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Saturday, July 08, 2017

Tennis bum, tennis elbow and the couch potato




Tennis Bum is not so much a medical condition as a mental state of mind when the tennis season is on. Millions of couch potatoes sit glued to the box with little or no movement thereafter. A numb bum is usually the result caused by watching too much tennis. Fortunately I am of a certain age where the impetus to play the game, much as I love to watch it, has become an avenue of pleasure closed off. But I cannot say the same for the countless throngs of couch potatoes who inspired by what they see on the telly decide to play tennis with the inevitable outcome of getting blisters. Now as we have seen with the professionals it is amazing how sore feet can impair peak performance and blisters are no exception.



The simple blister is caused by shear. Friction causes damage to the skin cells and fluid gathers then separates the skin surfaces. Severity determines depth. A common cause of the simple blister is the foot rubbing against the inside of a shoe or sock. Damaged caused by dynamic friction roughens the shoe or sock surface and the constant wearing over the skin causes an inflammatory reaction. The skin fills with fluid, which initially tries to separate opposing surfaces. Pressures cannot pass through fluid and the associated burning pain ironically provides the two ways the body can protect itself from further damage. If ignored and the player plays on, the blister bursts and infection is a likely outcome. Hours and hours of play drive the skin separation deeper and sometimes a bursa (fluid filled sac) or bursitis (inflamed bursa) will arise.



The term bunion is a kind of bursa, known medically as an advantageous bursa and is formed to protect the big toe joint, the major lever of the foot. Painful bunions will stop your sporting prowess just ask any lady who suffers from them and they will soon confirm how they burn with exquisite pain. Lleyton Hewitt has been plagued with sore feet throughout his professional career because of the punishment his regime. When ladies complain of sore feet, they usually have a bunion or hallux valgus, or both. Hallux means big toe and valgus describes an anatomical position, where the big toe is tilted and faces outward diagonally towards the small toe. The forefoot looks like an arrowhead. There are more than 150 operations for hallux valgus. One critic of forefoot surgery was Hans Rudolph Mayer, a Swiss medic, he believed many procedures had been designed to alter the female foot not for functional reasons but instead for cosmetic reasons to fit typical female shaped shoes. He called this the Cinderella Principle. In Cinderella (Walt Disney) the glass slipper was broken by the grotesque ugly sister. However in the original version of the fairytale, the wicked mother cuts the daughters foot in order to fit the shoe.



So if you want to play the odd game of tennis you might like to take a few sensible precautions. First thing is to get a pair of tennis shoes that fit the feet comfortably. The range of tennis footgear is extensive and these have been designed to cope with the stresses of the game, ordinary trainers may seem similar but are not. Slipping on the old shoes for a few sets is bound to aggravate the skin. Some people advocate greasing the skin which gives lubrication and does cut down friction but this can be messy. Others prefer to use surgical spirit to toughen the skin. This may appear logical but is not recommend because it dries out the skin and makes it less able to deal with friction. The secret to prevent blisters is to wear two pairs of socks. When friction occurs it rubs the two layers of socks and not the skin. Any old war wounds like burst blisters or small new ones should be covered with a strapping such as a band aid. The tight binding of the skin offers an outer cover to the damage area. Always take time to warm up before a session by stretching and warm down after a game. This prevents stiffness and reduces the risk of injury. Aches and pains should not be ignored and persistent pain may need professional care. Follow these simple steps and keep up the practice and I may see you on the telly, next year.

Reviewed 8/07/2017

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