Overuse injuries—sometimes called stress injuries—sneak up on you by developing over time with many little traumas. Overuse injuries happen from doing too much, too soon, too fast, too hard or too intensely for your body.
Overuse injuries begin with a little irritation or pain, which you tend to ignore with words "no pain, no gain" or "it's part of the process." It might eventually lead to some swelling, inflammation and daily pains.
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The best approach to prevent overuse injuries is to become physically fit, well balanced and evenly flexible and strong on both the left and right sides of your body.
You need to train smart with proper periodization, eat healthy nutrition, and eliminate as much stress as possible. Additionally, you need to use good quality equipment and shoes.
It All Begins With the Hips
The core and hips are the most important part of your athletic body. You use your core and hips in any athletic movement to transfer the forces between the lower and upper body. Any imbalances in your core or hips will cause uneven forces on other muscle groups and joints, and over time create overuse injuries.
A good start in your physical well-being and injury-free training is to look at your hips. You want to keep the hips balanced and equally strong and flexible on both sides.
The lopsided nature of tennis and our lifestyle creates small imbalances in our hips that are hard to spot, unless you search for them.
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The open-stance forehand, close-stance backhand, serving (one side only), driving your car (using your right leg most of the time), and many more daily activities that we do, support the developing imbalances.
The most common problem in your hips is rotational misalignment --- one hip is rotated forward, the other backward. This very common condition can create many other symptoms, such as piriformis syndrome (often mistaken for "sciatica"), pain in the patella (front of the knee), plantar fasciitis (pain on the bottom of foot/heel), excessive foot pronation, groin strain, IT band syndrome, and hamstring strain.
How to Determine if Your Pelvis is Misaligned
Compare your left and right side and see if it is harder to balance on one side. Determine if one side is weaker, more painful, tighter or stiffer. Your pelvis may be rotated if you experience any of the symptoms just described.
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Another test is to lie on your back on the floor, bring your knees to your chest, and then slowly stretch them straight. Have a friend observe if you have one leg longer than then the other leg. In about 80 percent to 85 percent of right-handed tennis players, if there is a pelvic rotation, the right leg is longer than the left leg.
While you are on the floor on your back with straight legs, have your friend check if your hipbones are level. Often, the right hipbone will appear lower than the left one. Perform a similar check from the back, when you lie on your stomach and your friend checks the level of your hipbones. Most often, the right hipbone appears to be higher than the left one, if the pelvis is rotated.
This rotation of your hips can happen during the aggressive movements on the tennis court or in the intense training sessions, where the many muscles of the hips are pulling in different directions. If you have imbalances in strength or flexibility in these muscle groups, then the forces are even more uneven.
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