May 11 2014

Road To Left Handed Tennis

Health | Injury | Injury Prevention       Clif Render      
Okay x-ray

As an avid USTA tennis player and sometime captain, I have come to expect the unexpected. There have been times when the team that I thought would be trouble has had a bad day, and we ended up winning far more easily than we should have. A lower rated team that I thought would be a pushover ends up on the winning side while I sit scratching my head trying to figure out exactly what happened. The weaknesses that I know we have may end up being the driving force behind a loss or it may be a complete non-issue as our opposition either never notices or cannot capitalize. Every day on the court is a new day, and every surprise seems more unexpected than the last. Well, my latest surprise is certainly no exception to that rule.

During the Winter, I was bumped up to a new rating level which brought with it the promise of new teammates, new opposition and new opportunities to improve my game through stiffer competition. I was really excited and dove in head first signing up for three teams at my new level determined to get acclimated to the speed of a faster game as quickly as possible. I was really looking to this new challenge. Little did I know, however, that along with this one new challenge would come several additional "unexpected challenges" (e.g. injuries) that I didn't see coming.

Do NOT try to overpower
the ball with your arms
- especially if it works!

First up in the "unexpected challenge" column was strained abdominals. This problem first reared its ugly head toward the end of last year but has come and gone randomly as I started playing tougher opponents. This one is really all my fault. It is a result of me not using my core properly when I swing. I'm a pretty strong guy and this is a very unfortunate thing for my abdominals. Too often I try to muscle the ball with my arms rather than rotating into the ball with my core. This wouldn't be a problem for me if it didn't usually work. The fact that it usually works encourages me to keep doing it. All of the sudden, however, I'm playing at a new level requiring more power more often and bam! Too much Muscle + An Improper Swing Motion = Strained Abdominals. So, dear reader, learn my lesson: Do NOT try to overpower the ball with your arms - especially if it works!

Next up is an injury that set in late in the fall when the weather started to get cold. I took an awkward step on the raised line of a cold clay court and felt intense pain on the heel of my left foot. I figured that the pain would go away on its own - a bruise of some sort. Unfortunately, it did not go away as I expected it would. Rather than going away, in fact, it became more frequent with the pain being at its worst in the mornings when I first woke up. I would also have pain when walking around during the day - especially after playing tennis the night before. The funny thing, though, is that it didn't hurt when I was actually playing tennis (chalk that up to adrenaline, I guess). After that first cold night when I felt it at its worst, playing tennis was the only time my foot didn't hurt. Turns out it was something called Plantar Fasciitis. I know that sounds like a condition caused by a tiny little speck of virus lodged just below the skin but, in reality, it has nothing to do with warts. Plantar Fasciitis is caused by painful inflammation of the tendons that connect the heel bone to the toes. It can be an uncomfortable (and sometimes debilitating) condition that can last months or even years. I am now on month 6 with very little let up in the pain. I know that it will clear up at some point, but I have yet to see that point anywhere on the horizon. Also now, as a side effect of the pain in my foot, I now walk with a slightly unnatural gait which has led to painful problems with my left knee, as well. When it rains, it pours.

A smarter, more reasonable person
than myself might have taken
a break...I didn't. I've never been one
to let reason get in the way...

A smarter, more reasonable person than myself might have taken a break from tennis at this point to heal up. I didn't. I've never been one to let reason get in the way of what I wanted to do, so I just decided to deal with the pain. It will get better eventually. That's when my third "unexpected challenge" reared its ugly head. With only two matches on the books, I suffered a season ending injury injured to my hand - my right hand – my primary, dominant, tennis-playing hand. I was executing a pretty standard backhand volley at the net when it happened. The ball was travelling fast when it made contact with my racquet. My hand flashed with pain like a knife had been stabbed straight through it: sharp and intense. My volley went off the mark but still ended up being a winner which was good because that would prove to be the last winner that I would hit for quite some time. The intensity of the pain caused me to involuntarily drop my racquet (sorry, Babolat). I tried to work out the pain by rubbing it, but every time I squeezed my racket handle, my hand would involuntarily lock up and become painful and useless. At first I thought it was some kind of cramp, so I downed a couple of mustard packets and tried to keep playing. It was no good, though. Every time I made contact with the ball, I felt a similar stab of intense pain followed by a painful aura of discomfort radiating from the base of my middle finger. There was mild swelling, and there were occasional stabs of intense pain. I didn't know it yet, but my tennis playing days would be over for some time.

For the next several days, I tried to keep ice on it to keep the pain and swelling at a minimum. I hoped that babying it would be the proper course of action. A visit to our friendly neighborhood orthopedic verified that there was no bone damage but was uncertain as to the true cause of the pain. A tentative diagnosis of “Torn Tendon Sheathing” was issued, and I was given a steroid to accelerate healing. The doctor thought I might be able to use it again in 7-10 days. I was skeptical. I'd never heard of anything tendon-related that took less than "months" to heal, but I was going to be patient and give it a shot. Three weeks later, the hand was no better, and I still couldn't hold a tennis racquet. I decided to try a new tactic. A good friend suggested that I try some hand and finger exercises to work it out. Maybe it was like a sprained ankle that needed to be stretched and worked gently in order to recover. I tried this for the next two weeks, and the condition did improve slightly. I felt those sharp stabbing pains less often, and I was able to use it for more things without pain but when I tried hitting tennis balls, I was quickly reminded that I definitely wasn't ready for tennis. The intense pain and cramp-like spasms were back, and I was done for the night.

Enter doctor number two. A good friend of mine (the same one who advised stretching and exercising) was able to track down the name of a hand specialist in the area who had addressed a similar issue for a mutual friend, so I made a call and set up an appointment. The appointment was for early in the morning. I made it in a good bit earlier than expected, filled out the required paperwork and was ushered back to an examination room well before my original appointment time. After some excellent discussion with the Doctor's intern, the doctor came in and took a look at my hand. Mild swelling on the knuckle…some tenderness but not too much…when does the intense pain happen? I tried to illustrate the types of activities that would cause it, but had trouble pinning it down. The only clear cut example was "...almost any time I hit a tennis ball with a racquet." Other than that, it was things like digging a hole with a shovel or trying to manually roll down a car window (yes, there are still cars out there with handles instead of buttons). I tried to make it happen in the office but couldn't find any way to do it (and didn't really want to, anyway). We took a look at the x-rays from my previous doctor visit on my phone (isn't technology awesome?) and even took an additional x-ray just to be sure. The verdict has nothing to do with the tendon sheathing, but rather, something called the "tendon sling".

The tendon sling is this little ligament that runs across the knuckle whose sole purpose is to hold the tendon in place on top of the knuckle. As it turns out that little piece of tissue is torn, and this is allowing that tendon to slide off the knuckle completely causing intense pain and temporary immobility. Will it heal on its own? Probably not. It might have healed on its own if it had been properly splinted early on (within the first 3-6 weeks after injury). Since we were now just past the 6 week mark, we are effectively past the self-heal window. Also, I wasn't willing to splint it and wait another 4-6 weeks to see what would happen because I might still have to wait and have surgery anyway. So, surgery it is. Extensor Tendon Realignment surgery, to be exact. I will be awake during the hour and a half long procedure when the doctor will slice open my knuckle and reattach and adjust the tendon sling. I have to be awake so that I can make a fist and straighten out my hand at the doctor’s request. Apparently, attaching the tissue at just the right tightness is a fairly delicate maneuver that can't really be done without the patient consciously working the tendon occasionally during the process. Fun. Four to Six weeks after that, I can potentially begin hitting tennis balls again. So, I now have a week until surgery and then another 4-6 weeks after that before I can play right handed tennis again.

I am not left handed!

At least this gives me a good bit of time for healing and rest and recovery, right? Wrong. Because instead of taking the time off and doing some cross training like a reasonable person might, I have instead decided to start playing tennis left handed. Ridiculous? Probably. Doomed to failure? Most assuredly. But, for someone who's favorite movie is "The Princess Bride", how could I not at least explore the option of being able to battle someone to a stalemate with my left hand only to smile and say "but I am not left handed" before putting the match away in a third set tiebreaker? You know I can't!

So, I have now been out to hit left handed with my son several times and I'm doing okay overall. My strokes are all a bit weak with my forehand falling short of the net about 20% of the time, but they do make it across the other 80% which is way better than I had expected. I'm doing okay at the net although I have a tendency to use my wrist for extra pop which I have to stop doing. The last thing that I want to do is to have to have surgery on my other hand, too. The biggest weakness in my left handed game is (and probably always will be) my serve. I can usually only get one of every three balls in the box. That part is way harder that I thought it would be! I've got a long way to go but at least I'm not stuck sitting at home on the couch. And so, my road to left handed tennis begins...

Comments (4) -

Christy Vutam Christy Vutam says:

Oh, Clif! That sucks. That sucks big time. I don't know what I will do when I am finally sidelined with injuries (besides eat a ton to cope), but I am thankful everyday when I make it through a tennis day without incident. I am so sorry to hear about all the ailments, and I hope when you're able to play with your right hand again, everything else has cleared up, too. :-/

Clif Render Clif Render says:

Thanks so much , Christy! I've just been been playing vicariously through my teammates, following the results of their matches and wondering wistfully about what might have been. On a brighter note, however, I have been out to play left handed about half a dozen times now and have built up some respectable consistency on my serve. Not much power there still but my ground strokes have gotten fairly decent. I can at least hold a rally for 4 or 5 strokes how which is awesome! My surgery on Monday went really well, just waiting to get the staples taken out (seriously, when did doctors stop using stitches and why?) so I can get my left handed butt back out on the court. Woo hoo!

Christy Vutam Christy Vutam says:

By the way, I don't always receive a notification when new comments are added even after I've checked off that box. The only time I've been emailed about a reply was for the It's All Babolat's Fault post. If I don't reply within the day of you replying to this comment, that means I didn't receive an email notification... Frown

Ugh, re-reading what your surgery entailed gives me The Willies...

This just hit me: when you're back to playing with your right hand, your two handed backhand (I assume you have a two handed backhand) is going to be amazing! You'll be able to hit the ball predominantly with your left hand on that stroke just like tennis coaches say to do!

Clif Clif says:

Yikes! I've gotta fix that! That explains why I haven't been getting those notifications, either. Smile

Yeah, It's been two weeks since surgery. They say that everything is looking good still but I'm not so sure. Still having lots of pain. Even if I weren't supposed to use the hand, I couldn't. A bit worried...

Good point about the two handed backhand, though! I used to use a two-handed backhand but it was just too weak so I abandoned it. That might not be the case after this is all done, though. Mmmmm, something good to look forward to, maybe...

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