I am active therefore I get injured. That’s probably the best way to think about it. So injury is part of life and something I need to learn about and overcome. To that end I have started to document what I have learned from my injuries

The other posts focus on specifically treating that injury including:

• wrist sprain,
• ankle sprain,
• toe stress fracture.

This article is about the general lessons learned from each injury and why I don’t keep going to a physio.

Why I’d rather learn for myself.

I’m happy to buy a solution for my car or house or other item but not for my body. Not knowing how to fix problems with my body is not an option for me because I believe that investing in understanding my body is the most important thing I can do in life. So these injuries are no different. I would have preferred to have the support of a physio but their business model wasn’t appropriate for me. I had a brief Google but couldn’t find online support that suited either. So I just chose to use these injuries as learning experiments. I am always experimenting on my own body because it’s one of the best ways to learn.

I’m very glad I have done this because the amount I have learned is tremendous.

As a simple summary for my wrist I have been flexing and working it regularly. Pain on full flex goes then comes back next day. Pushing to full extension helps over time. Each day it’s better. Strengthening at the same time is working too.

I am doing the same with my ankle. Keeping it flexed when I can. Strengthening on stairs regularly and stretching. Each match there is less swelling.

Why try fixing injuries myself and how can I put up with one that lasts for years?

Knowledge. Like many others I have limited funds. I can’t just spend money in the hope of a fix. I need to get a return. As with any regular player I have injuries all the time. It’s impossible to know which injury will linger and which will pass. This wass the first sprained ankle that lingered. I have had many before and all healed without extra help. The same goes for the stress fracture. The wrist sprain was new but it wasn’t the problem. It was healing fine. The problem occurred each time got back into tennis. So, knowing when, where and how to come back was the problem. Not the short term healing process.

In fact with each injury it is the path back to activity that hasn’t been clear and all my research indicates the physios have no better answer than me. I wasn’t impressed with the expensive approach each physio used for assessment and treatment. Instead of asking me to provide most of the detail upfront beforehand allowing them to get on with treatment in the session they prefer to spend the entire initial session diagnosing the problem in what I see as the slowest way possible.

I understand why but I feel there are better and cheaper ways these days. You’d think I should let them do their jobs because it’s a very challenging job and they have the training. That’s true but I did a similar job working on a computer helpdesk. I had to diagnose and fix most problems within the first phone call and we were allowed 3 mins max for most calls. It was a very difficult job which taught me a lot about diagnosing problems from random situations. Ever since I’ve found the same principles apply to any problem. Essentially the process physios use is fine for those who can afford it and haven’t experienced faster and more accurate approaches. I have and I can’t afford to pay for inefficient services.

Instead I prefer to learn from every challenge I face. I prefer to use my injuries to teach me how to take better care of myself. Each of my previous injures has improved my game. Whether its back, foot, neck or any other problem I look at how I play my game and adjust, removing the pain causing dynamic and improving my technique. This always fixes the problem. It’s why I don’t suffer from recurrent back pain or any other. All injuries, I know how and why they are caused and thus I can fix and prevent them. I don’t want to be like most athletes I know my age. All limping or otherwise hindered through an injury that has been chronic that they now use to justify playing less and less and thus reducing their activity. I see it all the time. Some one limping but not knowing how to fix the problem.

Sprains are common issues. wrist and ankle sprains need similar support. The actual implementation is the difference. a physio could not have provided a tennis specific rehab plan. They could have helped but only someone with specific sports experience and training can do this. I did sports science so my training prepares me better,  and I enjoy using it.I don’t get to apply it directly at work so it’s fun applying it during play. What I couldn’t find on the web or with a physio is a practical rehab plan. I could only find something very generic with very little detail, nothing tailored to my exact injuries and nothing specific to the kind of rehab I needed.

I used to be quite inactive. I could easily opt of sport for weeks and months. These days I can play every day and I want to. I have fixed most injuries whilst playing. Always found a way to keep going and all the evidence points to that being the best approach. By stopping activity the rest of your body weakens and you generally get other injuries when you return. That is exactly what the stress fracture is. An injury from a recovery to the wrist injury. It’s also because I am now competing. The leagues don’t really end. One leads into the other so I have to keep playing and dealing with it.

I prefer to see it as though I’m on tour and need to find active solutions. Instead of constantly letting myself be sidelined.

Why keep playing?

Why do I keep playing instead of just resting? Because I’ve tried it and rest doesn’t cure most injuries either and I was taught that active rest and recovery is key. Our bodies need the right kinds of activity to direct and encourage the healing process. I rarely have serious injuries because I correct niggles before they become fully fledged injuries with most of the noticeable improvements having come from a balance of play and rest. I still see no reason to abandon this philosophy. I just feel I need more experience to learn how to adjust it.

Strengthening all around the joints has seen the biggest improvements along with improving my technique.

For my wrists adding pronation has helped considerably along with limiting wrist extension. Particularly in the serve. Now that it’s pretty much fixed I am confident in my diagnosis and treatment. I could knock happily for a long time but the instant I started serving my wrist started hurting. Looking deeper I simply found that I was extending the wrist a lot when I served. I was sort of catching the racquet as I went through motion and leading with my pinkie snapping my wrist towards me. This meant all the force of the swing was going through the tendon and muscles. This was hurting the tendons over time and so they had become slightly inflexible, short and weakened and at the same time. It turns out this is a more recent tweak in my serve that I didn’t used to have. I started doing it to get more spin and control. I used to pronate well and serve very fast but had little control. So I researched a little. Got better advice and watched a few videos. The best thing was that I found that pronation could solve all my problems. Literally twisting my wrist the opposite way pushed all the energy out into the racquet and ball instead of keeping it in the wrist. That’s how it feels. The trick for control was also the trick to save my wrist. No take back. I literally just lift my arm and pronate. The swing is tiny the serve is HUGE!!! It’s fantastic. More recently I am able to add in more take back and swing etc but any time I feel uncomfortable I just remove the take back. No pressure on the tendon means it can guide the stroke but not get involved and thus it can heal. At this point I am starting to apply the strengthening and rehab I developed for my ankle which has worked wonders because I need to restore full extension and strength to my wrist.

For my ankle and toe the answer was to improve my footwork to reduce the pounding on my feet. The specific advice was to strengthen my foot muscles. The reason for the injury was coming back too fast from injury. I just hadn’t moved like I used to so my feet weren’t as strong, both in the bones and the structures moving the bones (muscles and tendons etc) so the natural cushioning wasn’t happening. The muscles tired early and the bones had lost  At the same time I also developed better balance through various exercises which spread the load of movement better through my body and feet.

Risk and Recovery

In the end the balance of read, risk and recovery is turning out to be most important. Recovery was the thing I allowed least of. I am learning to value it more. It started to make a lot more sense when I saw the relationship with weight training.

I grew up doing weights and learnt that recovery is everything in getting stronger. You just don’t train the same muscle groups on consecutive days. The pattern with my injuries has been the same. I didn’t know how often I should do my rehab exercises and how intensely I should do them. So I basically over did it. Often too intense and often too often. I’ve got the best results when I’ve spaced things out and toned them down.  Last week my ankle was perfect because for the last month or so I have not been playing every day. I’ve taken many more rest days and my ankle has seen the benefits. At the same time I’ve been protecting the ankle through better movement. Instead of being explosoive I’ve been moving constantly but slowly and deliberately, much like walking. It’s been very frustrating choosing not to play but the benefits can’t be argued with.

The reference to weight training is even more pertinent because it seems to be the most important part of the protection part of the PRICE protocol. Essentially a healthy joint has the strength to protect itself from normal activity. An injured one like mine isn’t strong enough so damage occurs. That’s what has been happening so each time I played full out I would cause small bits of damage which would need a few days rest to recover from. So it’s no surprise that the rehab that worked was the gentle deliberate kind that slowly and gently strengthens the joint as a whole. Something that doesn’t push the joint hard. Just gently builds up the strength and control of the joint. Coupled with lots more rest than my healthy ankle. The healthy one can happily play every day because it’s much stronger and has proper coordination.

So, for now I’m exploring the proper weight training program to provide proper protection for the joint. A proper strong infrastructure for intense tennis.

Was it all worth it?

In a word, yes!!! What I have learnt is that I was right. In the end I have found solutions to all these injuries. Only two have been prolonged and the answer was essentially simple. It’s just that no one had bothered to explain a practical solution I could follow. I had to create my own. Thus I wanted to document and share so others could benefit.

I also wanted to see if I would in fact develop any long term problems through this approach. I won’t know for years but already I have hope that I’ll be fine. Both the alzheimer’s study and the way the joint feels as it heals give me cause for optimism.

References

Injury reduction in manual labourers The point of sharing is to help others recovery from their injuries. Particularly showing them that it’s possible.

tennis elbow and tennis elbow pain Best explanation yet of the need for active recovery to build stronger connective tissue, muscles and blood supply.