Article by Jess Clarey
What are the Common Injuries in Squash?
Squash is a high-speed racquet and ball game that requires the repetitive use of your spine, legs and especially your dominant arm. As a result of this whole body involvement, injuries can occur anywhere from the shoulder, elbow, and wrist, to the hip knee and ankle, as well as the spine. There is a risk of head and eye injuries from the ball or racquet and don’t forget how hard and unforgiving those walls can be when you crash into them!
Most squash injuries are a result of an acute injury and less so from overuse. However, the most common upper limb injury seen from squash is lateral epicondylalgia, which is an overuse injury. Lateral epicondylalgia is the medical term to describe tennis elbow. But, since you're playing squash I think we are within our rights to call it squash elbow!
Other common overuse injuries can affect the wrist and knee. De Quervain’s tenosynovitis is an issue that involves the tendons just below the thumb and causes pain in the wrist. In the knee, you can get overuse injuries to the tendons due to the high constant load and stress these can be placed under with running and change of direction sports. Patella tendinopathy is common.
There is a vast array of acute injuries that can occur and the following is by no means exhaustive:
Head and facial injuries, especially to the eyes are prevalent. Eye injuries can include anything from possible retinal detachment, scratched cornea (front surface of the eye), globe rupture to hyphema (collection of blood in the front of the eye). The shoulder, wrist, and elbow are common joints for strains.
Due to the fast and agile nature of squash, it is no wonder there is a higher prevalence of sprained ankles, calf muscle tears, back muscle strains, knee ligament sprains, knee meniscal tears and even Achilles tendon rupture.
What Causes Injuries in Squash?
Due to the variable nature of the sport, many different factors can influence the risk of injury.
Overuse injuries such as elbow lateral epicondylalgia and de Quervain’s tenosynovitis of the thumb are caused by repetitive movements arm movements especially at high-velocities as is required in squash.
The elbow injury is aggravated by the frequent use of the gripping muscles in the forearm, in particular, those that extend, or bend, the wrist backwards, as these attach to the outer part of your elbow. Backhand shots can cause greater inflammation to this area as they require a large force from the wrist extensors.
The wrist/thumb can be worsened with gripping and turning your wrist over and as a result, can affect your ability to perform wristy or powerful shots.
For eye/facial injuries, these usually occur when either a racquet or the balls collide with the eye or face. Some injuries can be quite severe and require immediate medical attention to prevent loss of vision. Safety eyewear is recommended.
Shoulder injuries, particularly acromioclavicular joint sprains (tip of the shoulder), can occur with impact by diving or collide with the wall. This can cause a disruption of the ligaments that attach your shoulder to your clavicle (collarbone). Similarly, falls/collisions with hard surfaces can cause injury to the wrist, hand, and elbow.
Lower limb injuries occur due to the rapid change of direction required for squash as a result of sprinting, pivoting, rapid change of direction, sudden stopping and jarring. This places your joints and muscles under high load and strain and unfortunately, when this becomes greater than your healing recovery rate, it results in injury.
If you sustain an injury playing squash please contact your PhysioWorks physiotherapy team for an accurate diagnosis and assistance with getting you back onto the court as quick as possible.
Risk Factors for Squash Injuries
Factors influencing the risk of squash injuries include:
- 40+ years of age
- Inexperience/poor technique
- Poor level of fitness, strength and endurance
- Prior injury; particularly if rehabilitated poorly
- Amount and level of participation
- Not wearing protective eyewear
- Equipment & footwear
- Fatigue and tissue overloading.
How Can Squash Injuries Be Prevented?
For certain injuries, such as eye injuries, it is as simple as wearing protective gear, ie glasses.
For soft tissue, bone or joint injuries, both acute and overuse, the best prevention is strength, coordination and balance work. For guidance specific to your body, please seek the advice of your physiotherapist. They will provide you tips specific to your needs.
It is important that you have an appropriate warm up and cool down routine. Having your muscles warmed up before putting them under high load decreases your risk of muscle strains. Performing a change of direction and landing exercises can also help to prevent lower limb joint injuries, as too can certain movements/exercises for the shoulder/arm. Recovering well with stretching and foam rolling decreases post activity muscle tightness/stiffness which can also be a predisposing factor to injury.
As mentioned earlier age and tissue overloading are both risk factors. This is particularly important when it comes to tendon injuries. Your physiotherapist can work through your tendon tissue loading levels and advise you regarding specific training hours, preparation and prevention exercise strategies depending upon your needs. Tendinopathy programs are designed to not only successfully rehabilitate you from injury but also to prevent tendon injury.
If you would like some ideas as to appropriate prehabilitation (injury prevention) exercises, please speak to your PhysioWorks physiotherapist who will be able to best tailor an exercise program specifically for you.
Return to Squash Post-Injury
In the event of injury, it is important you rehabilitate appropriately to minimise your risk of reinjury or a compensatory injury as you return to squash. Feel free to speak to your physiotherapist to ensure you have undertaken the appropriate management to get you back onto the court, performing at your best!
If you require more information or are interested in discussing an injury, please don’t hesitate to contact us at PhysioWorks.
For more information please contact your nearest PhysioWorks clinic to discuss your needs.
Common Squash Injuries
- AC Joint Injury
- Bursitis Shoulder
- Dislocated Shoulder
- Rotator Cuff Calcific Tendinitis
- Rotator Cuff Syndrome
- Rotator Cuff Tear
- Shoulder Impingement
- Shoulder Tendonitis
- Back Muscle Pain
- Bulging Disc
- Degenerative Disc Disease
- Facet Joint Pain
- Pinched Nerve
- Sacroiliac Joint Pain
Hip & Groin Injuries
- Adductor Tendinopathy
- Femoroacetabular Impingement (FAI)
- Gluteal Tendinopathy
- Greater Trochanteric Pain Syndrome
- Groin Strain
- Hip Arthritis (Osteoarthritis)
- Hip Labral Tear
- Osteitis Pubis
- Piriformis Syndrome
- Poor Hip Core
- Trochanteric Bursitis
- ACL Injury
- Bursitis Knee
- Chondromalacia Patella
- Fat Pad Syndrome
- ITB Syndrome
- Knee Arthritis
- Knee Ligament Injuries
- Lateral Collateral Ligament
- Medial Collateral Ligament Sprain
- Meniscus Tear
- Osgood Schlatter's
- Patella Tendonitis (Tendinopathy)
- Patellofemoral Pain Syndrome
- Plica Syndrome
- Posterolateral Corner Injury
- Sinding Larsen Johansson Syndrome
Calf and Leg Injuries
- Achilles Tendon Rupture
- Achilles Tendonitis / Tendinitis
- Calf Muscle Tear
- Shin Splints
- Stress Fracture
Anke & Foot Injuries
- Anterior Ankle Impingement
- Heel Spur
- High Ankle Sprain
- Morton's Neuroma
- Peroneal Tendonitis
- Pes Anserinus Bursitis & Tendinitis
- Pes Planus - Flat Feet
- Plantar Fasciitis
- Posterior Ankle Impingement
- Retrocalcaneal Bursitis
- Severs Disease
- Sprained Ankle
- Stress Fracture Feet
- Tibialis Posterior Tendinopathy
Muscle & Overuse Injuries
Common Squash Injury Treatment
FAQs Squash Injuries
Racquetball and Squash, Injuries in. (2011). Ashlee Warren & Stephen M. Simons. Encyclopedia of Sports Medicine. DOI: http://dx.doi.org.ezproxy.library.uq.edu.au/10.4135/9781412961165.n418
- Squash Fact Sheet- SMA. (2008). http://sma.org.au/resources-advice/sports-fact-sheets/squash/
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Last updated 21-Oct-2017 11:01 AM
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