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, a 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 of 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 in 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.
Eye/facial injuries, 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 with 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 the 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 re-injury 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!
Leg Pain Causes
Common Youth Leg Injuries
Pelvis & Hip
- Osgood Schlatter's Disease
- Sinding Larsen Johannson Disease
- Patellofemoral Pain Syndrome
- Patella Dislocation
- Meniscus Tear
- Discoid Meniscus
- Juvenile Osteochondritis Dissecans
Heel & Ankle
Arm Pain Causes
Arm pain and injuries are widespread. Arm pain can occur as a result of either sudden, traumatic or repetitive overuse. The causes can be related to sports injuries, work injuries or simply everyday arm use.
Causes of Arm Pain by Region
Causes of Arm Pain by Structure
Neck-Related Arm Pain
Shoulder-Related Arm Pain
- AC Joint Injury
- Biceps Tendinopathy
- Broken Shoulder - Fractured Humerus
- Bursitis Shoulder
- Dislocated Shoulder
- Frozen Shoulder
- Rotator Cuff Calcific Tendinopathy
- Rotator Cuff Syndrome
- Rotator Cuff Tear
- Shoulder Arthritis
- Shoulder Impingement
- Shoulder Tendonitis
- Swimmer's Shoulder
Elbow-Related Arm Pain
Wrist-Related Arm Pain
Hand-Related Arm Pain
Muscle-Related Arm Pain
- DOMS - Delayed Onset Muscle Soreness
- Muscle Strain (Muscle Pain)
- RSI - Repetitive Strain Injury
- Overuse Injuries
Other Sources of Arm Pain
Common Causes of Arm Pain
- Your rotator cuff or frozen shoulder most commonly causes shoulder pain.
- Elbow pain is most commonly caused by tennis elbow or golfers elbow.
- Wrist & hand pain can be related to carpal tunnel, wrist arthritis or even a thumb tendon condition known as de Quervain's tenosynovitis.
Referred Arm Pain
As mentioned earlier, arm pain can be referred to from another source. Cervical radiculopathy is a common source of referred arm pain. Cervical radiculopathy will not respond to treatment where you feel the arm pain. However, it will respond positively to treatment at the source of the injury (e.g. your neck joints).
Professional assessment from a health practitioner skilled in diagnosing both spinal-origin and local-origin (muscle and joint) injuries (e.g. your physiotherapist) is recommended to ensure an accurate diagnosis and prompt treatment directed at the arm pain source.
Arm Pain has Diverse Causes.
The causes of your arm pain can be extensive and varied. Due to this diversity, your arm pain should be assessed by a suitably qualified health practitioner to attain an accurate diagnosis, treatment plan and implementation specific to your arm pain.
What Arm Pain is Associated with a Heart Attack?
Left-arm pain can be an early sign of a life-threatening cardiac issue. Based on this, a professional medical assessment that involves an accurate history, symptom analysis, physical examination and diagnostic tests to exclude a potential heart attack is important to exclude this potentially life-threatening source of arm pain.
For more information, please consult with your health practitioner, call an ambulance on 000, or visit a hospital emergency department to put your mind at ease.
Good News. Most Arm Pain is NOT Life-Threatening.
Luckily, life-threatening arm pain is far less likely than a local musculoskeletal injury. Arm pain caused by a localised arm muscle, tendon or joint injury should be assessed and confirmed by your health practitioner before commencing treatment.
Arm Pain Prognosis
The good news is that arm pain, and injury will normally respond very favourably to medical or physiotherapy intervention when early professional assessment and treatment is sought. Please do not delay in consulting your healthcare practitioner if you experience arm pain.
Common Arm Pain Treatments
With accurate assessment and early treatment, most arm injuries respond extremely quickly to physiotherapy or medical care, allowing you to resume pain-free and normal activities of daily living quickly.
Please ask your physiotherapist for their professional treatment advice.