Wednesday, August 14, 2013

Shuttlecock Woes - A Layman's Guide to Common Badminton Injuries


A rather common opinion about badminton is that it is one of the safest games possible-a fun, family game innocent of malice and devoid of any real danger of injury. Such notions are highly probable, given the immense popularity of the game worldwide, as entertainment for children during playtime as well as a serious Olympic sport.

However, contrary to popular opinion, badminton players are also prone to injury-some so intense in nature that they may take months to heal completely. According to one study conducted by a Denmark-based group of doctors and published in 2006, badminton injuries occur at an average rate of 2.9/person every 1000 hours of play time. Despite being a non-contact sport, where there is no physical contact between the opposing players, badminton injuries happen frequently-mostly due to over use of certain parts of the body and sometimes because of accidents happening suddenly and painfully. Mostly they occur in players who wear the wrong shoes, do not warm-up, warm-up more than required, sport bad technique, are overweight or generally unfit. Injuries are witnessed in players who have not indulged in sport for a while as well as in seasoned players who have overused body parts such as wrists, ankles, knees and elbows to name a few.

Acute/Accidental injuries:

Ankle Sprains- Although still wanting in detailed statistical studies, some research papers have shown that on an average, ankle sprains constitute more than half of all reported badminton injuries. An ankles sprain can be described as the stretching and or tearing of ligaments and muscles in the ankle. In extreme cases, there may also be damage to tendons, bones and other joint tissues. The resulting bleeding within tissues can cause sudden edema and swelling of the ankle, which in third degree sprains, often takes more than 6 months to heal completely. Ankle sprains are accidental in 99% of the incidences and happen when the player lands on his partner's foot or on the floor with his own foot turned inwards, outwards or flexed. The extremely quick directional changes required during badminton, often cause the feet to roll over or twist, resulting in a sprained ankle. Fatigue, extra body weight and shoes with more than normal 'grip' are frequent contributors to such injuries.

Meniscus Tear- This also goes by the layman-friendly alias 'Torn Cartilage Knee Injury' and is as painful as a sprained ankle. During the intricate footwork required during a badminton game, the meniscus or cartilage, which provides a soft cushioning between the thigh and shin bones, sometimes ruptures, causing pain in the joint-line of the knee, swelling and inability to flex the leg completely. This may sometimes also be accompanied by an injured or totally ruptured ligament, which increases the pain factor and healing time. Normally, the swelling and pain settles down easily for most people. However for some sportspersons, the knee can become prone to knee locking or 'giving way', in which case, surgery is required.

Muscle Strain- Unexpected movements, such as a sudden overhead smash, may put muscles in various parts of the body under pressure, thereby causing a disruption of fibres in the affected muscle. This can result in pain, swelling, bruising and in extreme case, loss of function. Muscles commonly affected are the hamstring, knee, shoulder and calf, to name a few.

Ocular hurt- A Malaysian study reportedly called badminton the 'sport which presented the greatest ocular hazard in Malaysia'. Another Canadian study backed up these claims saying that 30-58% of all eye injuries in Canada caused by racquet sports were attributed to badminton. This may seem funny to a layman, since a shuttlecock looks anything but devious, with its lightweight feathery appearance, compared to the heavier balls used in tennis and squash. Although the frequency of eye injuries on an average is more in squash than in badminton, the latter does account for injuries which are greater in severity. This is partly because the bottom round of the shuttlecock fits into the eye orbit and also because of the extremely high speeds achieved during badminton. Badminton is widely considered to be the fastest racquet sport in the world and shuttlecocks have been known to reach speeds of more than 300 km/hour. On 25 September 2009, Malaysia's Tan Boon Heong set the international smash record of 421 km/hour in the men's double's category at the Japan Open 2009. This is 1/3rd the speed of sound at sea level, so one can imagine the effect of a shuttlecock travelling at that speed and hitting one's eye. It would be painful to say the least.

Fractures- Fractures are fairly rare in badminton, although some have been reported. They normally happen when another player's racquet hits a player's arm or leg or if the player himself falls down heavily or if another player missteps and falls/steps on him/her.

Chronic/overuse injuries:

Achilles Tendonitis- Loosely defined, Achilles Tendonitis or Achilles Tendonipathy is an inflammation of the heel cord of the foot. In reference to badminton, it can be described as a chronic degenerative change in the Achilles Tendon (a cord of inelastic tissue connecting bone and muscle running from heel to calf) occurring due to repetitive jumping and running, worsened by poor warm-up techniques. More common as one ages, it also tends to worsen with activity.

Tennis Elbow- Do not be mislead by the nomenclature of this particular injury. Tennis Elbow is often seen in sports other than tennis and very frequently among badminton players. The injury, known as Lateral Epicondylosis among the medical fraternity, is a chronic overuse injury which occurs due to the inflammation of the tendons of the forearm on the outer part of the elbow. Players who indulge in repetitive backhand strikes are often subject to Tennis Elbows. Change of grip size, lack of recovery and excess stretching tend to make them worse.

Golfer's Elbow- This particular injury is similar to Tennis Elbow in mostly all respects except for the location of the injury. While Tennis Elbow causes inflammation on the outer part of the elbow, Golfer's Elbow usually occurs on the inner side of the elbow with the pain sometimes radiating along the forearm. It is also a chronic degenerative problem, mainly caused by an overuse of the wrist.

Jumper's Knee- As the name suggests, this injury often comes on due to repeated jumping on hard surfaces. Known in medical terms as Patellar Tendonitis, the Patella Tendon located below the knee cap is affected over a long period of jumping and landing during badminton. Activity normally worsens the tendon damage and a rupture may sometimes follow with lack of rest

Rotator cuff injury- The most prominent shoulder injury to affect badminton players over time, typically a rotator cuff injury is brought on over time by repeated stress to the shoulder area while playing overhead shots in badminton. It usually begins as a lingering irritation in the shoulder known as an 'impingement syndrome', which if left uncared for, worsens to develop partial tears in the rotator cuff muscles. Further activity and stress can cause a complete tear in one or more muscles in the area.

Sacroiliac Joint Dysfunction- The Sacroiliac Joint connects the sacrum at the base of the spine to the ilium of the pelvic region. Continuous badminton playing with low core stability causes an anatomic issue in this joint, which results in chronic lower back pain. The condition is known as Sacroiliac Joint Dysfunction and affected players are advised to refer a physician for a complete evaluation of the condition.

Neck sprains- Focusing on the shuttlecock for long durations and turning one's neck accordingly in various directions, can cause the neck to be extended beyond the normal angles, especially while playing smashes and strikes around the head, thereby causing neck sprains.

Cramps- A cramp can be described in a badminton player as a sudden and intense pain caused mainly in the leg area due to major loss of fluid, overheating of the muscle and fatigue. Although the suddenness of a cramp could warrant it to be placed in the "acute injury" category, it is considered to be a chronic injury, since it happens after playing badminton for a long time.

Abrasions and blisters- Common yet less malignant as compared to the rest of the above-mentioned conditions, abrasions occur mostly on the hands and knees due to direct contact with hard surfaces when the player falls or scratches himself. Blisters occur due to pus or fluid formation under the skin caused by extended periods of gripping a racquet, an abrasion not being cleaned or healed properly and heels or toes being continually encased in shoes or being in direct contact with a hard surface for long periods.

Prevention and cure:

It would be wise to adhere to the oft heard rule in the exercise arena "You don't get fit to play a sport, you play a sport to get fit!" Therefore it is advisable for badminton players of all ages and levels to take a few important pre-game precautionary measures, which include but are not limited to increasing fitness levels, better nutrition, decreasing weight, getting the proper shoes, grips and other attire, warming-up before playing and improving playing technique.

One cannot stress enough the importance of a good warm-up session before and cool-down session after a heavy game of badminton. A typical warm-up should include about 5-10 minutes of gentle jogging , spot walking or skipping, followed by short stretches of 30 seconds each, slightly longer stretches on the tighter muscles ending with stretches for certain individual muscle groups like shoulder, hamstring etc. If the player wishes, he/she may also follow this with certain specific exercise drills such as push-ups, sit-ups and the like. Stretching releases tension within muscles, allows freer movement and circulation and not only prepares the body for heavy-duty badminton, but also the mind. Begin the game with around 5-20 minutes of gentle shots with your partner and then gradually increase the pace and tempo of your game. Ideally one must end a game with cool down exercises and stretches too.

Shoes and grips especially are of utmost importance in preventing ankle and elbow injuries respectively. Gripping a racquet too hard or long can bring on a Tennis Elbow, while wearing heavy grip non-supportive shoes cause ankle sprains and Achilles Tendonitis.

To prevent elbow issues, take extra care to buy a good quality racquet which fits precisely into the palm of your hand. Turn your racquet into a powerful, injury-preventing instrument by adding more grip to the handle, taking care not to add too much to disrupt the racquet balance. For those of you, who already have suffered from Tennis Elbows before, it would make sense to wear a Tennis Elbow Compression Strap, which works by reducing tension on the elbow tendons.

Badminton requires the player to slide across the court and hence it would be a good idea to get shoes which have a good arch support, shock absorbers to prevent injury to the ankle, heel cups to keep the heel protected and special soles which do not provide much room for friction with the ground below. Take care to buy a shoe which has a combination of these qualities in order to be assured of all rounded protection. Never wear jogging or basketball shoes for your badminton game and make sure you keep a pair of good badminton shoes aside meant solely for badminton.

A few other recommended products for badminton injuries include orthotics and insoles, knee and Achilles straps, ankle braces, shoulder supports and blister socks.

To prevent eye injuries, many research scientists recommend that certified plastic polycarbonate glasses be worn by beginners and experienced badminton players alike.

Lastly, as a generic rule, make sure you are always well stocked up on water or isotonic sports drinks, especially while playing badminton in hot weather, since like all other sports, badminton too tends to sap the fluids and cause dehydration.

When a badminton injury has already happened, quick and correct procedures are essential for a speedy cure. In case of acute injuries like sudden sprains, strains and tears, the first step towards healing is correct diagnosis. This must be followed by the rest, ice, compression and elevation protocol which is absolutely necessary for recovery. Special care must be taken to keep weight off the injured area and lengthy periods of rehabilitation are a must. In case of a sprained ankle a removable plastic cast walker may be necessary to provide the required support. Tennis Elbows can usually be alleviated by rest and ice therapy, but in the more severe cases, pain relief and anti inflammatory medication and sometimes corticosteroid injections are required. Golfer's Elbow on the other hand is usually treated with tape, elbow guards, manual therapy and stretching. When Achilles Tendonitis occurs, ice packs are normally helpful, but a minimum rest period of three months is required for the body to produce the collagen tissue in order to repair the injured tendon.

Sounds scary? It doesn't have to be! Badminton can continue to be a fun sport for all those who have even a smidgen of interest in it. The fear of injury need not come into the picture at all, if the necessary precautions are taken and if players choose to keep themselves intelligently informed about the protocols to be followed- in case of injury.

Keep the shuttlecock flying fearlessly and treat yourself to a great injury-free badminton blast!

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