Tennis Injury Videos - Post Yours

[Chas Tennis]

What happens to cause tennis injuries is very important. Research can't cause injuries for studies, so the information on causes is difficult to pin down. And cameras are rarely on the moves that cause the injuries of average players.

Here is a video of my recent injury. If you have videos either showing a sudden injury or are injured and believe that it might be related to one of your strokes please post related videos. For example, they say that medial epicondylitis, Golfer's Elbow, is related to high level forehands and serves. If you have medial epicondylitis/Golfer's Elbow please post a video of your technque. etc.

Some possible associations found in references on common tennis injuries are:

1) Tennis Elbow - One Hand Backhand
2) Shoulder Impingement - Serve
3) Wrist Injury - Serve, Forehand
4) others, etc.

Videos from posters won't be very reliable indicators of injury causes but some videos may indicate interesting things to look into. Maybe seeing forehands from 10 players who suffer from Golfer's Elbow might show something to point us in the right direction. ?

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I happened to have a camera on a platform tennis match when I re-injured a recovering plantar fasciitis injury. I assume that the move in this video is what stressed and caused my recovering injury to suddenly become much more painful than it had been. Probably the plantar fascia tore farther. ? Details in the Vimeo descriptions.

https://vimeo.com/115804312

https://vimeo.com/115802389

Unfortunately, the 60p fps video is saved in Vimeo as 30 fps for playback, half the frames are discarded. (If you downloaded it soon after uploading, 2-3 days?, before Vimeo processing you may get all 60 fps.)

The next 3 replies have the 12 frames at 60 fps to show the motion and foot position believed to have caused the injury.

 

[Chas Tennis]

Consecutive Frames at 60 fps. Frames #1-4.

Injured foot is on left. The left foot is coming down at about the same time or just after I decided to lunge to the right to cover a lob. See video for the overall body and leg motions. Injured area never touches the court, impact not involved. 60 fps frames are 16.7 milliseconds apart.

Frame #1 Left (injured) foot coming down.

Frame #2

Frame #3 Foot is first in contact with the court.

Frame #4 Foot is supinating as lower leg tilts to the right. Heel never touches the court.

 

[Chas Tennis]

Frames #5-8

Frame #5 Heel lowest, stationary but not touching for frames #5,6 & 7.

Frame #6

Frame#7

Frame #8 Foot is supinating and the ankle seems to be pushing out the side of the shoe. Lower leg to the side and forward. Heel rising.

 

[Chas Tennis]

Frames #9-12

Frame #9 The lower leg is angled to the side in this frame and the next at about it's maximum angle. Maximum stress around this time?

Frame #10

Frame #11

Frame #12

I don't see why this motion would stress the media side of my PF next to the heel bone.

One possibility might be excessive supination although I don't see how that stresses the medial area of the side of my heel bone, where pain was felt on palpation.

"Plantar fasciitis
Plantar fasciitis results from an overload of the plantar fascia at its
insertion into the medial calcaneal tuberosity. Excessive pronation of the
foot and tightness of the gastrocnemius-soleus muscle complex are thought
to contribute to plantar fasciitis
[67,68]"
Musculoskeletal Injuries in Tennis
Robert H. Perkins, Denise Davis, Page 627.
http://www.med.nyu.edu/pmr/residenc...clinics NA_sports med/MSK injuries tennis.pdf

I have read that often injuries might be associated with a muscle that is lengthening rapidly, under heavy load, perhaps with reflex contraction, and a second external force is imposed. In this case, a little different, I believe my foot was coming down and the muscles were perhaps reflex activated at the same time that I had initialed a strong lunging action to the side. There also is a sort of tiny double step, a hesitation step, that is hard to see in the original 60 fps video and won't be visible at 30 fps Vimeo playback. I have not looked at the rest of the 45 minute video to see if I use similar footwork at other times. ?

If someone got a sudden PF injury and happened to have a camera on it - that's what the interest would be.............

 

[ollinger]

All I see in the platform video are some rather ordinary steps and movements, certainly nothing that could have been avoided, or that one would have thought should be avoided. The more salient point here is why the hell were you playing platform with a plantar fascitis that you hadn't recovered from yet?? The answer to this question may be far more useful than a video.

 

[Chas Tennis]

All I see in the platform video are some rather ordinary steps and movements, certainly nothing that could have been avoided, or that one would have thought should be avoided. The more salient point here is why the hell were you playing platform with a plantar fascitis that you hadn't recovered from yet?? The answer to this question may be far more useful than a video.

The story is included in the descriptions on Vimeo.

In the early summer 2014, I had mild PF that bothered me, not while playing, but the day after tennis. I took off 3 months. I saw a Dr near the end of the 3 months, received brief PT with exercises and stretches. The Dr said that I could start tennis after a few weeks, which I did. When I started playing there was some mild pain the day after playing. For two months of playing, 2 or 3 times a week, it seemed to be probably improving with time - ? - in any case, not getting worse.

About 5 years ago, I had worse PF in both feet. The pain worsened for a year while I kept playing. I took off 3 months then and when I came back there was a very slight pain that gradually lessened and went away.

I'm not young. The fact that my feet have changed size from 12 to 14 in the last 8-10 years may be a factor, seems reasonable that it would be, since that length change must change the arch and stretch the plantar fascia. ?

Also, I believe that if you take off for too long there is a serious risk of miscellaneous injuries from the general lack of conditioning.

My foot is feeling better now so I'm trying to pick a reasonable time off again. I need to get in condition before starting tennis. Leg & foot conditioning is tricky with PF since you can't use your legs and feet as you do when playing.

I've been off for 1 month, since early Dec of 2014. The foot feels much better in the last week but I'm not running. I can't play for sure. ............

I hope some players might have and post some videos in this thread, we could discuss my PF details farther in a separate thread.

 

[Chas Tennis]

This picture shows a foot, heel off the ground, supported by the ball of the foot and the main muscle force (MF) supplied by the calf muscles. The re-injury pain was mostly low on the medial side of the heel. I don't see how the forces applied to the Achilles Tendon would cause stress at the injury site but the injury was near by. ?

http://www.slideshare.net/joldham5/module-2-kinesiology-getting-started

The video and pictures of the injury above also shows that the lower leg angled to the side and not as vertical as in the above picture.

 

[RogueFLIP]

1. In your video, your ankle and foot are supinating, not pronating.

2. I would have been curious to see footage longer after the supposed moment of injury to see if there was any conscious or subconscious reactionary movements of your foot/ankle to pain. That could have been more supportive in concluding at that moment of time is when you injured yourself. Maybe you have it on your raw video.

3. Kinda jumping on Ollinger's post that why are you playing if you have PF already? You tell people to seek medical advice for losing eyelashes :twisted: but yet you're playing on an injured foot. This alone is probably the biggest factor in aggravating your condition.

4. A possibility in your desire to figure everything out is the supination of your ankle/foot caused some compressive force onto the medial side of your foot effectively shortening and tightening that side. Then the rapid pronation of your foot as it moved back to neutral may have caused the tissues to tighten as part of the stretch reflex.

5. Say you can conclude that this particular motion was the cause of your injury. Realistically what can you do about it? It's not like you can be aware of a similar motion during a competitive match, surely there's other things you need to divert your attention to.

Good luck and speedy recovery.

 

[Chas Tennis]

1. In your video, your ankle and foot are supinating, not pronating.

2. I would have been curious to see footage longer after the supposed moment of injury to see if there was any conscious or subconscious reactionary movements of your foot/ankle to pain. That could have been more supportive in concluding at that moment of time is when you injured yourself. Maybe you have it on your raw video.

3. Kinda jumping on Ollinger's post that why are you playing if you have PF already? You tell people to seek medical advice for losing eyelashes :twisted: but yet you're playing on an injured foot. This alone is probably the biggest factor in aggravating your condition.

4. A possibility in your desire to figure everything out is the supination of your ankle/foot caused some compressive force onto the medial side of your foot effectively shortening and tightening that side. Then the rapid pronation of your foot as it moved back to neutral may have caused the tissues to tighten as part of the stretch reflex.

5. Say you can conclude that this particular motion was the cause of your injury. Realistically what can you do about it? It's not like you can be aware of a similar motion during a competitive match, surely there's other things you need to divert your attention to.

Good luck and speedy recovery.

1- Supination, you are right. I think I somehow viewed my left foot like a right hand. ? Will correct.

2- I recalled jumping at the time of injury and that is the only sort of jump in the point. I am not certain of the time of injury as indicated.

3- See my reply to Ollinger's post. I'm off again and am going through the same decision making again.

4- I'll have to think about that but I agree a stretch reflex might have been involved as discussed in a book by Knudson. I did not see rapid motion and I don't understand how tension would have been created at the site of the pain. Maybe your compression theory can explain as so far I can's see how tension would have been created in that area of my medial heel.

One issue that has interested me was that I had thought the weight might be coming down on a foot, and before the heel hit the court it might force too much dorsiflexion. Maybe the calves are tight - we are told to stretch them - and that also adds stress. If the video had shown my coming down and causing hyper dorsiflexion we might have been on to something. But that senario does not seem like what is happening in the video. I don't see how tight calves cause excess tension on the plantar fascia in the video.

But if there were several videos on injuries they might be useful in giving us some idea of the causes.

You will be interested in this. Could it have played a part in the injury? Unbalanced sides the gastrocnemius?

My Dr asked me to show her how I stretched my calves. For Gastrocnemius, she said to point the foot being stretched toward the other foot and not straight ahead. That would seem to stretch the lateral side of the gastrocnemius a little more I guess. She also said something new and very interesting - maybe we had discussed this in another thread, long stretching times - but to hold the stretch for 4 minutes to permanently lengthen the muscle. I am doing those 4 minute stretches. On studying stretching, I first learned about 'sacomergenesis'. New sacomeres are created at the ends of the sacomeres in the myofibril - the muscle lengthens. For exercise hypertrophy, I had always read that the number of muscle cells does not increase or that the increase is very small. This is the first time that I read about sacomeregenosis. I guess that is the way muscles get bigger. ?

 

[RogueFLIP]

One issue that has interested me was that I had thought the weight might be coming down on a foot, and before the heel hit the court it might force too much dorsiflexion. Maybe the calves are tight - we are told to stretch them - and that also adds stress. If the video had shown my coming down and causing hyper dorsiflexion we might have been on to something. But that senario does not seem like what is happening in the video. I don't see how tight calves cause excess tension on the plantar fascia in the video.

But if there were several videos on injuries they might be useful in giving us some idea of the causes.

You will be interested in this. Could it have played a part in the injury? Unbalanced sides the gastrocnemius?

I'll have to read the first part of your statement over bc I'm not quite getting what you're getting at....
But your last questions, just remember not only can you have an unbalanced tightness and restrictions to the gastroc muscle but also the inverters and everters of the ankle/foot which are located deep underneath the gastroc complex.

One can easily have plantarfascitis like symptoms and not have an issue with the gastroc/soleus but bc there's excessive inversion/eversion in some way which can lead to problems.

My Dr asked me to show her how I stretched my calves. For Gastrocnemius, she said to point the foot being stretched toward the other foot and not straight ahead. That would seem to stretch the lateral side of the gastrocnemius a little more I guess. She also said something new and very interesting - maybe we had discussed this in another thread, long stretching times - but to hold the stretch for 4 minutes to permanently lengthen the muscle. I am doing those 4 minute stretches. On studying stretching, I first learned about 'sacomergenesis'. New sacomeres are created at the ends of the sacomeres in the myofibril - the muscle lengthens. For exercise hypertrophy, I had always read that the number of muscle cells does not increase or that the increase is very small. This is the first time that I read about sacomeregenosis. I guess that is the way muscles get bigger. ?

I've been advocating a minimum of 5 min stretches since I've started posting here. We've had this discussion before in one of your threads (either the postural issue or stretching threads) - you even mentioned that you had some positive experiences once you started holding the gentle stretches for 5 minutes. Not sure of the time frame on your end on whether you heard it from your doctor or read it from my posts first, but either way it's the way to go IME.

 

[Chas Tennis]

I'll have to read the first part of your statement over bc I'm not quite getting what you're getting at....
But your last questions, just remember not only can you have an unbalanced tightness and restrictions to the gastroc muscle but also the inverters and everters of the ankle/foot which are located deep underneath the gastroc complex.

One can easily have plantarfascitis like symptoms and not have an issue with the gastroc/soleus but bc there's excessive inversion/eversion in some way which can lead to problems.

I have been attempting to think of ways that the plantar fascia could be over stressed and injured. The only idea that I've been able to think of was -

1) you are running, jump into the air and spin around 180d.
2) your foot lands in the opposite direction to the direction that your were running, the ball of your foot is in contact with the court.
3) if the heel were to touch the court your foot would exceed the amount of non-injury hyper dorsiflexion so your calves and plantar fascia must absorb the forces to slow the weight of your body and the forward velocity of your run to prevent injury. They can't and your tear your plantar fascia.
4) that seems like a possible way to suddenly and directly tear the plantar fascia.

The first video that I have ever seen, the one above, I think was of another cause because it does not look as if the ankle is excessively dorsiflexed. (it is not a good camera angle to see dorsiflexion, so I'm not certain.) Maybe the reflex forces could be a cause of the injury and pictures, what do you think?

Also, I certainly don't see any heel impact that might be associated with the injury. Of course, we both know that there's a lot of uncertainty. If we only had more videos........

You have some other interesting ideas, inverters & everters, etc.. If you can see how my supinated foot might have gotten an injury on the medial side, lowest area of the heel bone, in a way that fits the above pictures, please speculate. What tissue might be injured? Any references on supination & pronation injuries, etc.?

 

[RogueFLIP]

Well, you are right in that there are so many ways to injure yourself.


For example:

Regarding your video remember that your foot and ankle isn't a rigid piece of bone. There are many tarsal/metatarsal bones that can move in different directions. So it's entirely possible that while your rear foot is moving in a supinated position, your forefoot while appearing also to be in supination, is relatively pronating in essence to balance the system. Thus a twisting motion to the plantarfascia, kind of like if you were wringing out a towel. Easily could strain or microtears the region.

Kinda works the same way with inverters/everters...


Postural issues can stress the region. Anterior rotated pelvis on one side or both sides changes the center of gravity causing you to be tipped forward. To compensate, your gastroc can contract to try to adapt. Bc you're tipped forward on one or both sides, now your heel hits the ground biomechanically different and with a bit more force. This triggers Wolff's law which basically means a stressed bone causes the area to lay down more bone. Viola, now you've got a heel spur. And bc of the tight gastroc now it's tightening all the surrounding tissues and finally when all that tight tissue comes in contact with your developing heel spur....pain...stress....and a sudden movement or even a movement you've done a 1,000 times before causes a problem.


As usual, no I don't have references or studies....just a lot of experience evaluating and treating people with injuries.