Squash Injuries

Summer is a great time for squash players to work on their fitness and recover from niggling injuries. Dr. Joseph Tanti from Garneau Chiropractic has written up a guide to squash injuries, what causes them and how to prevent them.

Squash is a high-speed, sport that is dominantly one-sided. It requires quick and repetitive movement of the spine, hips and legs, and racket arm. As a result, injuries occur more often than we would like. These injuries may occur anywhere in the body from the shoulders and arm down to your ankles.

Squash Movement Overview

The human body functions as a whole. What occurs in one area, will affect other areas in the body. Squash requires that the body moves in and patterns. The three major movement patterns in squash are:

Rapid acceleration/deceleration. Squash match includes many quick and short bouts of sprinting and changing direction.
Lunging/ stretching out. The end of each short sprint is followed by a lunge or stretching of the legs and arms to strike the ball.
One-sided. Each time you lunge and stretch out to reach the ball, the spine is flexed to the side.

Your body is a very efficient system. When you want to move, the amount of movement that is required is distributed over the different joints in the body. When the joints, and muscles are functioning optimally, the total load is optimally distributed over these structures.

But what happens if one of these areas is not working the way it should, even if there is no pain?

What if your ankle does not have enough mobility? When you reach out and lunge, the movement that should occur in your ankle doesn’t. This means that this movement is taken up by the other joints: the knee and the spine.

This is what we call ‘compensatory movement’. When one area is not moving enough, your body adapts and creates movement somewhere else.

Is Compensatory Movement A Bad Thing?

Compensatory movement is not bad. It allows us to get on with our lives even if we have an injury or poor mobility. Yet, in an athletic and active population, it will often lead to injury, as the excessive strain is placed on areas of the body that it is not meant to.

The most commonly injured areas include the calf and Achilles, hamstrings and the low back.

Calf and Achilles Injuries

The calf is made up of three muscles. The gastrocnemius, the soleus, and the plantarus muscle. These three muscles all coalesce into the Achilles tendon and insert into the heel.

Injuries to these structures are especially common in racquet sports(1). Rapid acceleration is a large precipitating factor to injuring the Achilles (1). When sprinting, and lunging, the Achilles complex undergoes a tremendous amount of load. This may cause either micro-strains or even tears in the muscle belly or tendon. On and off cramping and pain in the calf is common. This may be due to repetitive microtears and scar tissue formation in the muscles and tendon. This is due to inadequate rehabilitation(1).

Squash Injury Treatment

The type of treatment will depend on the severity of the injury. There are 3 overall approaches for rehabilitation.

Stretching: Reducing muscular tension and lengthening the muscle/tendon is important. This is especially important in areas where there is excessive scar tissue formation.
Strengthening: Concentric and eccentric strengthening is a vital component to a successful rehab program. This form of strengthening will promote tissue healing(1).
Correcting biomechanics. As described earlier, if your biomechanics are faulty, this will lead to injury. If there is not enough movement in one area, excessive stress will be placed in another area. For example, there must be adequate movement in the ankle, knee, hips, and back.

Hamstring Injuries

Hamstring injuries are very common in sports where athletes quickly change directions. The more well-known type of injury is when there is sudden pain, usually, this involves a lot of soft tissue injury, swelling, redness, and bruising. If the injury is severe, the athlete may not be able to put weight onto their leg. Depending on the severity of the injury, recovery time can vary from weeks to several months.

4 ways to Avoid Hamstring Injury

Strong glutes – Many people recall Tiger woods reporting that “[his] glutes [were] shutting off’” after a round of golf. What does that have to do with hamstring injuries? If you glutes are ‘shut off’, your other muscles compensate. This can cause over-activation of your hamstring muscles. When you sprint and lunge, your hamstrings are busy doing the job of your glutes. Gradually the hamstrings become fatigued and overloaded. The next thing you know, BAM, you’re injured.
Exercise (1)- You should include eccentric hamstring exercises into your workout routine. Studies show that this will drastically reduce the risk of injuring them. The glute ham raise or Nordic hamstring curls are fantastic exercises to do the job.

Warm Up- Performing a thorough warm-up is important to get your body and your muscles ready for your strenuous match ahead. This doesn’t mean just wack the ball around a few times. A thorough warm-up will help to lessen your risk of injury.
Listen to your body- Many times when before athletes become injured, they ‘felt off’ leading up to the injury. They had been having unusual aches/ pains. But, like most athletes, they try to play through the pain. In these cases, their bodies were yelling at them to STOP! If they were to get the appropriate treatment, they likely could have avoided injury. This would mean they wouldn’t have to miss out on weeks or months of squash.

Lower Back and Hip Injuries

Lower back pain is one of the leading causes of disability worldwide. If you’ve ever had a severe bout of low back pain you know why. It can stop you dead in your tracks, and make you feel 50 years older than you are.

The elite athletes know that the power in any rotational movement occurs at the hips. The hips and legs rotate, while the upper body becomes stiff and rigid. This creates a strong foundation for your power to be delivered to the ball.

When the hips don’t rotate, the back does.

When rotation and lateral bending occur in your spine, and not your hips. This compensation would not be a ‘big deal’ if this were to occur once in a while. Yet, when this occurs repetitively, like in a squash match, this is where the trouble starts.

This excessive spinal motion puts strain and stress into the joints and discs in the back. This will often lead to back pain.

The solution? Get your hips to be mobile and flexible again.

Hip Stretches For Squash

Hip Flexor Stretch

Walking lunge with Overhead Reach

Summary

There are many effective ways that you can reduce your risk of injury. If you want to play more squash, longer while avoiding aches, pains, and injury, try to implement the described strategies. You won’t be disappointed.

References:

Brukner & Khan (2012) Clinical Sports Medicine 4th Ed. Australia, McGraw-Hil