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Reduce Injuries and Stay in the Game

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Dr. Michael Axt, D.C.

You can’t win a tennis match before it begins, but it’s possible to lose one due to injuries or forfeiture from an improper warm-up routine.

It only takes about 10 to 15 minutes to properly warm up, with the goal being to increase your body’s core temperature enough to break a little sweat. This means the warm-up is active — not passive — like lying on the court stretching. Studies have shown that passive stretching actually leads to more injuries than no stretching at all, so the goal is to get your muscles warm and loose through active movement.

Keep in mind that the season will also affect your warm-up, as it usually doesn’t take quite as long to warm up in the summer as it does in the winter. When competing in colder temperatures, my warm-up begins on the way to the match — I turn the heat up in my car just long enough to make me hot. If your car has a seat heater, get a head start on warming up your glutes and hamstrings — this may be the only time when sitting in traffic may actually improve your athletic performance!

Once you arrive, keep the warm-up going by immediately beginning to move. Spend the first five minutes or so jogging around the court, parking lot or in the neighborhood with enough intensity to break a sweat. Then, begin to focus on your joints. Start by placing both hands on the fence, leaning forward slightly. In an alternating pattern, swing each leg out to the side as high as you can, and then cross it in front of your body in the opposite direction. This exercise warms up the ball and socket joint in your hips.

Following the hip swing, turn your back to the fence and walk toward the net doing “the Frankenstein walk”: keep your legs straight and your arms straight out in front of you, then swing your legs as high as you can forward trying to kick the palm of your hands. Once you reach the net, return to the fence performing a set of walking lunges and then repeat for a couple of sets.

Now, you’re ready to kick up the tempo. Depending on your level of fitness, do a series of high-knees and butt kickers, moving forward slowly from the net to the fence several times. For the high-knees, rapidly lift your legs up and down raising your knees as high as you can. For the next set, kick your legs backward forcing your heels toward your glutes.

Your lower body should be properly warmed up at this point, so it’s time to focus on the upper body starting with a set of arm circles. With both arms outstretched to your sides, begin moving your arms in small circles, gradually increasing the size of the circle. Repeat the exercise in a forward and a backward motion in an alternating pattern.

Next, focus on one of the most overlooked areas for warm-up: the rotator cuff. Hold your arm straight out to the side and bend your elbow 90 degrees. Keeping your elbow at shoulder height, move your hand up and down almost in swimming or waving motion, pivoting at the elbow but keeping it in a stationary position. This is called internal/external shoulder rotation.

To finish up your stretch, stand with your feet shoulder-width apart and your arms extended from the sides of your body. Twist your torso from left to right in a controlled motion.

The key to playing injury-free tennis includes raising your core temperature while simultaneously warming up all of your major muscle groups. While studies have proven that doing an active pre-game warm-up is vastly superior to using the common passive stretching approach, remember that passive stretching does have its place and is most effective when employed immediately following your practice or match. Take five minutes or so to cool down and stretch your exerted muscles.

If pain is persistent, or causing you to change your swing or your approach to your game, it’s time to get checked out to prevent further injury and get you back on the court as soon as possible.

When To Consider an MRI 

While a proper stretching routine can reduce or even eliminate some injuries, at some point you may still be sidelined by pain or injury. While muscle strains and sprains can be routinely managed with basic care such using the RICE technique (Rest, Ice, Compression, Elevation), lingering or more severe injuries may need professional attention.

Some athletes can be diagnosed simply using clinical history and physical examination, however magnetic resonance imaging (MRI) may be useful for determining if there are deeper issues such as tissue or muscle damage in patients who do not respond well to conservative treatment. “If the symptoms are not responding to conservative treatment, it would be time to utilize advanced medical imaging such as an MRI,” said Dr. Stephanie Hsu, orthopedic surgeon and longtime ALTA member. According to the American College of Radiology, one of the accrediting organizations for diagnostic imaging in the United States, MRI is a proven imaging modality for the detection, evaluation, staging and followup of a myriad of athletic injuries and disorders. Properly performed and interpreted, MRI not only contributes to diagnosis but also can guide treatment planning and help predict outcomes.

But what exactly is an MRI? It’s a noninvasive medical test that uses a powerful magnetic field, radio frequency pulses and a computer to produce detailed images of organs, tissues, bone, musculature and virtually all other internal body structures. Once the images are captured, a board-certified radiologist closely examines them and delivers a detailed radiology report to the referring physician. MRIs are considered extremely safe, while offering an in-depth view without the utilization of ionizing radiation from X-rays or CT scans.

The latest MRI technology offers a large tube opening to reduce the feelings of claustrophobia that earlier machines often caused patients. Today’s open-bore, high-field scanners offer more room inside while delivering the visually precise images radiologists and physicians demand.

If your physician has given you an order for an MRI, understand that it’s your choice as to where you have your scan performed. With today’s high-deductible insurance plans, patients are finding it necessary to take more and more responsibility for their own health-care decisions, expenses, and overall treatment. At one point in our health-care history, the only place to receive care was through the local hospital. Now, outpatient facilities offer everything from labs and surgery to diagnostic imaging.

An MRI in an outpatient facility in most cases will offer dramatic cost savings to the patient, potentially saving them hundreds (if not thousands) of dollars. Additionally, many of the outpatient imaging facilities deliver faster scheduling, more convenient locations and better overall customer service. With all of this in mind, patients should shop around and ask educated questions. In general, the newer, high-yield, open-bore technology will deliver a better overall experience for the patient, while producing the best diagnostic quality images for the radiologist and the referring physician, so make sure your MRI center offers these advantages.

Dr. Michael Axt, D.C. practices at Advanced Integrative Medicine in Alpharetta (aimmedicine.com.) Dr. Stephanie Hsu practices at Westside Orthopedics and Sports Medicine in East Cobb (westsideorthoatl.com.) To learn more about MRIs and advanced diagnostic imaging, go to americanhealthimaging.com or call 1-855-MRI-CHOICE.