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Lateral Epicondylitis is often more commonly referred to as ‘Tennis Elbow’.  It occurs when there is inflammation of the tendons in the forearm located on the outer side of the elbow.
 
There are a few causes of tennis elbow, but regularly over-usage is a major contributory factor.  It occurs when the muscles and tendons in the forearm are strained due to repetitive or strenuous activity.  Banging or knocking the elbow can also cause it; but I believe that in regards to badminton, poor technique is potentially the main reason that it occurs, be it your hitting technique, holding the grip too tightly or often because of the grip being too thin.
 
Symptoms
 
The most common symptom is pain and tenderness.  Symptoms may not occur instantly and may develop gradually over time so it may be difficult to attribute the injury to a specific time or event.  The discomfort and pain can vary from mild to severe and can cause problems gripping, holding and shaking things.
 
Diagnosis
 
A doctor can usually diagnose tennis elbow by asking questions about your symptoms and by examining your arm.  You will typically experience pain when the doctor examines the outer part of your elbow.  The doctor may ask you to maneuver your wrist in a particular way, which will usually initiate your pain/discomfort.  Diagnosis is usually pretty simple; however if after a period of time your pain does not subside, your doctor may refer you to a specialist for an X-ray or an MRI scan. 
 
Treatment

• Apply ice or cold therapy to the elbow for 20 minutes up to 6 times a day; this will reduce the discomfort and inflammation.
• REST – This is probably the most important facet of the healing process
• Some find it beneficial to wear a brace or support to protect the tendons whilst healing and strengthening, particularly when returning to playing.  The brace should not be put on the painful area but rather approximately 10cm down the forearm.
• When returning to playing try increasing the size of your grip, which usually stops you from holding the grip too tightly and causing tension in the forearm.
• Take Paracetamol (painkillers) or ibuprofen (anti-inflammatory) tablets to help with the pain and swelling.  Caution must be taken when taking tablets as they can cause side effects, so they should only be used short term.
• Perform range of movement exercises to reduce stiffness and increase flexibility.
• Have physiotherapy to strengthen and stretch the muscles.
• Steroid injections can temporarily ease some of the swelling and pain around the joint
• Other therapies such as shock wave therapy and acupuncture may help to relieve the pain and help to promote movement.

Blisters are usually caused by friction and shearing forces (forces directed across the skin).  Ill-fitting footwear can also be a cause and as a result, causes the layers of the skin to separate and fill with clear fluid or blood.  Blisters can appear on both hands and feet from sustained rubbing, be it on socks, footwear or grip.

Blisters start as “hot spots”.  Initially, the skin becomes tender and appears red and irritated.  If the friction continues, the skin separates usually resulting in the area being filled with fluid.
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The correct treatment is dependent on whether the blister is intact or torn open – each need to be treated differently.  If the skin overlying the blister is still intact and not torn, allow this to remain in place for as long as possible as it acts as a protective layer.  Also removing the skin exposes the underlying skin making it more susceptible to possible infection and allows raw nerve endings to be exposed.

Treatment
If the blister is filled with fluid, the pressure of this fluid is what is causing the pain and discomfort.  Draining the fluid will instantaneously reduce the pain.

To do this correctly:

• Clean the area thoroughly with antiseptic.
  
• Sterilise a household needle by heating it.
• Gently apply pressure to one side of the blister causing the top skin to rise on one side.
• Create a small hole where the skin is raised to drain the fluid.
• Use a sterile gauze pad to gently push the fluid out of the blister until it has all been removed.
• Apply antibiotic ointment to prevent possible infection
• Cover the blister with a bandage or plaster
• recheck and change dressing daily until skin has completely healed.

Treatment for Semi-Open Blisters
If the blister has a small tear, it is advised that as much skin tissue is salvaged as possible to allow the underlying skin to mature.  Treatment for an semi-open blister is as follows:

• Clean thoroughly with antiseptic.
• Allow area to dry and apply antibiotic ointment to the open wound.
• Replace flap of skin (if possible) and cover with a sterile non-adhesive dressing.
• Recheck wound and change dressing daily until fully recovered.
• When the tenderness has gone trim away the dead skin.

 
Treatment for Open Blisters
If the open blister has completely torn:

• With sterile scissors, carefully remove any torn skin associated with the blister so it doesn’t tear into healthy skin.
• Clean with antiseptic.
• Apply antibiotic ointment
• Cover with a bandage or plaster.

 
How to Prevent Blisters From Forming
Sometimes this is easier said than done, but blisters form because of friction so you should try to keep friction to a minimum.  I have personally found that wearing two pairs of socks helps hugely as it reduces the amount of friction – also regularly changing my socks to avoid them getting wet with sweat.  I have heard of some people applying antiperspirant to the bottom of their feet to limit sweat.

Footwear that is too small or too big can also be the cause of blisters.  Shoes which are too big allow the foot to slide back and forth causing “hotspots” and shoes which are too small can rub.

There is not much that can be done with preventing blisters on the hand apart from applying powder to absorb the perspiration – this can also be applied to feet.



Next blog post in the series "Common Badminton Injuries" will be regarding Tennis Elbow.

Cramp is a common affliction in those performing to a high intensity and often affects muscles under constant duress – namely, the quadriceps, hamstrings, calves and sometimes in the arms. An occasional, minor cramp here and there is largely inevitable, but for the most part muscle cramps can be prevented with proper care and attention to your food and water intake.


Dehydrated muscles are very prone to cramping so it is important to ensure that you remain adequately hydrated whilst playing. During a match, an intake of water and fluids high in electrolytes should be consumed to replenish all that is being lost.  If you drink sufficient clear fluids throughout the day, your urine will be clear or a light yellow colour and you are less likely to suffer from cramping. The easiest method for determining whether or not you are dehydrated is by looking at the colour of your urine; as a general rule, the darker it is, the more dehydrated you are.


The contraction and hydration of your muscles is based on the delicate balance of electrolytes (including sodium, potassium, calcium and magnesium). When levels of these compounds are low, your muscles cannot carry an adequate charge and will produce either a weak contraction or a contraction that won't relax (i.e. a cramp). If you're suffering, try eating fresh bananas for potassium, nuts as a source of magnesium, live yogurt for calcium and a sprinkle of unrefined sea salt to top up your sodium levels.  I found it difficult to eat while I was competing so cramping was habitual for me; my Mixed Doubles partner (Sarah Bok) got so fed up with it that she used to bring me cramp tablets (another good supplement to avoid cramp) and demand I take them. HAHAHAHA – LOVE HER!


N.B. The thirst mechanism doesn’t kick in until you are actually dehydrated, so never wait until you feel thirsty; consume fluids before, during and after your game.  Avoid orange juice, caffeinated drinks and needless to say, alcohol as these naturally dehydrate you.

 

Amateur and some inexperienced athletes often overlook the significance of stretching.  It is not only an essential part of a warm-up but should be employed during your cool-down and applied when you’re relaxing.  Frequently, I see people come through the doors and run straight onto court without a fleeting thought of stretching or warming up; this is without a doubt a contributory factor as why so many injuries occur.


Stretching plays an important role in every sportsman’s/sportswomen’s training programme.When performed consistently, stretching exercises can help increase the range of motion of a joint (reducing the risk of muscle and tendon tears during competitive activity), relieve muscle tightness and stiffness, increase localised blood flow to the muscles being stretched and help to reduce the severity of DOMS (Delayed Onset Muscle Soreness).


Stretching is most beneficial when the body is warm and muscles are pliable. To get the most effect, hold each stretch until you feel a slight pulling in the muscle (but no pain). As you hold the stretch the muscle will relax, meaning you can gradually increase the stretch until you feel the same slight pull. Hold this position until you feel no further increase.


Stretching as part of your cool down is vital to muscle strength and integrity. However, your body can quickly adapt to a stretching routine (much like any exercise programme), making it important to vary your stretching exercises to ease muscle pain, soreness and stiffness.


Cooling down is important after intense physical exertion as it helps bring your heart rate down to a calmer state and relax the muscles from tension after activity. Your muscles will be warmed up after exercise, making them more elastic and pliable and meaning you will also see increased benefits in flexibility. If you try a mix of dynamic stretching you are likely to experience a decrease in next-day soreness in your hamstrings, quads and calves.