Returning to squash post COVID-19 lockdown – Achilles Tendon Injury Prevention

With the lockdown rules gradually easing, hopefully we are not too far away from being able to play in-door sports like squash again.

Squash is a unique sport that requires multiple dynamic movements such as:

• lunging to retrieve low bouncing balls,
• pushing off rapidly
• changing direction mid flow
• short sharp sprints.

Therefore, your Achilles tendon is put under a lot of strain. Whether you’re a Brackley Squash Club team player, compete in the club’s leagues and ladders, or play socially at the weekends, Achilles tendon problems are one of the most common injuries that can arise in any squash player.

You are even more susceptible to injury when returning to squash having not been on court for many months.

The Achilles tendon is the longest and strongest tendon in the body. It attaches your calf muscle to your heel bone and helps you push your foot off the ground during walking or running.

Essentially there are two main Achilles injuries:

• Achilles tendinopathy
• Achilles ruptures.

Achilles tendinopathy

This is a soft tissue injury due to overuse. Repetitive small tears occur in your Achilles tendon that you might not recognise whilst playing. These small tears do not completely heal after each injury.

You gradually develop pain, stiffness and swelling of your Achilles tendon. Your symptoms are usually most noticeable when you wake up first thing in the morning and can even prevent you from participating in any exercise.

Achilles ruptures

An Achilles tendon rupture is a more sudden and severe injury. The tendon ‘snaps’ and it feels like you have been kicked in the back of the heel by someone. You will experience severe pain and will have difficulty walking. If you suspect you have ruptured your Achilles tendon on court, you must immediately seek medical attention. Preventing an Achilles tendon injury is much easier than managing it.

Here are FIVE Top Tips to help reduce your chance of sustaining an Achilles tendon injury:

1. A good stretching program
   This is the best way to prevent an Achilles tendon injury. Having a tight Achilles tendon is very common. Thorough stretching before and after exercise will help re-lengthen your Achilles tendon, and more importantly, reduce the risk of sustaining an injury.

2. Gradually increase your playing intensity
   When you first get back on court, warm-up with your squash partner longer than usual. Consider focusing on basic drills or playing friendly knock-ups before strenuous competitive matches. Increase your intensity levels as you feel stronger and more aerobically fit.

3. Wear the correct shoes
   A good pair of squash or tennis shoes have a supportive sole to stabilise your foot and provide cushioning on the hard-court floor.

4. Strengthen your calf muscles
   You calf muscles might be weaker than usual if you haven’t been able to participate in other sports. Some simple ways to strengthen your leg muscles include:

1. lunges,
2. calf raises
3. squats.

5. Seek medical help early on and avoid high impact sports
   This is the one that not everyone wants to here, however, if you have ANY Achilles tendon symptoms it is better to be cautious and avoid having an Achilles tendon rupture. Avoid high impact sports until you have spoken to a professional.

There is no perfect preventative measure to avoid an Achilles tendon injury, but I hope these tips will help fellow members of the club safely to return to playing squash post lockdown.

Joel Humphrey

Joel is a member of Brackley Squash Club and is an experienced Consultant Orthopaedic Surgeon with specialist expertise in the foot and ankle.

At Mercury Foot & Ankle Clinic, we help many people who have had injuries either while playing sport or simply during social activities. We are also one of the few clinics that only specialise in injuries to the foot and ankle.