El Diablo 01-06-2013 10:31 AM

An injury significant enough to warrant rehab is not an injury you return from in one week. Things don't heal that quickly.

El Diablo 01-06-2013 10:43 AM

(consider the implications.....this is a KID and he's already having back problems, something that typically occurs later in life.)

Say Chi Sin Lo 01-06-2013 11:42 AM

Kid or not, lower back takes the longest to heal, and it's often ever-lasting. Because everything you do requires the lower back in one way or another. Walking, sitting, standing, everything requires the lower back.

Like El Diablo said, he's at a huge disadvantage for injuring his lower back at such a young age.

WildVolley 01-06-2013 01:14 PM

Why is he trying to touch his toes or the ground with an injured back?

I tend to think that you should be slowly trying to regain range of movement with an injured part of the body, but the danger of stretching an injury is that you don't allow it to heal properly. I've had a bullet-proof lower back my whole life and and I can't come near touching my toes. There aren't any movements in tennis that require bending over at the waist to touch the ground with your legs straight. (Bending over to pick up the ball doesn't count.)

My advice would be to back off of the tennis practice, stop the stretching (which can round the back and irritate the lower spine and muscles) and work on strengthening the core doing things like side bridges, bird-dogs, etc. But these should only be done in the absence of pain.

webbeing 01-06-2013 01:38 PM

Many thanks to all for your prompt reply! By rehab I meant rubbing/massaging the injured area one/twice a day. He got "hurt" the second time on Thursday evening, and got his full range of motion back without pain by Saturday evening. How does one distinguishes pain from soreness v.s pain from injury?

He does all the stretches as part of routine conditioning. He was "testing it out" to find out where his body (16 yo) is at.

But I heard and really appreciate your message loud and clear. We weren't training for anything significant, and even if we were, I would always erred on the side of caution.

Thanks again.

WildVolley 01-06-2013 01:48 PM

That's good. It doesn't sound too serious, but back injuries are not to be trifled with.

If he can afford it, it is worthwhile to let his body heal up. So you are doing the right thing to encourage him to give his body time to heal before training hard again. Teenagers don't tend to think about the long term. He could be looking at another 50 years of tennis as long as he takes injuries seriously.

Good luck with the recovery.

charliefedererer 01-06-2013 06:36 PM

With a son in competitive tennis, you may be interested in reading the USTA Recovery in Tennis booklet - it is an easy read and has many practical recommendations:
USTA Recovery in Tennis

For instance the following advice on when to return after play is found there, along with a pain scale:
"A pain rating scale can help determine the
severity of an athlete’s situation and his/
her participation capabilities for upcoming
training or competition. An athlete should not
continue training or competing if swelling,
range of motion limitations (above normal) or
muscle weakness (above normal) is present.
The pain scale can also be used to assess
the degree of recovery from any type of
injury. Return to play may be allowed if pain
levels are 1 or 2."

It may seem quite "unscientific" to rely so much on pain as an indication on when to return to play, but outside of being evaluated medically it is probably the best indication we have.

But as your son's case illustrates, tennis can suddenly place undue stress in the most unexpected manner. The sudden movements that caused both the initial injury and the recurrence don't always occur during the course of a match - but are not all that unusual either.
It is what makes tennis a tough sport.
Is your son doing off court conditioning with special emphasis on the core/back?

TennisCJC 01-15-2013 01:23 PM

Reading and learning is important but take you son to a licensed physical therapist and get a professional plan in place.

My opinion for what it is worth is you should not play practice sets or even have intensive practice for a few weeks after a substantial injury. You go through physical therapy to stretch and strengthen. Then, you start playing again slowly - like every 2 or 3 days for 30 mins, than 1 hour, 1.5 hours 2 hours. Then you play practice sets and finally matches. But, my opinion is just my view of common sense - go see a doctor or physical therapy.

I rehab-ed with just physical therapy for about 8 weeks after minor knee surgery. Then 3 weeks of gradually increasing practice before I played a real match and continue the rehab exercises to this day - at least 3-4 times per week. It has been 6 months and knee is doing pretty well.

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