Category Archives: Injuries

injuries and the quick fix

The women are doing grass in Birmingham, England, this week in preparation for Wimbledon. It sounds like a broken record, I know, how many more weekly injury reports do we need for the women but here it is: Tennis-X reports that Daniela Hantuchova, Maria Kirilenko, Chanda Rubin, and Meghann Shaughnessy have dropped out of Birmingham due to injury. I have my own injury problems.

Early last year I discovered a service motion that gave me a strong serve after years of hitting popgun serves. I shortened my toss just like Roscoe Tanner, reared back and whacked the ball. One morning, a guy wandered on to the court as I was practicing and asked if he could return my serves. After about half an hour he gave up in frustration because he couldn’t handle my serve down the middle. It wasn’t the most consistent serve in the world but I count that as one of my proudest days in tennis.

I didn’t realize, however, that I was arching my back and definitely not bending my knees. Later in the year I developed pain in my lower sacrum whenever I served and I still cannot serve without pain. That is, no doubt, the only parallel between my game and Taylor Dent’s game.

In an interview with Tennis Week, Dent discussed the injury that has limited him to five matches this year. The article reports that “He initially sustained two fractures after years of bending his back in an extreme arch during serving. The pain is primarily caused by damaged nerves now, which continue to flare up virtually every time he tosses the ball up in the air to begin his service motion.”

What’s interesting about the article is Dent’s optimism, or, you could say, denial. He thinks the problem is “just a matter of finding a solution and I mean that could be in the next couple of days, it could be in a week or two or a month or two.” And this is after a recent unsuccessful surgical procedure which tried to deaden the nerves which are causing the pain.

If you do the same movement for years, especially a movement so extreme that it produces fractures, it’s possible that you can find a treatment which will reduce pain but it’s more likely that you will have to retrain your body to do the movement differently. Changing your service motion would be a start but it also likely that the new service motion will not be as effective. One of the reasons that Andy Roddick has the fastest serve on the planet is because he has exceptional rib and spine flexibility. Evidently Dent does not and he probably has less now than he had at the beginning of his career.

Dent is not alone. Every time I get an injury, and I get a lot of them, I am looking around the next corner for the “fix” and hoping that it will be quick and easy. Last week in a New York Times section on the upcoming PGA US Open, golfer Rocco Mediate was very upbeat about the back pain that has bothered him for much of his career.

“Believe it or not, Augusta National saved me. It showed me what was wrong with my body. It saved the rest of my career. I know I can still play,” he said in the article. Mediate had been in contention till the last round at the Masters at Augusta National when his back seized up. His fix is to increase his hip strength to take pressure off his back.

A little further down the page, though, you’ll see a bracketed paragraph reporting that Mediate had to pull out of the last two tournaments leading up to the Open. Rather than asking Mediate if he didn’t seems a tad bit optimistic given the reality of the situation, the writer included that paragraph as if to let readers draw that conclusion for themselves.

I am an eternally hopeful person and I have the results to show for it. I play tennis three or four times a week and that’s after a back injury so severe that I couldn’t sit for more than half an hour without throbbing pain for the first few years of the injury. I’m just saying that a chronic problem borne of persistent movement habits, particularly in the physically harsh world of professional sports, is not likely to respond to a quick fix. The process is more likely to take months and possibly years of small improvements that will lead to incremental improvement in reducing pain over time. If a particular movement is causing the injury – in tennis, the serve is critical and in golf, obviously, the swing is everything – the athlete will have to change that movement and that will significantly change their game.

Tiger Woods managed to find a way. After knee surgery, he realized that he had to smooth his swing out and he was willing to completely take his swing apart and reconstruct it at a time when he was the number one player in the world. Another reason that he is an exceptional athlete.

But that was also his knee, not his back, and surgery was sufficient to repair the damage. If Dent is back on the tour and playing pain free and if Mediate wins the US Open, I will be wrong. If so, you can criticize me all you want. But I don’t think I am.

For you ATP fantasy people, not much is happening on grass. Andy Murray went out at Queens but that’s no too surprising. He should, as the rumors suggest, sign Brad Gilbert up as soon as possible before someone else gets him. I’ll weigh in a little more in a few days, meanwhile here are the current draws.

wrong footed strategy

I’m trying to rent out two rooms in my house so I have a roommate ad on craigslist. I get phone calls from all kinds of people. Some of them can only afford one of the rooms. Some of them don’t really want a roommate but can’t afford to live alone. One couple emailed me from Berlin. I had a very long, enjoyable conversation with one man and we made an appointment for him to come to look at the house.

He didn’t show up.

I had another very long, interesting conversation with a man who had been an accomplished martial artist. This guy had so much confidence in his skills that he never thought about his upcoming opponent. He didn’t want to know about his opponent. It would only take his thoughts away from what he had to do at any given moment in the match. It would be a distraction to him. If he was prepared, it didn’t matter who he was fighting, he should win.

During preparation for a match, he sprained his ankle badly. He kept on training and his ankle healed enough to fight but it wasn’t completely healed. He knew that his opponent had heard about his injury and would attack him low to go for his bad ankle.

Just before the match, he taped up the ankle that was not injured and left his bad ankle untaped. His ankle held up through the fight and he won pretty handily because he already knew his opponent’s strategy. An excellent example of turning a competitive liability into a strength.

He didn’t show up either.

pride goes before an injury

I injured my right wrist by being dumb but it’s my left wrist that hurts. Nine months ago I saw a man practicing his serve on the public courts where I play and I asked if I could return his serve. He was practicing his second serve trying to kick it as high as possible. Pretty quickly I realized that I was out of my league but I stayed out there still trying to get the ball back over the net. One of his serves kicked up and bent my right thumb backwards. Turns out he was a semipro player. Way, way out of my league.

It took about three months and many different treatments before my thumb healed. One of the treatments was acupuncture. The acupuncturist put needles in both wrists for symmetry but the needle in my left wrist accidentally hit a nerve. That is why my left wrist still hurts even though my right wrist is fine.

Last week I found myself in a similar position. This time the server was hitting the ball so hard I knew that my back would hurt if I continued to return his serves. Yet, I could not pull myself off the court? What is the problem here?

I have been taking Alexander Technique lessons since 1990. F.M. Alexander was an actor who lived in Australia at the turn of the 20th century. He liked to give solo shows of readings in Shakespeare but each time he started to perform, he would lose his voice. No one could tell him why this was happening so he embarked on a long study of observation and experimentation to find the cause of the problem.

It turns out that just as he was about to open his mouth and speak on stage, he would pull his head back, depress his larynx and suck in breath. These movement were present whenever he spoke but they were magnified when he performed. Sitting in front of a mirror, he worked to change his movement habits until this was no longer a problem. Alexander eventually moved to England and began training others with the technique he developed.

After fifteen years of Alexander lessons, I still get injured. And it doesn’t help me figure out why I can’t leave the court when I know that I am likely to get hurt. I recently came across the work of David Gorman. He is a certified Alexander Technique teacher but he has taken it one step further with work that he calls Learning Methods. He wondered what would have happened if Alexander had asked himself what he was thinking when he performed publicly instead of changing his movement habits. What if Alexander thought that he had to speak much louder and try much harder in performance than he did during rehearsal?

The key here is not to change the movement that is causing the injury but to work with the thought that leads to the movement.

David lives in the south of France and there are no instructors in California so I made an appointment to speak to him by phone. He asked me what I was thinking when I couldn’t pull myself off the tennis court even though I knew my back would hurt. I said that I didn’t want to leave the court because I wanted the server to think that I was a good tennis player and I certainly wasn’t a good tennis player if I couldn’t even stay on the court.

The server might think I’m a good tennis player no matter what I did or he might think I’m a bad tennis player no matter what I did, David pointed out. And what is the criteria for a good tennis player? A more useful question would be, “Is this thought helping me?” Clearly it’s not if the result is injury.

David asked me what I was thinking when I played well. I told him that I use a technique I learned from Lanny Bassham’s work. When I play a match, in between points I occupy my mind so that there is no room for negative thoughts. Before I play a point, I think about where I want the ball to go on the next shot and I mentally rehearse the shot. After the point ends, if I won the point I say to myself, “That’s like me.” If I lost the point, I repeat the preparation for the next point. These thoughts are helpful, they prepare me for the next point and they keep me from getting distracted by discouraging thoughts.

Because I want to perform well in front of others, I do things that are beyond my capabilities and I get injured. What if Alexander had taken the stage and used exactly the same voice he used in rehearsal, doing nothing extra? Maybe he wouldn’t have lost his voice.

The key here is not to change the movement that is causing the injury but to work with the thought that leads to the movement.

How will I use this information? Tomorrow I am meeting members of my new USTA team. If I’m playing with someone new, I like to get to the courts an hour and a half early, use the hitting machine and practice my serve so that I am completely warmed up when I meet them. All the better to impress them. Tomorrow, it turns out, there are no courts available so I will just have to warm up with everyone else.

Trying too hard in a performance situation is a common way to interfere with yourself and end up underperforming or, possibly, getting injured. David told the following story as an example. Someone asked Anne-Sophie Mutter, a well-know concert violinist, what she does about stage fright. She said she never gets stage fright. For her it’s just like practice and if something goes wrong, well, then that’s just something to learn from.

pitchers and steroids: why I believed in Sidd Finch

I am embarrased to tell you that I am one of those people who believed in Sidd Finch, the engimatic mythical figure created by George Plimpton for a 1985 April Fool’s article in Sport’s Illustrated. I was so excited to read about Sidd because I am the kind of person who is always looking for faster, easier ways to get by in life. If there was magic to be found, I was going to find it. I read books like Autobiography of a Yogi and thought it was wonderful that his guru helped him pass his exams. I wanted a guru too.

I haven’t found one. Turns out that magic usually involves hard work.

I’m also embarrassed to say that it means I believed that a pitcher could throw a 168 mph fastball. Why not, I thought? It seems that pitchers limit themselves to 100 mph for some reason.

Well, there is a reason. A recent Slate article, Pitcher Perfect, Why can’t anyone throw a baseball faster than 100 mph, explains the limitation. To send a fastball screaming towards the plate, you need to generate as much force as possible to get your arm moving as fast as you can. It turns out that you can build up your muscles all you like but beyond a certain point, the ligaments and tendons will snap from the force applied to the shoulder.

The official record for the speediest fastball is a shade over 100 mph. It’s no surprise that Nolan Ryan holds that record.

Increasing muscle strength, of course, can increase pitch speed. In the Slate article, a biomechanical engineer says that he has seen increases in pitch speed of 84-88 and 88-91 but not 98-100. A 4 or 5 mph increase in pitch speed. That’s a good enough reason to take steroids.

Steroids help in two ways: they increase strength and they decrease recovery time. Are pitchers taking steroids? Almost fifty percent of the players who tested positive for steroids in Major League Baseball’s new testing policy were pitchers. That answers that question.

We know that sluggers have been taking steroids by looking at the court records and the home run records. Between 1920 and 2004, 61 players hit 45 home runs or better. Twenty seven of those players played from 1990 to 2004. In case that wasn’t clear enough, that means 44% of the top single season home run hitters played in the last 14 years.

How could we measure the impact of steroids on pitching records? The JUGS radar gun has been around long enough for us to chart the average speed of a major league fastball over the last decade and see if it has increased. The problem is that there is no way to accurately know pitch speeds for eras before the JUGS gun was invented.

Though it is unlikely that Jason Giambi could have become his formerly bulky self without steroids, pitch speed is harder to pin on steroids. Tommy John surgery and sophisticated biomechanical exercises have helped pitchers recover from injuries better, increase their speed and pitch longer.

I no longer look for magical solutions to life’s problems. I’m happy enough if I can do something today that I couldn’t do yesterday. Although… This past week 11-year-old Katie Brownell threw a perfect game and struck out all 18 batters she faced in a Little League game. That’s pretty magical.

magic pill for tennis elbow

What is a magic pill? First of all it’s magic. Second, it makes something simple that otherwise would be very difficult.

Dr. Allan Mishra has tested a new treatment for tennis elbow that consists of injecting tennis elbow sufferers with platelet-rich plasma. After eight weeks, patients experienced 60% less pain. Those who did not receive the treatment experienced 16% less pain.

I have had a few bouts with tennis elbow, you can read about them here. The first time I had to stop playing tennis for ten months. A year and a half later I had to stop again for five months.

I am the queen of quick fixes. I injured my back in 1996 and went from chiropractor to chiropractor, each one promising to fix me up as good as new. I finally realized that you can go to a million chiropractors but if you walk out the door with the same movement habits you walked in with, your spine just goes back to its old pattern and you are in pain all over again. If I wanted to be free of pain, I had to change the way I moved.

For instance, if you bend at the waist instead of at the hips, there is no hinge at the waist by the way, you will eventually get lower back pain. You can take all the pain pills in the world but if you keep doing the same thing you’ll get the same pain.

If you hit the ball in a way that hurts your elbow and you don’t change the way you hit the ball, tennis elbow will only recur and recur and recur.

Tennis elbow is not as bad as a severely injured back but you probably will have to change your tennis stroke. Not only that, but if you have tennis elbow you usually have scar tissue. If the scar tissue is not directly treated, it will not improve so resting your elbow usually doesn’t help.

After wasting a few months resting my elbow, I finally went to the UCLA Sports Medicine Center who sent me to physical therapist, Andy Choi. He treated the scar tissue with ultrasound and gave me stretching and strengthening exercises. Just as importantly, he turned out to be the best swing coach I’ve ever had.

He changed my grip and my swing and told me to strengthen my forearm.

No doubt individuals have different levels of joint health. A platelet-rich injection might be sufficient to allow some tennis elbow sufferers to get back on the court. But for most people there is no magic pill. If you hit the ball in a way that hurts your elbow and you don’t change the way you hit the ball, tennis elbow will only recur and recur and recur.