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Why Badminton Injuries Happen


January 9, 2015 // In Fitness // By tjfit




In case you haven't noticed, badminton has made a comeback in a major way. Once just another amenity being offered at sports clubs and country clubs, badminton is now being played in multiple courts (in some places as many as twelve courts) in converted warehouses in the most unlikely places.

 

Take a drive from the South Super Highway to C-5, and you will see banners proclaiming the opening of the latest badminton centers. The cutest name I have seen so far is "Shuttle's Best". Badminton centers are also cropping up in Cebu and Davao.

 

No one really knows exactly why badminton has taken off with such fervor here in the Philippines in the last two years. Some people credit Lotlot de Leon for starting the craze because she lost a considerable amount of weight a while back playing badminton. Whatever the reason, people who had previously no interest in working out are now driving up sales for badminton racquets, shoes, and other accessories.

 

I think this is great because it's not easy to get people off their seats and into an active lifestyle. So whatever gets them to get moving is a good thing.

 

Unfortunately, there is a not-so-good-side to this badminton frenzy. And that is the rise in badminton-related injuries. One reason for the increase in injuries is simply statistical. Badminton is not a super-dangerous sport but when you have ten times more people playing badminton compared to a few years ago, naturally the number of injuries will also increase because of the sheer number of people playing.

 

But the major reason for the increase in injuries according to sports medicine and orthopedic surgeon George Canlas of St. Luke's Hospital, is that the people flocking to play badminton are mostly unfit people who haven't exercised in years.

 

No one quite remembers who first said this but it is now considered a truism in exercise science: "You don't play a sport to get fit; you get fit to play a sport".

 

What this means is that all sports require some level of fitness to be able to play relatively well without injuring yourself. If you have gathered moss for the last ten years and you suddenly play badminton five to six times a week, don't be surprised if you get hurt.

 

This exercise axiom also means that if your only form of physical activity is playing the sport, the muscles that are primarily used when you play become much stronger than the muscles that are not used as much and this creates an imbalance that can lead to an injury later on when the "weakest link" gives way. This is why serious athletes still continue to lift weights and do stretching exercises as a "foundation" upon which to be able to play their sport at the top of their game both in terms of performance and lowering the risk of injury.

 

Canlas says that the four most common injuries he sees among badminton players are "tennis" elbow, knee problems, wrist and Achilles tendonitis. He says has already had to do surgery on four badminton aficionados with a ruptured Achilles tendon. In case you don't know where the Achilles tendon is located, it's that thick "cord" at the lower part of your calf near your heel.

 

Canlas claims these injuries are due to a lack of strength and flexibility, poor warming-up techniques, the wrong shoes or racquet, and playing too many games on consecutive days.

 

A "tennis elbow" doesn't just happen to tennis players. It can happen to anyone who grips a racquet too tightly and has weak forearm muscles. It can also occur in rock climbers, golfers, and baseball players. I once had a client who got it from blow-drying her hair everyday. Canlas says racquets that are too light and are too tightly strung are contributing factors for an inflamed elbow.

 

Badminton is what is called a "cutting" sport or a sport that requires stop-and-go rapid changes in direction. This can be challenging for strong athletic knees, but it can be deadly for middle-aged out-of-shape knees.

 

It doesn't help either if you don't wear the correct shoes. In badminton, you need to be able to lunge and pivot quickly in all directions so you need a shoe that allows you to "slide" on the court. If you want to visit the emergency room for an ankle or knee injury, wear running or basketball shoes while playing badminton.

 

However, Canlas says that competition level badminton shoes may not be the answer because they don't have enough arch support and they allow too much of a sliding motion for beginner players.

 

This is confirmed by a Danish study on badminton injuries by Uffe Jorgenson of the University of Copenhagen. Jorgenson writes, "Most shoes have a flat heel, low shock absorption and give no support to the foot." He recommends a shoe that has less friction between the sole and the playing surface but that has "a higher heel, has shock absorption, and a stiffer, anatomically fitting heel counter". Unless you can find a brand of badminton shoes that has these features, a tennis shoe is probably your best bet.

 

Sports injuries are divided into acute or traumatic injuries and chronic or overuse injuries. Acute injuries happen suddenly and accidentally and there is an easily identified reason. For example, you sprain your ankle because you trip over your shoelaces or your doubles partner smacks you in the face with his racquet.

 

Chronic injuries are those that take a while to develop and sort of creep up on you. For example, your knees start to ache because of all the lunging movements that are a necessary evil in badminton. Instead of correcting your lunging technique, strengthening the muscles around your knee, and checking with an orthopedic doctor if you have abnormal knee alignment, you ignore the aching feeling. After a while, your knees start hurting when you climb the stairs or you sit too long in one position. Eventually, you can't play badminton anymore because your knees are just too painful.

 

Badminton is a popular sport in England and its former colonies as well as the Scandinavian region so most of the research on badminton injuries comes from these countries. According to the studies, the most dangerous traumatic injury that can occur in badminton is an injury to the eye. While eye injuries are not as common as ankle or knee problems, they are nevertheless worth mentioning because of the potential damage to the eyesight.

 

A Malaysian study called badminton the sport that presented the "greatest ocular hazard" in that country. A Canadian study published in the Physician and Sports Medicine Journal found that badminton accounted for 30% to 58% of all racquet sport eye injuries in Canada during a ten-year period.

 

Seventy percent of all badminton-related eye injuries happen during a doubles game. The person most at risk is the one near the net who either gets hit straight in the eyes by the opponent's shuttlecock or gets hit by the racquet or shuttlecock of his or her partner. A study in the British Journal of Opthalmology suggested that the "forward player should hold the racquet in front of the face while awaiting the return stroke, particularly if a high lob has been delivered when a smash return is probable". Another study says to avoid looking behind at your partner.

 

The studies also noted that children playing badminton in school tend to have more accidents involving getting hit in the face with a racquet or shuttlecock. According to the Canadian Journal of Opthalmology, of all the sports-related eye injuries among children, badminton was the highest single cause. The study called for "mandatory eye protection in badminton" and that this should apply to schools as well as sports clubs.

 

All the research scientists recommended the use of certified polycarbonate plastic glasses while playing to protect against eye injuries. It used to be believed that only beginner players were prone to injury because they don't keep their eye on the shuttlecock at all times but research shows that very experienced players can get injured as well.

 

Several studies pointed out that while there are more eye injuries in squash, the injuries from badminton tend to be more severe. This is because, according to the Clinical Opthalmology textbook, "the 25- to 28-mm diameter shuttlecock head fits nicely into the orbit" of the eye.

 

The shuttlecock may not look like a deadly weapon compared to a squash or tennis ball but it has been clocked at top speeds of 130 to 134 miles per hour. The fact that a shuttlecock looks like it couldn't kill a fly is a big reason why there is a lack of awareness among badminton players about the potential for eye injury.

 

Ankles 


The two most common injuries to the ankle in badminton are ankle sprains and Achilles tendonitis or ruptures.

 

Ankle sprains happen when the foot turns inward due to wrong foot placement in a side-to-side motion. Athletic training experts recommend that athletes dorsiflex (pull the toes upward) their ankles and land with the whole foot (rolling from inside to out) when making wide movements to the side. Small quick side-to-side movements are done on the balls of the feet, but if the same technique is used for larger sideway movements, the chances of an ankle sprain are increased.

 

Ankle-strengthening exercises are a must. A study on elite Scottish badminton players also indicated that ankle braces may help minimize the incidence of ankle sprains by restricting foot inversion.

 

If you are experiencing pain in the heel, back of the ankle or calves, go see a sports medicine doctor because pain in these areas can be an indication that your Achilles tendon is weak or overworked, which can lead to a rupture.

 

According to Dr. Christopher Nanninni of the American Academy of Emergency Medicine, ruptures most commonly occur in middle-aged "weekend warriors" who play recreational sports that require bursts of jumping, pivoting and running like tennis, basketball and badminton, because "the Achilles tendon can grow weak and thin with age and lack of use."

 

George Canlas, sports medicine doctor of St. Luke's Hospital, told me that his four patients who needed surgical repair for a ruptured Achilles tendon due to badminton were middle-aged.

 

Nanninni further explains that ruptures happen most often "when a player makes a forceful push-off with his foot with the knee straightened (like when jumping) or when he suddenly trips or stumbles, and the foot is thrust in front to break the fall, causing the tendon to forcefully overstretch."

 

It can also happen upon landing from a jump. A Swedish study found that the majority of ruptures happen at the middle or end of the game.

 

Nanninni's advice to prevent Achilles tendonitis and rupture is to stretch the calf muscles daily and always warm up before a game. He also recommends that you "maintain a continuous level of activity in your sport or work up gradually to full participation if you have been out of the sport for a period of time."

 

A study on elite Swedish badminton players also recommended eccentric strength training of the calf muscle to help prevent Achilles tendonitis and ruptures.

 

When you lift up on your toes, your calf muscles shorten and contract concentrically. When you lower down, your calf muscles lengthen under the load and contract eccentrically. Eccentric training of the calf focuses on the lowering part of a calf exercise. By training the calf eccentrically, the calf and Achilles tendon will be better conditioned to take the rigors of the game.

 

Coaching manager Andrew Martin of the Badminton Association of England writes with regard to stopping, "In the rear court, the back 'brake' foot should be placed at almost right angles to the direction of travel to enhance push off from the floor and decrease the chance of injury to the calf muscle and Achilles tendon. The foot should be placed flat on to the floor; the knee should be placed directly over it and in line with the foot. If this braking action is done well, it can be pushed off from strongly to start recovery back to a suitable position."

 

The term "ACL" doesn't ring a bell for many people, but if you are a professional, amateur, or recreational athlete, you are probably quite familiar with it.

 

ACL stands for "anterior cruciate ligament," which is the main stabilizer of the knee. A torn ACL is one of the most common athletic injuries. It usually happens in basketball, soccer, snow skiing, tennis and, yes, badminton.

 

A 1997 study in the scientific journal Orthopedics said that most non-contact ACL injuries were mainly due to "planting and cutting," straight knee landing, and landing with a hyperextended knee.

 

"Planting and cutting" refers to when an athlete plants the foot facing one direction and rotates or cuts to the opposite side, leaving the foot still facing the original direction. In other words, the foot and knee end up going in opposite directions. Something has to give, and that "something" is the ACL.

 

As more women are joining sports that were formerly dominated by men, ACL injuries in females have been increasing. The study mentioned above lists several theories why women tend to have more ACL injuries than men.

 

Women are in poor physical condition when they are introduced to sports, women tend to land from a jump with relatively straight knees rather than in a bent knee position, women's ligaments may be affected by a rise in estrogen during the menstrual cycle, women have weak thigh muscles, and women have wider hips (making the thighbone connect to the shinbone at a greater angle than that of a man). This anatomical quirk, coupled with weak thigh muscles, pulls the kneecap sideways out of alignment.

 

Another anatomical oddity that may predispose women to an ACL injury is a small ligament size. A study found that 80 percent of women have smaller than normal ACLs and so do 20 percent of men. These people, male or female, are the ones who usually end up with knee surgery.

 

There is still much research and discussion going on about the best way to prevent ACL injuries, but so far, two things stand out. The first is to strengthen and stretch the muscles that surround the knee. The second is to teach athletes, especially females, to assume an "athletic ready" stance at all times (a lowered bent knee position) and to land properly with a bent or flexed knee.

 

The US Naval Academy as well as European and American sports teams have been able to dramatically reduce ACL injuries in their female players by making them undergo strengthening programs and by teaching them how to land properly with bent knees.

 

Lunges in different directions should be emphasized in the strengthening program because these are movements that mimic what happens during the game. A word of caution though: Doing these exercises wrong will actually cause injury. So make sure you know what you are doing, or get a fitness or badminton trainer who does.

 

Strong trunk muscles (abdominals and lower back) are necessary to act as a stabilizing and balancing force when a badminton player makes sudden starts, stops and changes in direction. When these muscles are weak, performance is affected and the risk of a lower back injury is increased.

 

Tight lower back muscles and tight hamstrings (back of the thigh) are also contributors to lower back pain because they pull the pelvis and consequently the spine out of proper alignment.

 

Strengthen and stretch the abdominals and lower back with core stabilizing exercises (Pilates exercises are a good example). Improve the flexibility of your hamstrings if they are very tight.

 

Shoulders 


All sports where you have to constantly bring your arm overhead can cause overuse injuries in the rotator cuff, and badminton is no exception. The rotator cuff is composed of four small muscles that go around your shoulder joint like a cuff. They rotate your shoulder inward and outward. These muscles can easily get irritated when they are weak and overused.

 

According to Jorgensen, overhead movements are the not only cause of rotator cuff injuries. Functional studies have revealed that there is much more shoulder rotation involved in the forehand and backhand stroke in badminton than was previously believed, "with the internal/external rotation of the shoulder as the greatest force-producing movement."

 

Strengthening and stretching the rotator cuff should be part of the fitness regimen of all racquet sports players. Rotator cuff exercises can be done using dumbbells, rubber bands and special strength machines.

 

Elbows and wrists 


According to Canlas, lightweight racquets that are tightly strung and absorb a greater impact from the ball may not be very appropriate for beginners who don't have the forearm strength to absorb the impact. Their elbows end up taking a beating, and they can develop an inflammation of the tendon on the outside of the elbow or what is generically called a "tennis elbow."

 

A small grip can also lead to a tennis elbow because the muscles that attach to the elbow have to work harder. The Act Badminton Association of Australia says, "Grip is crucial. Small grips are best for small hands and large grips for large hands. Most handles are between three-and-a-half and three-and-five-eighths inches in circumference.

 

Many players build up their grip size by adding extra wrap-around toweling grips. Why? Because racquet-head speed is generated by using short, fast strokes, and a larger grip gives more effective transfer of power from arm to racquet. It can also mean less strain and injuries to the forearm, elbow, upper arm and shoulder."

 

Don't disregard a tennis elbow. It won't kill you, but the condition is notoriously hard to get rid of and it can affect your daily activities.

 

The wrists play a major role in playing badminton since they determine where the ball will go. If your wrists are not used to anything more strenuous than computer keyboard typing, you may experience a sprained or overused wrist somewhere along the way in your fledgling badminton career.

 

Wrists and forearms can be strengthened with light dumbbells by doing exercises like reverse bicep curls, hammer curls, wrist curls, reverse wrist curls, ball squeezing, etc. The use of elbow bands can also help, because they reduce the amount of impact transmitted to the elbow.




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