What playing style is easiest on the knees?

[EKnee08]

Originally Posted by corners

What was the state of your knee when you had the microfracture? How advanced is your arthritis?

Its hard to say but it does not bother me on a day to day basis. Its probably mild at this point or I wouldn't be able to play the level of tennis with the movement I have and with no major pain.

Play only on har-tru and clay. Don't go after balls that you have a little chance to get to or if you reach them, your opponent will probably put-away

This is tough to do, mentally, but smart.
Yes, its a mindset you have to develop and is hard as the competitive juices flow but you have to train yourself. It is a fine line because footwork and movement is everything. In drill and training sessions in particular, I let drop shots go as well as very wide balls and some lobs I would ahve no trouble getting to. In matches, I will go after some of these but not ones where i have little chance of winning the point. You have to learn to think several steps ahead. Is getting that ball worth it in the long-run to your long-term ability to play.
Avoid jarring, twisting motions.

How is this done in tennis? Seriously.
Good point.

Play mostly doubles (I play singles as well but probably shouldn't).

This is tough. I don't really care for doubles.

I know. Me too. In addition, if you play high level doubles, the movement can be worse for your knees than singles. I discussed this with my ortho. I have not competed in singles leagues anymore but might consider subbing.
Before my microfracture, I played mostly agressive baseline game but have adopted to more of an all-courter and look to end points quicker.

Has it helped?

Yes, because I end points quicker and is enabling me to transition to playing more doubles.

Stretch and ice after playing.
Start a maintenance program, light weight training following physical therapist and orthopedists recommendations only. Be wary of following personal trainers advice as it may be contrary to what your health care professionals would suggest.

So, generally, be really conservative with rehab/prehab?

[i]yes. Do all the maintenance stuff that will enable you to play with less pain and with lesser risk of injury or doing greater damage./I]
Stretch religiously, it will provide relief.

Thanks. Time to get out my yoga mat again.

Do cardio on stationery bike (best for knees) and alternate with elliptical. Avoid stair masters, etc.

Are these considered the least stressful for knees?

Yes, it has also been shown that particularly the bike motion is very good for you. After microfracture, although I was on crutches, I was advised after the first week to go on a stationary bike only using the non-surgical knee and letting the surgical knee just follow.
How about swimming?

Swimming is great, non-jarring but you are not focusing on the legs. Most guys use as much or more upper body. I did it for more than 20 years and is great as cross-training.

Good discussion on biking: http://www.cartilagehealth.com/cycling.html


If your knees are arthritic, avoid walking up and down stairs unnecessarily because that places wear and tear on the knees.

In an effort to strengthen my legs in the manner most useful to stabilizing the knee while playing, I actually seek out stairs. My feeling is that all the lunging done in tennis is best prepared for by more controlled lunging elsewhere. Do you think my logic is inverted?

Absolutely, anyone with osteoarthritis is told not to seek out stairs! It places a tremendous amount of stress on the joints! Lunges are great but I don't do it anymore.. Speak to a physical therapist about all of this.
Wear non- movement restricting knee braces when playing tennis such as marshall type knee braces from juco. Mine are covered by my health insurance plan and can purchase several a year with no out of pocket cost.

I did a search for these but couldn't find them. Could you point me in the direction?

Here is a link to the one I have used for both knees for years. After the microfracture, my ortho had me start playing tennis with the unloader brace that I wore to transition back to walking after crutches. After I became comfortable again with movement, after a few sessions, he enabled me to try my marshall knee braces. Since then I have been fine with the Marshall's. However, your orthopedist might recommend a different brace depending on your needs. Some guys who have had microfracture are required to only play with an unloader brace for example.
http://www.juzo.com/ww/en/pub/produc...__genu_404.cfm

[Frank Silbermann]

Originally Posted by Frank Silbermann

I disagree with those who advise serve-and-volley. Such a player must squat down low for the dippers, jump up to smash the lobs, and cut this way and that. Billie Jean King was a S&V player, and it killed her knees.

Pushing and retrieving is also not good.

Think Ivan Lendl, Jimmy Connors, Don Budge and Andre Agasse. You have to make the opponent do the running.

I think the best style would be to have super ground strokes on both sides. You need killer flat shots so you can end points early -- especially against high balls (so you don't have to run back for them to drop). You need heavily topped loops to give you time to amble slowly back into position when you cannot kill the ball. You should be able to take the ball on the rise and play in close to minimize the running.

So that you never have to squat down really far, you should be able to hit low ground strokes off either side using a one-handed continental grip.

You should practice killing the short balls -- whether low or high -- so your opponent won't be able to jerk you around at the net. This means mixing well-disguised drop-shots, sharp angles, and deep approaches. (Yeah, you can't always avoid having to hit a volley, but if your approach shots are like Connors you mainly just have to knock away the sitters.)

You should be able to hit hard, inside-out shots off either side. That way, no matter which corner your opponent hits to, as soon as you hit it you'll already be almost in position for the next shot (like a big-forehand player standing near his backhand corner).

A big serve also helps. More free points you don't have to run for.

By the way, one approach that may help you pursue this strategy is the ambidextrous style of play -- two one-handed forehands. Think about it:

You can kill high balls off both sides.
You can blast inside-out shots off both sides.
You can hit overhead smashes off both sides.
Using a second forehand instead of a backhand, you don't have to squat down as far to hit topspin off of low balls.
You don't need quite as much trunk rotation as with a two-handed backhand (the knees are what rotate your trunk).

Court coverage is a natural weakness if you have bad knees, but most people can cover more court with a forehand than with any kind of backhand.

It will be easier to hit while running through the ball -- which is less hard on your knees than running full-speed and then stopping to hit.

Because you can hit with any stance -- open, square or closed -- you can get by taking fewer steps.

If the ambidextrous style tempts opponents to hit the ball straight at you, well, that's exactly what you _want_ them to do if running a lot hurts!

I would add that you would do best with an extreme-eastern grip for most shots; semi-western at the most extreme. This is so that you can combine hard-hitting with decent reach on balls which are low or wide. But when you're just rallying, that semi-continental slice will let a person with weak or lazy legs easily scoop up those low ones.

I don't have bad knees (except for six months with a meniscus tear a couple of years ago, which seems to have healed up nicely). But this is the approach I've been pursuing -- because I've always been slow and easily tired, and on top of that now I'm old!

[LeeD]

I'd generally agree with your inseted post, but that idea of using both hands.......
There's a gang, the ORANGE shirt gang, at the local SanPablo courts who are trying your idea of changing hands.
Two of them are reputed to be solid 4.5 players. Problem is, when pressed even in doubles, they adopt a fully single handed playing mode, their stronger hand.
Just can't switch accurately fast enough, not just the grip, but also the location of the hand on the handle.
I have a better right handed forehand than my left, but I don't choose to play right handed on serious points. I can get by quite well with a SLICE backhand, a lob, a short angle, and hard flat shot right at my opponent, all with a backhand.
And hitting harder doesn't always shorten the points. It can if I miss my hard shots, but everyone I play can handle pace. I like to alter my spin with altering my pace, to shorten the points.
I don't see the need to hit with BOTH hands, none at all.
At least not during the same point.

[jazzyfunkybluesy]

I would advise you to play on clay. If you must play on hardcourt wear high quality shoes, keep the points short, don't play a defensive (Murray) style game.

Also do some lunges so you have some muscle mass in your legs to support your knees better

[EKnee08]

Originally Posted by jazzyfunkybluesy

I would advise you to play on clay. If you must play on hardcourt wear high quality shoes, keep the points short, don't play a defensive (Murray) style game.

Also do some lunges so you have some muscle mass in your legs to support your knees better

regular lunges are not advisable if you have osteoarthritis of the knee. It is great if you have jumper's knee, though (patella tendonitis). I would double check with a physical therapist and sports orthopedist on this. Do not rely on a trainer as they do not often have the background to advise properly.

[LameTennisPlayer]

wheelchair tennis......soft on knees, hard on arms

[SystemicAnomaly]

Originally Posted by SystemicAnomaly

You can also replace the insole of your "bargain" Wilsons with a good cushioning orthotic/insole such as one made by SuperFeet or SofSole.

Don't know exactly how much extra protection from a good warmup exercise is derived but. from what I've read, it appears to be rather significant. A low-impact or non-impact warmup, such as a stationary bike, should be particularly kind to the knees will promoting the release of added synovial fluid. Exercise such as this will also improve (reduce) the viscosity of the synovial fluid -- this should better serve to lubricate the knee joints.

Why Should Arthritis Patients Exercise & Not Just Stay At Home?

How does exercise help the synovial fluid?

http://www.MyOnlineWellness.com/topic/arthexercise

http://www.HowardLuksMD.com/tkrAlternatives
.

Consider looking into Kinesio Tape (available from TW) or KT Tape for your knees. Just got some of the latter tape. Not yet tried it for my knees but I've used it for my shoulder (rotator cuff) and shin splints with decent results.

[jrod]

Originally Posted by SystemicAnomaly

Consider looking into Kinesio Tape (available from TW) or KT Tape for your knees. Just got some of the latter tape. Not yet tried it for my knees but I've used it for my shoulder (rotator cuff) and shin splints with decent results.

I wish someone would offer up a coherent explanation of how this stuff works. I have had mild patella tendonitis in my knees for years now and often tape them in the manner of Nadal. This technique makes sense to me in the sense that the tape is providing relief to the point where the tendon attaches to the bone in the knee. With the KT, I don't understand how the same thing can be accomplished without with a partial strapping????

[KenC]

Well, I think "the shorter the points the better" makes a lot of sense. I'm 45 and have been working a lot with my teaching coach in order to get ready to do the local tournaments here. He convinced me the easiest way to win at the intermediate level is to have a good, hard first serve and a really consistent second serve that has either good sidespin or topslice. Then it is crucial to be a great returner of serve. Those two elements will most likely carry you much farther than trying to outlast baseliners. So, don't lose you serve, and use a good return of serve to keep people from getting you into long rallies.

Most tennis players as they age force themselves to become much more efficient. Its a lot of fun to hit long rallies, but you eventually pay the price later on. With age comes wisdom, and wisdom says you don't have to win every point, just the important ones.

Why not go see a few senior's tourneys or exhibitions? I wonder how Borg and Connors have adapted to middle age. Even players like Agassi and Sampras can give great insight.

Oh, and seemingly stupid little pieces of advice like "never hit a groundstroke down the middle" start to make a lot of sense.

[LeeD]

I always hit my groundstrokes up the middle when my opponent has fallen down, lost his racket, and is not looking my way...

[SystemicAnomaly]

Originally Posted by jrod

I wish someone would offer up a coherent explanation of how this stuff works. I have had mild patella tendonitis in my knees for years now and often tape them in the manner of Nadal. This technique makes sense to me in the sense that the tape is providing relief to the point where the tendon attaches to the bone in the knee. With the KT, I don't understand how the same thing can be accomplished without with a partial strapping????

It's FM (****ing magic). Not seen any in-depth explanations -- only bits & pieces here & there. There's a little bit on page 14 of the following page. This guy talks about 3 brands of tape (have only seen 2 so far). I believe that it was written in the past 2 months so it is fairly current.

Azata.net/meetings/winter2010/BACAElasticTherapeuticTaping2.pdf
.

[Frank Silbermann]

Originally Posted by LeeD

I'd generally agree with your inset post, but that idea of using both hands.......

Just can't switch accurately fast enough, not just the grip, but also the location of the hand on the handle.

I've lengthened my handle to the legal limit and got used to hitting left-handed with an incredible swing weight. My right hand is always choked up -- almost a normal swing weight (that's my preferred hand for volleys). Thus, my ready position has both hands in their forehand positions; to hit, I just drop one or the other.

Another thought. When you were just starting out, you'd use your legs to compensate for bad strokes -- e.g. running around your backhand. Now, you have to use your superior strokes to compensate for bad legs. It's not the number of steps that's really the problem for bad knees; rather, it's hard acceleration, hard deceleration, and abrupt changes in direction. The more time you have, and the less far you have to travel, the gentler you can be wrt starting, stopping and turning.

This means not only that you hit the ball with your closest stroke rather than with your strongest stroke, but also that you hit the ball to whichever side minimizes the distance you have to travel to prepare for the return. If the ball you're returning is in the corner, then you hit cross-court. This is analogous to the net player's preference for the down-the-line. In both cases, you make it easier to prepare for the next shot. You only break that rule when you can hit the ball so strongly that your opponent will be lucky to get his racket on it. (So that, even if the shot is not an outright winner, he won't be able to take advantage of your poor positioning.)

When the ball is at the middle of your baseline, then you'll prefer the inside-out shot. That's because, if the ball is in the dead middle, to hit it you'll already be standing a bit to one side of it or the other. Hitting inside out means you're already in position for the next shot. So you need to be able to hit your backhand inside-out just like your forehand.

If your opponent takes advantage of knowing where you're hitting it to prepare early, wind up, and blast a down-the-line winner, then he's too good for you (considering your condition). But at least you'll lose the point without hurting yourself. If your opponent can't do that, or if he makes too many errors, then you can win.

That's the goal -- to be able to play without hurting yourself, and to make your opponent show some real ability if hopes to beat you.

[flynhi]

Originally Posted by larry10s

no one thinks this is good on the knees?

It's a good idea, but bad for your doubles partner

[corners]

Originally Posted by EKnee08

Here is a link to the one I have used for both knees for years. After the microfracture, my ortho had me start playing tennis with the unloader brace that I wore to transition back to walking after crutches. After I became comfortable again with movement, after a few sessions, he enabled me to try my marshall knee braces. Since then I have been fine with the Marshall's. However, your orthopedist might recommend a different brace depending on your needs. Some guys who have had microfracture are required to only play with an unloader brace for example.
http://www.juzo.com/ww/en/pub/produc...__genu_404.cfm

Thanks for your replies to my questions earlier in the thread and for the above as well!

You mentioned that lunges and stairclimbing are no-nos for knee OA. What exercises are considered safe for strengthening the legs in the manner required for stabilizing the knees?

[SystemicAnomaly]

Originally Posted by jrod

I wish someone would offer up a coherent explanation of how this stuff works. I have had mild patella tendonitis in my knees for years now and often tape them in the manner of Nadal. This technique makes sense to me in the sense that the tape is providing relief to the point where the tendon attaches to the bone in the knee. With the KT, I don't understand how the same thing can be accomplished without with a partial strapping????

Originally Posted by SystemicAnomaly

It's FM (****ing magic). Not seen any in-depth explanations -- only bits & pieces here & there. There's a little bit on page 14 of the following page. This guy talks about 3 brands of tape (have only seen 2 so far). I believe that it was written in the past 2 months so it is fairly current.

Azata.net/meetings/winter2010/BACAElasticTherapeuticTaping2.pdf
.

Im addition to page 14, also be sure to take a look at pages 17 thru 23 to get a better idea on how these kinesiology therapeutic (KT) tapes work.

The fact that these various types of KT tapes can stretch to 140% of their relaxed length is part of why these tapes work the way they do. In some cases the tape is applied fully stretched to the skin to reposition the skin & underlying muscles. In other cases, the tape is applied partially stretched or not stretched at all. In these latter cases, the limbs or muscles are contracted or extended when the tape is applied.

Another feature of the various elastic tapes is the unique ripple pattern that can be observed you look at the underside of the tape. This pattern allows the adhesive on the tape to lift the skin a bit away from the tissue to promote circulation, reduce inflammation, etc.

After wearing the tape for several days now (shoulder and shin), I can get a little better sense of how the tape works and I can attest to its effectiveness. It is still a bit of a mystery to me, however. I tend to be a highly skeptical person when it comes to these kind of things -- so the placebo effect is rarely a factor with me. There are many other things that I've tried (including supplements) that I really wanted to work but have not experienced any significant results. This is further testament to the ineffectiveness of the placebo effect for me.

I can definitely see/"feel" the biofeedback quality that is claimed for these elastic KT tapes. My suggestion is to forgo your skepticism or lack of understanding and give it a try. The KT tape (brand) that is available at places like Sports Authority, Target & Dick's is only $13 (good for 10-20 applications) and is fairly easy to use. SpiderTech tape is the easiest to use but it is quite a bit more expensive. Kinesio Tape has been around the longest and has the most documentation available (for a multitude of applications) but it really requires a high degree of expertise to use.

[jrod]

Originally Posted by SystemicAnomaly

Im addition to page 14, also be sure to take a look at pages 17 thru 23 to get a better idea on how these kinesiology therapeutic (KT) tapes work.

The fact that these various types of KT tapes can stretch to 140% of their relaxed length is part of why these tapes work the way they do. In some cases the tape is applied fully stretched to the skin to reposition the skin & underlying muscles. In other cases, the tape is applied partially stretched or not stretched at all. In these latter cases, the limbs or muscles are contracted or extended when the tape is applied.

Another feature of the various elastic tapes is the unique ripple pattern that can be observed you look at the underside of the tape. This pattern allows the adhesive on the tape to lift the skin a bit away from the tissue to promote circulation, reduce inflammation, etc.

After wearing the tape for several days now (shoulder and shin), I can get a little better sense of how the tape works and I can attest to its effectiveness. It is still a bit of a mystery to me, however. I tend to be a highly skeptical person when it comes to these kind of things -- so the placebo effect is rarely a factor with me. There are many other things that I've tried (including supplements) that I really wanted to work but have not experienced any significant results. This is further testament to the ineffectiveness of the placebo effect for me.

I can definitely see/"feel" the biofeedback quality that is claimed for these elastic KT tapes. My suggestion is to forgo your skepticism or lack of understanding and give it a try. The KT tape (brand) that is available at places like Sports Authority, Target & Dick's is only $13 (good for 10-20 applications) and is fairly easy to use. SpiderTech tape is the easiest to use but it is quite a bit more expensive. Kinesio Tape has been around the longest and has the most documentation available (for a multitude of applications) but it really requires a high degree of expertise to use.

SA- Self-applying the tape properly seems like it could be problematic, particularly with certain types of problems. My view is this limits its appeal to club players since most won't have the motivation to do the research and learn about it.

Since you've used it, what specifically did you use it for? Also, I frequently tape my knees and wrist with standard athletic tape, primarily to provide some degree of support. Can this tape be used to accomplish the same goal?

[SystemicAnomaly]

Originally Posted by jrod

SA- Self-applying the tape properly seems like it could be problematic, particularly with certain types of problems. My view is this limits its appeal to club players since most won't have the motivation to do the research and learn about it.

Since you've used it, what specifically did you use it for? Also, I frequently tape my knees and wrist with standard athletic tape, primarily to provide some degree of support. Can this tape be used to accomplish the same goal?

I've not yet tried it for my knees (arthritis from some previous meniscus damage?) since my greatest pains and limitations right now are with my left shoulder and "shin splints" on my left leg. My shoulder limitation is primarily with external rotation and shoulder flexion. The KT tape does not use compression and does not limit ROM at all.

There is some minor improvement in ROM for my shoulder. However, the greatest benefit has been the lack of pain in my shoulder and shin during & after tennis & badminton.

The application to my shoulder required some assistance from another person. However, the shin application was very easy to perform on myself. I suspect that application to the knee and wrist should also be fairly easy to self-administer. Look over the pertinent printed material and watch the appropriate videos 2 or 3x and you should be able to perform the application. Even if your first attempt is not "perfect", you should derive significant benefit from the tape application.

The KT tape does not provide support in the same manner (primarily compression) that conventional athletic tape does. Instead, it sets up your skin, muscles & joints so that your own anatomy provides that support as well as improved function.

[charliefedererer]

It's hard for me to believe that the kinesio tapes either improve function or decreases joint/tendon/muscle inflammation.

They probably have a skin surface effect similar to Ben-Gay, TENS units or capsaicin cream. That is, there a lot of pain and touch nerve endings at the skin surface level, and stimulation of these superficial nerve endings disguises the pain at a deeper level, perhaps either because of the gate control theory or endorphin release.

And what is so bad about getting some pain relief?

Probably only good will come of it, unless you continue to ignore pain as the body's indication of inflammation and overdo it.

[SystemicAnomaly]

Originally Posted by charliefedererer

It's hard for me to believe that the kinesio tapes either improve function or decreases joint/tendon/muscle inflammation.

They probably have a skin surface effect similar to Ben-Gay, TENS units or capsaicin cream. That is, there a lot of pain and touch nerve endings at the skin surface level, and stimulation of these superficial nerve endings disguises the pain at a deeper level, perhaps either because of the gate control theory or endorphin release.

And what is so bad about getting some pain relief?

Probably only good will come of it, unless you continue to ignore pain as the body's indication of inflammation and overdo it.

Don't knock it unless you've really researched it and tried it.

It is much more than just a "skin surface effect". It is not a counter-irritant at all. It does provide an anti-inflammatory effect according to several resources that I've seen. The biofeedback, repositioning, "support" and other aspects that elastic (KT) tape provides, enable you to use your muscle & joints in a biomechanically correct and non-destructive manner.

"The tape is used in therapy to relax overused muscles and in rehabilitation to facilitate underused muscles. The wave pattern found on the tape's adhesive has a lifting effect on the skin which can reduce swelling and inflammation by improving circulation... "

I've not seen studies yet that indicate that KT taping has any destructive or detrimental effects on the body. Note that Kinesio tape has been in use in Japan for some 30 years now. It has gained popularity in the US in just the past 3-4 years with tennis players & Olympic athletes, particularly at the Beijing Olympics and recent Winter Olympics.

[SystemicAnomaly]

Note that the lack of pain that I experience after tennis or badminton is not due to any active analgesic effect or masking of pain. Less stress is placed on my shoulder/rotator and shin due to the use of the KT tape.

CharlieF, if you can dig up some reputable sources that indicate that KT taping does harm to the body, please bring them to light.