ice compression

Put it on ice, Playing through a pandemic

Sports Physiotherapist, Anne Marie Montgomery, stretching female tennis athlete Venus Williams post match.
We sat down and chatted with Anne Marie Montgomery , Sport Physiotherapist.
Covering all things from Australian Open Grand Slam Tennis and what to expect from performance this year, how to pivot through a pandemic & what to keep in mind when returning to play.
Anne-Marie has extensive experience in private practice and elite sports. She has worked with Irish Olympic team athletes and the Irish Rugby Union team, before emigrating to Australia in 2002. She has worked around Australia, with highlights including time at the Australian Institute of Sport working with netball, basketball, swimming, rowing and tennis.
Anne-Marie was the Head Physiotherapist at the Australian Open Tennis for 14 years and travelled full time with Tennis Australia athletes on tour for 7 years. Most recently she has worked privately with top 10 international tennis players whilst continuing to grow her practice Pro Sport Injury Clinic here in Melbourne , Australia.


As we’ve seen the first few rounds now underway at the 2021 Australian Open (AO).

Have the nature of injuries changed due to athlete’s physical preparations compared to previous years?

There are a few things impacting the tournament and in all honesty it’s really two different sides of the coin.

For the athlete’s whom I work with personally, the timing and conditions of this slam could almost be considered beneficial. The AO is a few weeks later than “normal” which in turn has provided the opportunity for an extended off-season to train. For most players one of the most noticeable differences were not having the diversity of hitting / training partners available to practice.

Under “normal” conditions we would see players taking a small amount of time off at the end of their season , training at home and then having a sudden and significant increase in load when playing the lead in tournaments throughout the Aussie summer. It’s then not uncommon to see a rise in injuries and as a physiotherapist this means the pressure to get athlete’s bodies ready for the start of the Slam.

Unfortunately for those athletes in “hard lock down” or restricted hotel quarantine, we will likely see a decrease in the training affect. The loss of court time for those in this position will mean the sudden increase in load that could  bring about soft tissue injuries we've seen in the past. The other point “quarantined athletes” will contend with is loss of rhythm. We’re not talking dance class, we mean the feel of the ball. A lot of players really need this. Finding rhythm with only three days before a tournament is a huge ask for any player. Some players can do it, but others two weeks away from the ball will mean they’re going to be a few rusty early round matches.

 

Example of a hard quarantine “in room” workout:
  • Bike
  • Run (shuttle runs, agility etc, many athletes were great at covering between 3 - 5km in their room each day)
  • Body weight strength exercises (Squats , Static Lunges, Walking lunges, glute bridges)
  • Resistance band exercises

Regardless of the number of these sessions above per day,  we’re talking about athletes who are used to training minimum 4 hours per day, so unfortunately it doesn’t matter how hard they are training they will have a loss of training affect.

We won’t know the full extent until the end of the tournament.

Has your daily work differed during the tournament?

This year I’m working solely with two female athletes , we were part of the smaller contingent who started our preparation with an exhibition match in Adelaide. Isolation was run very tightly and it wasn’t until we all received our negative covid-19 tests that we were then able to access the court as a team.

From a support staff perspective not too much has differed from previous years (treatment tables at the courts, modified gym’s at both court and hotel), if anything it has taught coaches and support staff to think “outside the square” for travelling resources.

Social distancing at the AO has meant for a lot calmer & less busy warm up , cool down and gym spaces.

What’s your ideal pre and post match routine?

When it comes to match play , all the ground work has already been done. If you’re an elite athlete you should already know what works for you and your body.

If you’re an adolescent and you’re grinding through all the tournaments and moving through the ranks with the dream to become professional. Then it is now that you need to learn what works for you. Know how your body responds to certain training & recovery methods.

Some players like really dynamic warm ups. Some like to go out and feel a little bit tight, on the other hand I have had athletes that like a little bit of massage before they take the court to feel more fluid.

PREPARE
MATCH DAY
RECOVER 
Pre Hydration (electrolytes) & good nutrition
Great warm up: run, exercises, hitting, activation exercise (for tennis specifically shoulder internal and external rotations)
Cool down & stretching > Great facilities here at Melbourne Park, long match or really hot days,  ice massage or ice baths.
Sleep well (best thing for muscles to recover and repair. )
Rehab type exercises pending previous injuries
Refuel & recover

No Social Media , no phones in room, no Netflix , screens away an hour before bed at least.

Time set aside for the final few moments with your coach, be clear and concise (hit the court with as little mind clutter as possible).
then normally much later on some massage and working through any niggles.

 

Tips for returning to play:

For the “weekend warrior” who is returning to the court after an extended break from match play.

  • Ease yourself back into it > if you’re going from a period of no to very little training and jump straight back into a repetitive sport like tennis you’re at huge risk for injury.
  • Preparation > make sure you are organised. Have all your equipment ready and easily accessible. Pre hydrate & fuel your body correctly.
  • Proper cool down > stretch , listen to your body and ice any of those main areas of concern.

 

*It is absolutely imperative to keep an eye on younger athletes returning to the court, expecting to play & perform exactly as they were pre pandemic is a recipe for stress fractures and tendon injuries.

 

 

What are the most common injuries you treat in tennis?
  • Shoulder injuries > most of my time at Pro Sports Injury Clinic is spent on maintenance and preventative measures for the shoulder. High chance of shoulder injury in any “overhead” athlete
  • Growth injuries > prevalent in younger athletes. Such injuries include, but not limited to:
    • Server’s disease: the common name for calcaneal apophysitis. It is a common cause of heel pain, particularly in young and physically active people. Between the ages of 8 and 14 years the heel bone experiences a period of growth. This may lead to heel pain during or after physical activity (1)

 

    • Osgood- schlatter disease  (long bones grow really fast , soft tissues around them get tight and this can cause enthesopathy)

Osgood-Schlatter Disease (Knee Pain)

In most cases of Osgood-Schlatter disease, simple measures like rest, ice, over-the-counter medication, and stretching and strengthening exercises will relieve pain and allow a return to daily activities (2). 

 

Overall tennis is a hugely rotational sport so keeping the whole body in check is important. Ensuring the thoracic spine remains as mobile as possible so that we don’t overload the lumbar spine, back or neck, or shoulder. To caring for tendons and lower limbs for time spent on the hard courts like those of Melbourne Park. 

That’s the thing about tennis , it requires the whole body. It practically coils the body up (especially on the serve), in order to create that power that’s needed,  all body parts become affected.

My main takeaway whether that be for my elite athletes, weekend warrior or junior players. Spend more time on your injury prevention & recovery measures:

  • self massage
  • seek regular professional advice & consult
  • stretching
  • long warm up
  • full cool down
  • rest, ice, compression

 

Endnotes

      1. https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/severs-disease  Accessed February 2021
      2. https://orthoinfo.aaos.org/en/diseases--conditions/osgood-schlatter-disease-knee-pain/m  Accessed February 2021