Originally Posted by Chas Tennis
Next issue to research - What occurs when you bear more weight on one side - maybe your gluteus medius is tilting your pelvis slightly to relieve one side? Was it weak before your first injuries? Did it get weak for your last injuries? Did you do exercises to strengthen your gluteus medius.
You can research the gluteus medius and the Trendelenburg test
I believe that the Trendelenburg is a very basic posture test and you probably have been examined already. ?
Are you already doing exercises to strengthen your gluteus medius? Clamshells, Firehydrants, Monster Walks, all with resistance bands, etc.? The gluteus medius gets weak in some tennis players, I guess that they don't use it enough. ?
I've had experience with just a few of many possible injuries and posture issues. But I believe that they are common posture issues.
When I started my physical therapy for the injuries to my right leg five or six months ago, I was also complaining at that time of an upper quad strain. At the initial examination, the therapist had me stand on a step-stool with one leg and reach down to touch the ground with the other leg. I could maintain my balance when my left leg was on the step stool, but when it was reversed and I tried to balance my body by standing on one leg with my right leg, my leg wobbled and I couldn't do it. My therapist told me at that time that my right hip was weak. I then spend the next 6 weeks working primarily on the hip. I started out solely doing elipitical and cycle, followed by light stretching, and ASTYM for the right calf, quad/hip. Was also doing leg strengthening for the upper quad with leg raises in three different positions. By week two or three, we then moved into hip strengthening exercises - Clamshells, Firehydrants. After two weeks, we then added Monster Walks with resistance bands + resistance bands to the claimshells and then light ankle weights to the leg raises. By the time I was discharged, my quad/hip felt fine, but we never did any leg strengthening for the calf.
After my insurance approved visits for PT expired, the PT told me to continue doing these exercises at home and then work on doing a core/leg strengthening program. Again, at this point, I decided to hang up the tennis racket for a while to focus on the core/leg. I then began going to a fitness club that is being on corrective exericses for postural imbalances. At the outset/initial evaluation, there were a number of tests done. To begin with, I was asked to put my left foot on one scale and right foot on another scale. the right scale showed that I was bearing approximately 30 more pounds on the right side of my body.
I did a Myokinematic Alignment Evaluation. I don't recall doing the Trendelenburg test, but I do recall laying on the training table and the examiner noting a negative for some test on my left hip and a postive on the test for my right hip.
You asked when I started having problems with the right hip. When I had all of these issues with my left calf last year, where I was truly "popping" the calf muscle, I had never had any sort of weakness in my right leg, whether lower leg or upper quad/hip. It wasn't until I was playing in the early spring that towards the end of a match, I all of a suddent felt like my entire right leg was weak - from the upper quad down to the calf. It's just a guess from my part, but I'm thinking that all of these injuries to the left side last year, I gradually began shifting more and more weight to the ride side...and maybe it became too much, especially with the amount of tennis I played at the begining of the year as I was so happy to be back on the court after getting over the left leg injuries.
Anyway, after this initial evaluation, a program plan was developed and I had spent the better part of the past two months doing a myofasical stretching program with the Trigger Point foam rollers/ball, stretching for calfs, hamstrings, hip (90/90 stretch), corrective spine exericss (cobras and a few others), and then core strengthening exercises with the swiss ball for the core/glutes, and using a cable exercises for the shoulders and lats.
Other than stretching the calves on a daily basis, I hadn't done any calf strengthening exerises.
Here and there, I have felt some discomfort with my upper quad area. I wasn't sure if was the quad or hip flexors, but the trainer kept saying it was an IT band issue and just to foam roll it out.
With the calves not really being a problem of late, although, granted, I hadn't done any strenuous exercise pushing off with the calves, I decided to finally give tennis a go again after basically taking off 6-8 weeks. Again, I made it through two matches, although towards the end of the second match, I suddenly felt the on-site of extreme fatigue/leg weakness. Then, the next day, my right calf just felt tight/inflammed, but there was never any swelling. I tried going through the RICE process for the first week, and after not going any relief, went in for some Active Release Technique therapy. That's where the therapist noted that the calf muscle was all balled up and then opined that the over pronation of the feet was a likely cause. Maybe its the weak hips. At this poing, I don't think anyone can figure this out.