| By Dr. Charles Ruotolo

Any athlete knows that the body must be in optimal shape in order to perform well in their respective sport. Cardio capacity will always play a vital role in any player’s success, as a player must be able to move laterally in each direction, charge forward and retreat backwards without missing a beat. However, just being in shape will not always keep you out on the court.

One of the most common reasons for lost time in tennis is an ankle injury. There are a few different reasons that these injuries may occur, such as:

Poorly fitting footwear

►​Running/walking on an uneven surface

►​Not properly warming up

►​A prior injury or condition

n order to comfortably stop, start and move fluidly, proper footwear is a must. A shoe that is too tight can cause blisters, which will change the stride and lateral movement forcing the athlete to run in an abnormal fashion. This change in form and stride can heighten the risk for injury. A shoe that is too loose will not support the ankle enough and also heighten the risk of an injury.

Taking recommendations from friends or other players also may not be as beneficial as you might think. What the majority of players do not know is that the sneaker should also compliment your style of play. For instance, a player that stays on the baseline should have extra support on the ankle due to the constant sideways motion and should have a strong sole. A “serve and volley” player should wear a shoe with a toe cap, due to this type of play causing the dragging of the toe over the base line during a serve and then charging the net. A toe cap is an extra piece of rubber inside the outsole at the toe area to increase the durability of the shoe. That type of shoe should also include a medial support inside the arch.

Playing surface
Another factor to consider is the type of surface most often played on. Most will play on the basic hard court, which shoes are designed to be more durable and supportive. These shoes will wear out quickly, so the soles should be checked after each session for damage. For a soft court (grass/clay) the shoe should feature ridges much closer together, so that they will not get clogged and allow the player to grip the court adequately.

Warming up
Younger players tend to enter a match “cold turkey,” meaning that they do not warm up properly or do not warm up at all. All players should give themselves an adequate amount of time to warm up every single time they play. A popular exercise to do is an ankle roll, which involves rotating the foot in a clockwise and then counter-clockwise motion. Also, holding the foot inward, outward, toward the center of the body and away from the center of the body for 10 seconds each will increase ankle flexibility.

Prior injuries
Should an injury occur, it is something that can nag a player for a long time, especially if that player chooses to return to play too quickly or ignores it all together. It should be taken very seriously, as an athlete who fails to allow an ankle injury to heal properly increases their risk for ankle instability. The key to recovering from the injury is initially resting the joint along with ice and elevation. As pain and swelling decrease, proprioception strengthening should be performed. Proprioception is the body’s ability to sense a joint’s position, analyze that information and react (consciously or unconsciously) to the stimulation with the proper movement. This requires millisecond muscle reaction which can be slowed by injury. Proprioception strengthening can improve muscle reaction times and can be performed by using a balance board and resistance bands. These programs have been show to prevent recurrence of ankle sprains by 50 percent to 75 percent and can be directed by a certified athletic trainer or a physical therapist.

“A patient suffering from an ankle injury should not return to the court until each of these three things occur,” said Dr. Charles Ruotolo, founder and president of Total Orthopedics and Sports Medicine of Long Island. “First, the patient would need to regain full range of motion in the ankle with no pain present. Then, they need to be able to walk, jog and run with no trace of a limp. Lastly, they would have to reach their maximum speed running straight ahead and be able to change direction in all four different directions fluidly.”

Patients with persistent pain lasting more than one or two weeks or with a recurrent injury should be evaluated by an orthopedist or sports medicine physician to formulate a treatment regimen to return the athlete to sport and to prevent further injury. 

Dr. Charles Ruotolo

<p>Dr. Charles Ruotolo is a Board-Certified Orthopedic Surgeon and the founder of Total Orthopedics and Sports Medicine with locations in Massapequa, East Meadow and the Bronx, N.Y. Dr. Ruotolo completed his orthopedic residency program at SUNY Stony Brook in 2000. After his residency, he underwent fellowship training in sports medicine and shoulder surgery at the prestigious Sports Clinic of Laguna Hills, Calif. He is also a fellow of the American Academy of Orthopedic Surgeons. As an Associate Master Instructor of Arthroscopy for the Arthroscopy Association of North America, Dr. Ruotolo actively teaches other orthopedic surgeons advanced arthroscopic skills in shoulder surgery. As an avid researcher he has also published multiple articles on shoulder injuries and shoulder surgery in the peer review journals of Arthroscopic Surgery and of Shoulder and Elbow Surgery. For more information, visit <a href="http://www.totalorthosportsmed.com" onclick="window.open(this.href, 'wwwtotalorthosportsmedcom', 'resizable=no,status=no,location=no,toolbar=no,menubar=no,fullscreen=no,scrollbars=no,dependent=no'); return false;">www.totalorthosportsmed.com</a>.</p>