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Coming Back from Knee Injury:

Equipment Considerations

by Joe Sheehan
February 1999

Joe Sheehan is a freelance writer who enjoys writing about sports and the arts. He inadvertently began researching this article in 1998 after partially tearing a tendon.
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    So, you've had a knee injury.  You've been to the orthopedist and through the physical therapy.  Have you thought about how you're going to prevent the next injury?  

    Shoes can't prevent an injury by themselves, but a good pair is a step in the right direction.

    Start by making sure you're buying tennis shoes!  Running shoes are designed for one thing and one thing only - going straight ahead.  They don't have the lateral support you need.  Basketball shoes are designed for playing on polished hardwood, so stay away from them.

    Tennis shoes are designed to grip on certain types of surfaces, so the surface you play on has a lot to do with what type of shoes you need.  If you play on clay as well as hard courts, it makes sense to spend the extra money on two pairs of shoes.  Get one with a herringbone pattern on the sole; these are designed to slide on clay.  If you don't know how to slide, learn.  On hard courts, you won't slide, but you will pivot.  Look for a tread design that has a circular "pivot point" under the ball of your foot.  The key phrase here is "your foot," so when you try the shoe on, make sure the manufacturer put the pivot point in the right place for you.

    Regardless of what type of court surface you play on, your feet will take a pounding.  They'll also pass some of it along to your knees, so make sure your shoes are properly cushioned.  Some manufacturers put extra cushioning under the heel and forefoot, and this is a good idea for players coming back from an injury.  An even better idea is full-foot cushioning.  When a tennis player plants their foot and changes direction quickly, stress is felt by more than just their heel or their toes, so the whole foot needs cushioning.

    And what kind of cushion do you need?  Nothing could be better than a bed or air, right?  Well, that depends.  Is that air cushion going to leave your foot too high off the ground?  If it does, that shoe will be less stable than others.  Nike's original Air shoes were great for runners because they had a very thick layer of air.  More recently, Nike has come out with what they call Zoom Air, which has a thinner cushion.  This makes for a more stable shoe and one more suited to tennis.

    Another outstanding cushion is the Si-18(r) formula used by K-Swiss in its shoes.  A silicon-based compound, Si-18(r) is used to form a padded footbed inside the shoe.  Try it on and see if you don't feel like you're walking on air.

    If you find a shoe you like, but that doesn't have the padding you need, look into gel inserts.  These inserts go inside the shoe in place of the cheap foam that some manufacturers use.  Like shoes, gel inserts are offered in different configurations for different sports, so be sure you're getting "tennis" inserts.  Try the inserts with the shoes right there in the store.  You'll probably feel the difference right away.

    After you've gotten comfortable on your new cushion, you'll still need some lateral support.  Some manufacturers build "roll bars" right into the sole, but the way the upper fits your foot is also important.  K-Swiss uses something they call the D-R Cinch(r) System, which is designed to keep laces tight and provide more lateral support.

    Your knees aren't the only joints you need to think about.  Tennis players need proper ankle support, also.  Does a knee injury mean you should go out and get a pair of high tops?  No.  Many high tops are made for basketball and can actually bind your ankles.  When your ankles can't move, stress is transmitted upward to your knees.  Most manufacturers of tennis shoes are aware of this and make many of their models available in both low-cut and mid-cut varieties.  The mid-cut shoes should offer you more support than low-cuts without causing discomfort or excess strain on your knees.

    The last thing, but of course not the least important, will be your knee brace.  Do you really need one?  When your doctor or therapist clears you to play, ask them.  When you're sure you're healthy, try playing without one.  If the knee aches or feels sore, you may need one, at least for a while.

    If you do feel some discomfort, try to find out what's causing it.  Ask your doctor or therapist to help.  You may only need compression or support at a specific spot, such as where the muscles and tendons join the joint just below or just above the joint.  A simple elastic bandage may do the job.  Players coming back from surgery may need something more elaborate, like the braces developed for football players in the 1970s.  These have metal bars running down the sides of the knee and provide protection against twisting.  Some braces have open spaces for the patella (kneecap), allowing for better freedom of movement.  If you wear one of these, make sure it is sized properly.  A brace that is too small may have an opening that constricts your knee, rather than frees it up.

    Proper sizing is as important for braces as it is for shoes.  If you have small legs and can't seem to find a brace that actually provides support, try an extra-large elbow brace.  The two joints aren't the same, but they're similar - and so are the braces.

    When shopping for shoes and related equipment, don't take the cheap way out.  This is the most important gear you'll take with you to the court.  Although they can't guarantee an injury-free match, good shoes can provide a safer, more comfortable one.

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