Treatment of Squash Injuries
Squash is a racket sport played by two players in a four-walled court with a small, hollow rubber ball. The players alternate in hitting the ball onto the playable surfaces that includes the four walls. The objective of the sport is to hit the ball in a way that the other player is unable to return the shot. The game of squash uses a rally point system where the first player to reach 11 points wins, or if it is a tied game at ten, then a player must win by two points.
To be conditioned for the sport, a player should have good lower body and arm/shoulder strength. The movements are fast and a player must sprint, jump, pivot and lunge from side to side due to lots of quick and explosive multidirectional movements. At the same time, the player must execute small or big racket swings and add speed to each shot they quickly bend their wrist while hitting the ball. All these movements combined are challenging the body’s centre and the deep core muscles of the trunk need to be strong to be able to move and place the joints of the upper and lower body efficiently.
What are Common Squash Injuries?
Golfers Elbow (medial epicondylitis)
Golfers elbow is a type of tendinitis that affects the inside of the elbow and forearm. The muscles in the front of the forearm tendons connect to the inside of the elbow and are responsible for wrist flexion. Some symptoms include: discomfort/pain on the inside of the elbow, inflammation on the inside of the elbow, hand and wrist weakness, difficulty moving the elbow. Everyday activities such as picking up items, shaking hands, or grasping to open a door can be painful.
Tennis Elbow (lateral epicondylitis)
Tennis elbow is a type of tendinitis that affects the outside of the elbow and back of the forearm. The forearm muscles responsible for wrist extension have become overused and inflamed. Some symptoms include: swelling, pain extending from the outside of the elbow down to the forearm and wrist, weak grip, pain when lifting something, using tools, or twisting motions such as opening jars.
Jumper’s Knee (Patellar tendinitis)
Jumper’s knee is a common injury or inflammation of the tendon that connects your knee cap (patella) to your shin bone (tibia). Common injury that is frequently seen amongst athletes in sports such as volleyball, basketball, running and racket sports. Symptoms include pain, tenderness and inflammation at the base of the knee cap. Actions such as kneeling, squatting or lunges can be painful.
Achilles tendonitis is a common squash injury. The calf muscles are in high demand with the lower body movements in squash. They must be strong and powerful to have explosive force transferred through them without tearing. If you are developing pain in the bottom of your calf or heel then this is something you will need to be assessed for. It is important to get treated early so it heals quickly and does not lead to a long term injury or ruptured tendon.
Muscle strains is another common squash injury. The quick movements, changes in directions, improper warm ups, or weak muscles can lead to a muscle being pulled during the activity. Commonly seen in the hips, calves, shoulders, wrist and elbow.
Ankle sprains occur due to the rapid stop and change in directions and jumping in squash. Players can roll their ankle which can result in a sprain to the ligaments.
Acrominalclavicular Joint Sprains and Dislocation (i.e. Separated Shoulder)
Acrominalclavicular joint sprains and dislocation (i.e. separated shoulder) is characterized by discomfort at the tip of the shoulder. The ligaments that attach from your shoulder to your collarbone are injured with a direct impact. This can occur when the player either dives or collides with the wall for a shot.
Low Back Injuries
The sport is physically demanding with lots of powerful spinal twists and bends. A player could sprain or injure their lower back easily due to these repeated movement patterns. Especially if there is an underlying injury or deconditioning of the back and core muscles.
How can a Physiotherapist, Chiropractor or Massage Therapist help you recover from a Squash Injury?
A health care professional can help with preventing injuries or treating them once sustained from playing squash. Your practitioner will begin with a thorough assessment to understand why you came in, the demands of your sport and your lifestyle. Your practitioner will look at the mechanics of your movement patterns, the range of motion of your joints, your muscle strength and any soft tissue adhesions. They will treat your injury with hands on manual therapy, soft tissue release and prescribed rehabilitation exercises. They may also incorporate modalities such as acupuncture, dry needling or machines to aid in healing. They will help you recover as quickly as possible and guide you to prevent injury in the future.
How to Warm-Up for Squash to Prevent Injury?
In squash, because of the use of your legs, shoulders/arms and core, a good warm-up would be to start with some light running and walking lunges. This warm-up will get increased blood flow to your muscles that will be in use during activity. You will want to incorporate some spinal twists, especially in the bottom of a lunge to mimic the commonly-used position during sport. Then, performing wrist rotations, hip swings, shoulder rotations, easy racket swings in the air and eventually leading to light rallies of hitting the wall before you begin the match. Other movement warm ups would be to get the player to practice the movements/footwork used in squash such as lunging in all directions, back, front and side shuffling.
What Exercises Can I do to Prevent Injuries while playing Squash?
Lower Body Exercises
- Squats, lunges (forward, side, reverse), lateral band walks, glute bridges (double or single leg), calf raises
Upper Body Exercises
- Back exercises – rows (single or double arm), face pulls, band pull aparts, Y’s and T’s
- Rotator cuff – external and internal rotation, front and lateral raises with a light dumbbell or resistance bands
- Wrist curls into extension and flexion with a dumbbell
If you enjoy playing squash and want to remain injury-free, it is important that you be proactive and prevent injury in the first place. This can be done with a regular strength training routine and a proper warm-up and cool-down (stretches) that target key areas used.
If you are injured while playing squash do not continue to play and address any pain lasting longer than 2-3 days. Contact us today to see one of our experienced physiotherapists, chiropractors or Registered Massage Therapists.
- Donohue, M., Morrison, W. September 17, 2018. Tennis Elbow. San Francisco, CA. Healthline.
- Hecht, M., Morrison, W. September 3, 2018. What Is Patellar Tendonitis (Jumper’s Knee)?. Sanfrancisco, CA. Healthline.
- N.D. Squash Injuries. Australia. Physio Works.
- November 7, 2020. Squash (sport). Wikipedia.
Ben Wong, Registered Massage Therapist
Ben Wong is a registered massage therapist practicing at Rebalance Sports Medicine in downtown Toronto.