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Squash Injury Prevention and Recovery

Posted on October 16th, 2013

The PSA Men’s World Squash Championships return to Manchester in October and Harris & Ross will be court side as the tournament’s official physiotherapists.

It’s an unbelievable spectator sport and is likely to encourage a few beginners to take up the game and amateurs to pick up their racquets again, so how do you make sure you leave the court injury-free? Alison Bugg explains:

The nature of the game, includes rapid changes of direction, explosive movements and pushing yourself, which always mean injuries are likely to occur. The immense level of activity, fitness and flexibility all can result in restrictive injuries or conditions that need medical help and advice.

As with activity at any level, certain injuries or conditions can be more prevalent among some sporting populations than others. When an athlete or participants body becomes fatigued, this increases the risk of them sustaining an injury. Hence why warm-up, cool down and strengthening and stretching regimes  are vital as injury preventers.

Common types of squash injury:
Muscle Strains and sprains
Overuse injuries
Biomechanical related injuries
Impact injuries
Slip or trip injuries
Heat related injuries

“Rob and the team at Harris & Ross were without doubt the major factor in extending my professional squash career. Their treatment and rehabilitation of injuries were the most comprehensive of any physiotherapists I’ve worked with.” – Stuart Boswell, senior coach at Aspire Academy Qatar and former top 20 squash player

As with all injuries early assessment, treatment and the correct intervention ensures a smooth and rapid return to activity in a safe and reasonable time. If you suffer an injury playing squash, stop immediately and apply ice as soon as possible.

One of the biggest problems we see are muscle pulls or strains, or participants experiencing discomfort. Instead of seeking advice, the injured players rest for a short while, then try and return to the court; this inevitably leads to a recurrence or further re-injury. The longer this cycle goes on for, the area of injury can become chronic and in turn this means a longer lay off from the sport in the long run. Early advice and guidance can prevent this and also highlight future areas of injury that with simple stretching or strengthening or advice on footwear or equipment could be prevented.

Potential areas of injury:
Achilles tendon and ankle
Knee cartilage, ligaments and anterior knee
Hamstring or quadriceps muscle strains
Groin discomfort
ITB friction syndrome
Shoulder muscle, ligament and tendon injuries, also bursitis inflammation.
Elbow golfers and tennis elbow
Lower back
Cervical Spine

In the upper limb, the conditions we see more tend to be the elbow tendonitis’, shoulder overuse and wrist injuries. As physiotherapists we look for the cause behind these problems. We look to treat and reduce the inflammation and discomfort. A graduated strength and stretching programme is essential to ensure a smooth return to activity without the risk of exacerbation or recurrence. Eccentric strengthening and consideration of neural components and spinal involvement, is often the key to resolving these.

A real risk among squash players and research, has shown the incidence to be greater among male squash participants in the over 35s, is Achilles tendon injuries and rupture. This often occurs as a player rapidly pushes off their foot to do a quick move forwards, such as for a drop shot. They report feeling as though they have been ‘shot’ or ‘kicked from behind by someone’ and yet there is no-one there.
It is essential in these injuries that we see them quickly. There is a window of opportunity to get a good outcome, and if necessary for us to get them to one of our surgical colleagues. One of the great things we have available at Harris & Ross is immediate links to the wealth of medical and surgical knowledge within the surrounding hospitals. It allows us to get our patients relevant x-rays, MRI scans or investigations at short notice and we can have them seen by some of the best orthopaedic surgeons available to us as sports physiotherapists.

With early intervention and good graduated rehabilitation programmes, injured players can successfully be returned to their pre-sport levels. Using our Alter-G treadmill allows us to mobilise these patients and even build to a run early in their treatment, whilst still keeping them partial weight bearing and allowing adequate healing.

As squash involves a lot of rapid twisting and turning, there is a high incidence of knee complaints. Bracing options can be of benefit here and at Harris & Ross we have a full range, designed by some of the best manufacturers to be worn by competitive sports people. It is vital that knee strength is balanced and developed in a measured way to eliminate the risk of imbalances and resultant tendonitis or patellofemoral inflammations.

Prior injuries that are not fully resolved or correctly rehabilitated are a real risk when playing squash and that is why it is essential the correct and thorough advice is sought to give you the confidence in both you and your physiotherapist.

General information to keep you safe playing squash:

Do a good warm up and cool down
Have a specific stretching regime for you
Drink plenty of water before, during and after to prevent dehydration
Play within your limits
Ensure you have correct footwear for you
Play with good equipment

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