Exercise and Injury

The Shoulder
The Shoulder
Does exercising and stretching help prevent injuries? According to a doctor friend of mine, the answer is NO.

I was hitting singles and talking about injured friends with Naples pro Spike Gonzales; and he observed that I would likely not get injured because I work so hard on being in shape.

Preventive or Psychological?

I try to do 20 minutes of stretching/yoga every day + do light weight training about three times a week. My belief is that you can…

• Strengthen the muscles around the joints (like the rotator cuff) and prevent injury,

• Do stomach/core exercises and help your back muscles be secure,

• And do stretching to keep the muscles and tendons as loose as possible.

But when I asked the opinion of a tennis-playing doctor friend, he said, “No. Injuries are purely genetics. If you are going to pop your Achilles, you are going to pop your Achilles.”

I would hate to think that all I do is for nothing.

What do you think? (Doctor friend, feel free to respond)

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15 thoughts on “Exercise and Injury

  1. If you feel the need to stretch, it should be done after a short warm-up. If the muscles are stretched when they are cold, they are more susceptible to injury.
    Most athletes whom I know, who stretch prior to a warm-up period, have had a greater number of muscle injuries than those who either do not stretch at all or who warm-up first.
    Most muscular or tendon injuries occur because of uses for which the muscles were not intended. Rapid lateral movements are the worst offenders. Human’s muscles evolved to help us avoid predators, by running in a forward direction, as quickly as possible.

    well, Dr. Fenster,,, you have created a hot topic. Pls see comments. thanks! george

  2. George,
    I couldn’t disagree with your Dr friend more. If I walked out to a court and just started hitting hard I would hurt myself by the 3rd ball. So many of us start of slow when hitting the ball and pick up the pace as we go. If we can agree on that then we can agree the body needs some warm up.

    I started playing again after being off for 25 yrs. About the 3rd time out pulled a leg muscle and spent 6 weeks going to rehab and recovering. Started playing again and pulled a muscle in my chest. My wife started telling me I was almost 60 and just couldn’t play like I used to. While she was certainly right in that (when I run I feel like I am waist deep in water) I have no idea how to play and not run after a ball or just push the ball in with my serve. So I was stuck with making a change.

    I started doing half an hour of stretching every time before I played. Yes a full half hour. After a year and tons of asking and reading questions I know have a half hour routine I do every morning. In the last 5 yrs I have become a very competitive 4.5 with very few injuries.

    Have you seen the pros before they go into a match. They are jumping stretching etc. Sure we don’t play like them, but if we are trying to imitate them on the court it might not hurt to imitate them off the court a bit to.

    Randy – i couldn’t agree with you more! i stretch for 20 minutes before playing. george

  3. I do not agree with your Doctor friend. It only stands to reason that a muscle or a ligament that has been stretched (Achilles, Back, Hamstrings, knee joints and associated tendons, etc. is far less likely to be injured than those tendons and muscles which are not used or exercised and remain taut and tight and are not ready to receive a jolt or serious blow from a quick movement in a tennis match, football game, basketball game or whatever. It is much easier to tear muscle fibers when the muscle is taut and tight. I would say that we should all continue to stretch and exercise before playing.
    One ex. is stretching a tight hamstring. It hurts like hell compared to one that is normal

    Dick – the “doctor” is our mutual friend Michael Fenster. see above. george

  4. I hate to say I agree with the doctor, but I think in many cases I do. It is interesting how we do the exercises, stretching and eating to keep us in shape, or to strengthen a particular “part” and still there is an injury. We just get worn out with over use and certainly some are more susceptible to injury. I liken this to cancer….either you have it or you don’t. Doesn’t matter what you do, you have it or don’t. But, like other parts, your past activities can be a stimulator for increasing the risk of injury….or cancer….like smoking. And the “but” is, we like our exercise and what tennis does for our minds and souls. So, we” keep on keepin on”.

    Howie – one for the other side. What you say is exactly the doctor’s belief. thanks. george

  5. I’ve heard that stretching AFTER tennis/strenuous activity is at least as important as stretching before.

    As we age, we lose strength and flexibility (‘10% loss of muscle every decade after age 50’)- but we can offset this with strengtheners and stretching – as has been proven in studies of elderly men lifting weights.

    A couple of years ago I saw a spinal specialist due to a bulging low back disc pressing on the nerve root. Happily I recovered but this well-regarded NE Baptist MD has worked with Boston Celtics. Bruins, etc in aiding them with PT, recovery, etc. and gave me sets of strength and flexibility exercises with emphasis on core strengthening. I believe this was not just for recovery but also to aid as a preventative.

    Dag – while i do stretch before playing, i too have heard that it is better after. But our professional trainer at Newk’s says, “You must get your big muscles ready to play.” thanks, george

  6. I’m sorry, I usually only talk trash on the court with friends, so won’t scream BS here.
    But want to say I VEHEMENTLY disagree with this is an understatement!
    “No. Injuries are purely genetics. If you are going to pop your Achilles, you are going to pop your Achilles.” AND “Human’s muscles evolved to help us avoid predators, by running in a forward direction, as quickly as possible.” ”

    I have much respect for our medical community and representatives, but I get so sad and disillusioned when they talk in absolutes.
    Our collective understanding of “things” is always evolving.
    As an example have you ever heard of Dr. Ignaz Semmelweis?
    In the early 1800’s this physician discovered that washing hands would eliminate germs and thus prevent “child bed fever” and death. “Despite various publications of results where hand washing reduced mortality to below 1%, Semmelweis’s observations conflicted with the established scientific and medical opinions of the time and his ideas were rejected by the medical community. Some doctors were offended at the suggestion that they should wash their hands and Semmelweis could offer no acceptable scientific explanation for his findings. Semmelweis’s practice earned widespread acceptance only years after his death, when Louis Pasteur confirmed the germ theory and Joseph Lister, acting on the French microbiologist’s research, practiced and operated, using hygienic methods, with great success. In 1865, Semmelweis was committed to an asylum, where he died at age 47 after being beaten by the guards, only 14 days after he was committed.”

    The latest research and studies are clearly demonstrating that it’s NOT all about genetics. We are learning more every day that genes are actually free to express themselves in may different ways. Lifestyle , attitude and choices have much to do with the ability of genes to express themselves. So the lesson… don’t live like your parents did if they struggle with medical issues.

    Are you telling me that appropriate exercise does nothing? What about the confirmed research about telomeres? What about Exercise and adequate protein intake? They are the ONLY two entities in double blind studies that have the proven ability to delay sarcopenia (loss of lean muscle tissue due to aging) . what about exercise and our mitochondria?? Mitochondrial biogenesis replicates mitochondria within a cell, in order to increase ATP production in response to an increased demand for energy. So more mitochondria more ATP. Dr Fenster you’re saying these things don’t matter?

    And in regards to “muscles evolved to help us avoid predators, by running in a forward direction, as quickly as possible.”, what about jumping, climbing, crawling, ducking, swimming, zig zagging, etc etc.

    This is not an attack on Dr. Fenster, I am competing with him in “long replies” 🙂 but simply an attempt to not get caught up in absolute statements like this. Exercise is perhaps the wrong word in all of this ….regular vigorous MOVEMENT is CRITICAL to our well being…especially as we age and especially if we want to enjoy old age more…

    Sorry for the rant 🙂

    Marc. Some really great stuff! Tks. George

  7. Anyone who claims that being stronger does not prevent injuries is not an athlete. At 81 I do weight work 3 times a week and I am very seldom hurt. I have friends that are my age and younger who do not do strengthening work and they continue to hurt themselves when they play. I am not so sure that stretching prevents injury.

    Jack. You are one of my top role models! Thanks. George

  8. I quit pulling muscles when I quit stretching before playing. Purely anecdotal. Probably related to my poor stretching technique. Hustling seems to come naturally to me, and I just can’t stand to see a ball bounce twice, even in warm-up. I’m constantly warned about going for too much too soon, but that hasn’t seemed to be a problem.

    My injuries seem to line up nicely with over-use. Joints are my issue. Bad genes and too much play over the years equals lots of joint pains. Have found ways to work around most of it, but you can only get used to a certain level of pain, it seems. Sure glad they can replace many of our joints these days. Don’t see how stretching would help joints and their issues with their various types of cartilage and damage to same.

    Kevin. Another vote for the Doctor’s views! Thanks. George

  9. Well, George, you probably guessed that I HAD to weigh in on this topic! Instead of using testimonial evidence lets use actual research evidence. (1) The research repeatedly has shown that “stretching” prior to exercise or sport activity does not prevent injuries and may actually be harmful because as was stated above “a cold muscle/tendon is susceptible to injury.” The research shows you need to do dynamic or movement type warm-up exercises to properly prepare your muscular-skeletal system for activities. This would include butt kicks, high knees, leg swings, arm circles, lunges, light jogging, shuffles, karaoke, and a myriad of over dynamic exercises. (2) Although some injuries are not preventable, many, many are. This is where generics become involved. There is not one program that fits all. The secret is to find your weaknesses that place you at risk for injury. This could include flexibility, strength, aerobic endurance, anaerobic power, and most importantly skill. In most cases, we as tennis players are weak in our glutes and core and are very tight in our hips. Look at the Legends – how many have had hip replacements – almost ALL! (3) Masters/senior players especially SHOULD and NEED to do supplemental exercises if they want to reduce the risk of injury and prolong their playing life. This should include good warm-up, post-activity stretching/foam roller, strength training, core exercises, proper nutrition/hydration, and adequate REST!
    Bottom line – get to know yourself – we do it on the court when trying to improve our game. Why not learn your weaknesses that places you at risk and work on improving them. If you look at elite athletes that are still performing at a high level into their senior years because they really never get out of shape, which lessens your chances of chronic deliberating injuries. There is no magic formula or one program for all but if you really analyze yourself, seek professional healthcare advice, and take care of the body given you, it usually will result in a long and productive life, both on and off the tennis court!

    George’s note: Larry is our trainer at Newks and was the trainer for the Cincinatti Reds baseball team.

  10. I have had a history of pulling calf and hamstring muscles my entire tennis life…..until December of this past year.
    I have been to many (yes, many) doctors…..the best of them admit that they don’t really know the relationship between stretching and injury, since there are no decent double-blind scientific studies on the subject. The others just pontificate.
    I have visited many trainers and rehab-degreed folks (every time I’m injured, I go right to rehab.) These specialists know that stretching helps, and they think they know why, but the fact is that they have no good scientific evidence to back their opinions either…….just common sense.
    I gave up statins on 11/30/14 because I have had leg pain for years, and it finally dawned on me, after talking to people (not doctors) that this might help.
    It may have (I have less pain), but what has really helped is 20-30 minutes of stretching before and after activity….every day. Along with the gym (mandatory at our ages), I’ve stayed healthy.
    The foremost expert that I have found on this subject is Aaron Mattes, who actually lives in Sarasota (coincidence, as I’m from there too). He’s great to see, but his books can be so technical that they’re difficult to understand. Two disciples of his have written the important and excellent book……”The Whartons’ Stretch Book….Active-isolated Stretching”. These two brothers work with college and pro teams to reduce injuries through an intelligent, different way to stretch….the Seahawks use this system.
    Another point that doctors say is that compression stockings, etc. don’t help at all, but they do keep the muscles warm, and isn’t that good all on its own?

  11. One more point….perhaps Dr. Fenster has not heard of active-isolated stretching, which is now very popular with college and pro teams. The stretch is only held for 1-2 seconds, and you flex the opposite muscle to the one you want to stretch.
    Dr. Fenster is correct, from what I’ve heard, that you can’t do a cold stretch for the usual 15-30 seconds…..with that method, you risk injury.

  12. George, I agree with Spike on working out. Most experts say stretch before and after tennis. Your body will tell you what works best for you. Keep an open mind on the subject.
    Anthony Rasile

  13. With regard to professional athletes warming up, jumping around and stretching – has anyone noticed the frequency of injuries in professional athletes? Many professional athletes also get massaged prior to playing, but it doesn’t eliminate the injuries.
    When forces are exerted on the muscles and joints, beyond what they were meant to endure, injuries may occur despite pre-game warm-ups and stretching. It is not genetics, but evolution of the human body that is the problem. Other animals can zig and zag and jump with impunity, but because of the structure of muscles and joints, the human body doesn’t fare as well.

  14. There are too many topics going now 🙂

    First, I didn’t address the stretching part, but I agree fully with Dr. Fenster and I have mentioned this to George also years ago. “Stretching ” cold muscles only causes “resistance” the very thing your trying to overcome.

    We are but human animals after all and no animal stretches before a sprint or movement. Now what they do do is engage their entire central nervous system prior to engaging in serious movement. Think of a tiger stalking….or a deer or rabbit tensing their entire body …. They are litterally putting their entire system under ” tension” .. This tension is what we should emulate in my humble and uneducated opinion. A few slow push-ups.. A slow controlled lunge … These wake your body up and more importantly your central nervous system.

    Of course professional athletes get injured… The toll on their bodies is just to much to bear for any human. Remember Bo Jackson anyone?

    But talking about performance and warming up and exercise… I can only think of many examples of people in their 70s 80s and even 90s in more traditional cultures that never “formerly ” exercised in their life. Their lifestyle as physically active people (farmers, fishermen etc) kept them un injured for most of their lives. The discussion we are having has so many layers. Do you really think you can stay uninjured as a business professional that spends 8-10 hours a day sitting down between work and commute and couch time at home for years on end? Playing 2-4 hours of tennis on the weekend and remaining un injured is a major challenge. There is no magic bullet except to keep moving each and every day.

    And our evolution is just fine, we are meant for all those things and more. It’s our industrialized life style that has made it more difficult to remain flexible, strong and adaptive. The American Indians were known for chasing down deer. Yes deer! Even at the ripe old age of 50 and 60. They used persistence hunts and outlasted the deer for hours on end and would sprint and zig and zag and litterally chase down a deer also. The Tarahumara Indians , famous long distance runners had many champions in their 40s and 50s. And. 60s

    Personal anecdote, I shattered my ankle almost 3 years ago. Tibia and fibula smashed … Yup did it on the tennis court… Dang hard courts and slippery worn out shoes .
    I believe that from exercise and eating right over the last 10 years , my body was strong enough to recover and I can honestly say , I didn’t loose a step from it. As a matter of fact im faster today. I focused on strength training and foods that would speed and enhance my healing. I don’t think we give our amazing bodies enough credit. With the right information we can pretty much do anything we set our mind to. I don’t like the absolutes…the “the human body doesn’t fare well” attitude I’m sorry.
    As I know I’m still a bit younger and perhaps full of bluster…. I urge you to take a read up on Mr. Don Wildman. At age 80 he simply blows me away.
    Our collective thinking needs to change a bit I believe… There is a huge surge in interest and research and In the years to come we will see many example of what’s possible at ages we now
    think are “too old” to compete. Staying injury free for non professional athletes is going to be the norm soon compared to what we think as normal today. George and jack and tom m and Matt d and others are all front runners of this change I believe. I could go on and on… But there are many things we can do for ourselves. And to say you get cancer or you don’t is not correct in my humble opinion. Our cells are in a constant state of flux and movement … How the cells express themselves are very much in our control. This is clear….but we must believe and take action to have that manifest.
    Again sorry for the rant… I kinda like this stuff 🙂

    Marc – More good stuff. I love the interest this topic has developed! thanks, george

  15. I think everybody is wrong. The secret to not getting injured on the tennis court is sex before playing. (Now George will say something about how brief my response is and wonder what the hell I am talking about.) 🙂

    Marty – maybe the “brevity” is related to your example! 🙂

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