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Lumbar SpineLumbar Spine  Disc Bulge/Disc Bulge/HerniationHerniation

Lumbar SpineLumbar Spine Disc Bulge/Disc Bulge/HerniationHerniation

Low back pain is the second most common reason for doctor visits in the USA, after
the common cold. Eighty percent of American adults will experience low back pain at some

point in their lives. Disc bulges and disc herniations cause significant pain, time away from work, and of course, time away from the pickleball courts. Pickleball and low back pain are closely related because of the nature of the movements seen in pickleball. Repetitive dinking at the non-volley zone (kitchen) means players are often bending forward in order to hit the ball. This, over time, can place a lot of stress on the spine and lead to disc problems (or exacerbate existing/underlying problems).

First, let’s describe the difference between a bulge and a herniation. Spinal discs are like jelly donuts lodged in between each vertebra. They provide shock absorption, and ensure that the load of the spine is dispersed evenly. A disc bulge is when the disc is pushed (most commonly posteriorly and laterally, back and to one side) out of place. This often leads to nerve roots being compressed as they exit the spine, and can create radiating pain, numbness, and tingling in the lower extremities (known as radicular pain). A disc herniation occurs not only when the disc is pushed out of place, but when a tear in the disc is also present. This leads to the gel-like substance within the disc being extruded (think of squeezing the jelly out of a donut). This, again, can lead to nerve compression and pain felt in the lumbar spine and lower extremities.


The most common mechanism of injury for a lumbar spine disc bulge (or herniation) is a combined spinal motion of bending and twisting. This unfortunately is seen all the time in pickleball due to the nature of the dinking game (not seen in other racquet sports). It is well-known that the majority of pickleball players are older than 50, and therefore their quickness, agility, and footwork may not be as good as younger players. This leads to a lot of reaching (often outside the base
of support) in order to return certain shots, and
places these individuals at higher risk for lumbar disc problems. Improving your footwork and agility at the kitchen line can lead to better positioning to hit the ball, and therefore decrease the repetitive stress placed on your spine over time.

How does a lumbar spine disc bulge or herniation present? Usually, people will report bending over to pick something up or reaching down for something, and then a sharp pain is felt. This is followed by significant stiffness, inability to move, pain in the lower back, and possibly pain in the lower extremities. In addition, a positional shift can often be seen, called a lateral shift (if you look in a mirror, your shoulders are no longer lined up straight above your hips). This is a normal response our bodies have in order to avoid compressing nerves and to decrease the pain. Unfortunately, if left untreated, this can lead to longer-term disability and keep you off the court (or even from returning to work).

The best thing to do when injuring your lumbar spine is to consult a health care professional (ideally a physical therapist) as soon as possible. Research has shown
that the quicker acute low back pain is addressed by a physical therapist, the better the outcomes. Physical therapists will be able to perform a full examination and determine the cause of your pain. From there, they can devise an individualized program to correct your problem and return you to the courts as soon as possible. There is a specific sequencing that needs to be followed in order to correct lumbar disc bulges/herniations. Positional shifts need to be corrected, then a progressive exercise sequence is put in place to correct the disc protrusion, followed by a progressive strengthening program in order to get back to all activities.

If you have any questions, email thepickleballdoctor@gmail.com.

Pickleball in Paradise

Pickleball in Paradise

As the fastest-growing sport in the country continues to expand its footprint, vacationers are choosing travel destinations with pickleball in mind. So, if you’re looking to play pickleball in a little bit of paradise, here are just some of the amazing destinations waiting for you.

Banning Lewis Ranch

If you’re looking for a master-planned housing community to surround your growing family with breathtaking views and award-winning schools, or you’re seeking a retirement community to fulfill your desire for an active lifestyle that includes playing pickleball every day, be sure to check out Banning Lewis Ranch. Banning Lewis Ranch is the fastestgrowing community in Colorado Springs, Colorado, with 75+ acres of trails and open space, community parks, water park, and community centers with amazing amenities, including 16 beautiful pickleball courts.

Banning Lewis Ranch offers leagues and regular programming – eight in Vista Park open to the entire community and eight newly opened courts exclusively available to residents of The Retreat— Colorado Springs’ first 55+ active adult, resortstyle community and private enclave within Banning Lewis Ranch. For more details, visit BanningLewisRanch.com.

Horseshoe Bay Resort

Just 45 minutes west of Austin, Texas, the Horseshoe Bay Resort is nestled next to one of the most “Instagrammed” beaches in the Texas Hill Country overlooking Lake Lyndon B. Johnson (LBJ). The upscale resort offers a unique lake resort experience, featuring eight pickleball courts, championship golf on three courses, casual and upscale dining overlooking Lake LBJ, fun family activities on the water or s’mores next to the fire, and annual entertainment and food events such as the Beer by the Bay Music Festival.

Whether you’re visiting as a guest or joining The Club as a member, the resort offers daily lessons and clinics with on-site IPTPA-certified instructors. Get your doubles partner and book one of the resort’s Ultimate Pickleball Weekend Camps, which include a twonight stay, nine hours of professional instruction and supervised match play, lunch on Saturday followed by beer and wine, and pickleball drills on Sunday morning paired with mimosas and Bloody Marys. A pickleball enthusiast’s dream vacation!

Visit hsbresort.com to explore the resort’s amenities and view the upcoming calendar of events.

JW Marriott Phoenix Desert Ridge Resort & Spa

The JW Marriott Phoenix Desert Ridge Resort & Spa saw the opportunity early on to create a pickleball getaway like no other for avid players, as the number of pickleball players continued to increase year over year. The 17 pickleball courts, plus an expansive center court with a 400-person capacity, offer spectacular views of the gorgeous Arizona desert. On-site private lessons, daily clinics, group one-on-one instruction and ball machine rentals provide pickleball enthusiasts the opportunity to improve their competitive game, or simply join in some pick-up games. With the new USA Pickleball corporate offices on-site, you never know who you’ll get the opportunity to play against!

While staying at the resort, guests can also enjoy the endless relaxation serenities at The Revive Spa, sip a cocktail inside one of the poolside cabanas, join friends on one of the two picturesque, 18-hole Championship courses and learn about Arizona history, flora and fauna on a leisurely trail walk or bike ride. Visit Marriott.com for details on JW Marriott Phoenix Desert Ridge Resort & Spa.

Las Vegas Plaza Hotel & Casino

Stunning, picturesque pickleball, Las Vegas’ best tourist entertainment, and an incredible city view are what the Las Vegas Plaza Hotel & Casino has to offer. It’s a stop you don’t want to miss on your pickleball vacation tour.

In addition to the outstanding pickleball amenities, guests can enjoy all the best Vegas experiences a vacation has to offer including the casino festivities, bingo, and the 70,000-sq.-ft. pool deck, giving plenty of space for relaxation and entertainment. Plus, it’s right next to the pickleball courts!

Visit PlazaHotelCasino.com for more information and a full list of upcoming entertainment events and pickleball tournaments.

Latitude Margaritaville

With pickleball being a major part of its DNA, Margaritaville—the global brand inspired by the songs and lifestyle of Jimmy Buffett—is the title sponsor for the USA Pickleball National Championships. In addition to Latitude Margaritaville 55-and-better communities, developed with Minto Communities, it has courts at a few resorts including Margaritaville Lake Resort–Lake Conroe, and the soon-to-open Margaritaville Island Reserve Cap Cana.

Latitude Margaritaville communities are located in Daytona Beach, Hilton Head, and Watersound in the Florida “panhandle.” These active adult communities offer pickleball clinics and lessons, and feature 10 courts each.

Latitude Margaritaville offers an irresistible concoction of fun, food, music, and friends. Amenities include a state-of-the-art Fins Up! Fitness Center with indoor whirlpool and lap pool; Latitude Bar & Chill restaurant; lagoon-style Paradise Pool with beach-like entry and swim-up Tiki Island; and Changes in Attitude poolside bar, along with nature trails, pickleball and tennis courts, and a Barkaritaville Dog Park.

Latitude Margaritaville Daytona Beach residents even have their own private Beach Club on the Atlantic Ocean, with shuttle service from the community to the beach and back. Phase Two amenities open soon and include a Workin’ N’ Playin’ Center with arts & crafts and multipurpose rooms; Last Mango Theater for performances, dances, and banquets; Hangar Workshop for golf cart tune-ups; even more tennis courts, pickleball courts and bocce ball courts with lighting for night play; and a Barkaritaville Pet Spa.

For more information, visit LatitudeMargaritaville.com and MargaritavilleResorts.com.

Minto Communities / The Isles of Collier Preserve

Minto Communities has been ahead of the curve from the early emergence of pickleball to it becoming one of the nation’s most popular sports. The developers anticipated the growing popularity of pickleball based on listening to their community homeowners, and gave them what they wanted! And that was pickleball courts and a healthy lifestyle.

Minto and Margaritaville joined forces in sponsoring the Minto US Open Pickleball Championships Powered by Margaritaville in Naples, Florida. Minto’s The Isles of Collier Preserve community is adjacent and connected by a gate to the East Naples Community Park, headquarters for the US Open, which brings hundreds of players and thousands of fans to the Naples area each year.

Minto also partners with the USOPC to present a pickleball instruction program that includes beginner lessons, private lessons, small group lessons and group clinics.

In addition to the pickleball lifestyle, the community’s luxury homes overlook miles of scenic kayak and hiking trails. Stroll along Fifth Avenue in Naples and discover a vast array of premier boutiques, art galleries, fine dining and entertainment opportunities.

All of us pickleball players also love a good beach day, so explore all that the beaches have to offer along the Paradise Coast on the Gulf of Mexico.

Visit mintousa.com for more information.

Nocatee

Last year, my family planned a trip to Florida to visit my sister. While there, we visited Nocatee, a nearby master-planned co-community. As pickleball enthusiasts, my husband and I were so excited to see 12 brand-new pickleball courts with an expansive onsite waterpark we thought only existed on a tropical vacation. We were so enthusiastic that upon returning home to Illinois, we sold our home and are now happy residents of Nocatee.

Just a few minutes from beach views and kayak launches, this master-planned community in Ponte Vedra, Florida (near Jacksonville), offers those 12 pickleball courts for residents as well as two waterparks for the kids that include waterslides. There are paths exclusively for golf carts that each family purchases when they move in, giving you an out-of-the-ordinary ride to a local restaurant or grocery store.

Other amenities include dog parks within each community neighborhood, some of the top-rated schools in Florida, an action-packed events calendar for residents and their guests, and holiday festivities that include golf cart parades, waterpark haunted houses and holiday light shows.

Del Webb Nocatee, a 55+ active adult community, also features its own pickleball and tennis courts within the gated community, as well as a clubhouse for resident activities and events.

Visit Nocatee.com for details.

OutDoor Resort Indio

The perfect desert oasis, OutDoor Resort Indio (ORI) is an exclusively Class A motorcoach community designed for active adults, located just minutes from Old Town La Quinta and Indian Wells Tennis Garden, and a few miles from fabulous shopping on El Paseo, Palm Desert. It offers a total of 419 individually owned lots wrapped around an 18-hole executive golf course, six permanent pickleball courts, and two tennis courts.

ORI Pickleball Association (ORIPA) has over 150 members. There is organized play most days with paddles on the fence by ability levels, round robins, scrambles and men’s/ladies’ days. Also, ORIPA provides free lessons weekly based on ability. The club regularly hosts parties throughout the season for both full-time residents and guests.

Many pickleball enthusiasts frequently return because of the hosted social events and its proximity to popular tournaments throughout the year. From the photos we’ve seen, it looks to be quite the spot for those seeking a fun, social pickleball getaway! For more details,

visit orindio.com.

Palm Creek Resort & Residences

With the motto “Because we waited for this moment, and it’s time to take full advantage of it,” if you’re 55 and over and haven’t heard of it yet, you need to check out the Palm Creek Resort & Residences. With some of the most incredible scenic views, there are 32 pickleball courts that have become popular for both athletic play and ongoing social events throughout the year.

Organized round robins begin daily at 8 a.m. on 24 courts for levels 2.0 through 5.0. The remaining eight courts are reserved for open play and challenge courts each morning starting at 8 a.m.

Other amenities on-site include billiards, yoga, swimming, dining, softball, horseshoes, tennis and plenty of activities to do with your friends—from bingo and arts & crafts to sewing and woodworking. A dream way of living an active lifestyle!

For a full list of upcoming tournaments, events and resort amenities, visit PalmCreek.com.

Palmetto Dunes

If you follow the pickleball tournament circuit, you frequently hear of the Palmetto Dunes Oceanfront Resort, its amenities, and professional pickleball instruction given by on-site pro Sarah Ansboury. Palmetto Dunes is one of the top pickleball vacation destinations in the country and host of the annual APP Hilton Head Open.

Located in the heart of Hilton Head Island, incredible oceanfront views for three miles along the Atlantic Ocean beachfront provide the perfect venue for three world-class golf courses, vacation rentals, a full-service marina, and an 11-mile lagoon system.

In addition to daily offerings including round robins and clinics for players of all levels, the Palmetto Dunes Pickleball Center is now a world-class destination for professional pickleball players across the globe, with 24 dedicated pickleball courts and state-of-the-art lighting. Among the popular pickleball offerings are the Daily Round Robins, a pro supervised session with players progressing up the ladder depending on play results, the “Daily Dose” clinic that teaches skill development on techniques and strategies to help improve every area of the court, and Pickleball 101, which helps beginners to learn the basics such as rules, scoring, court positioning, etc.

For more information, visit PalmettoDunes.com for an unforgettable vacation experience for your friends and family.

Sundial Beach Resort & Spa

A highly desired beach resort in Sanibel, Florida, Sundial Beach Resort & Spa features 12 plexi-cushion courts, stadium seating, and is host to some of the most popular pickleball tournaments throughout the year, with camps and tournaments already announced through February, 2022.

Lessons and clinics are offered at the beautiful waterfront facility, and resort guests receive complimentary court access and equipment rentals. Memberships are available to the public for $350 annually for an individual, or $500 for the family— and for those of you looking for a long-term summer getaway, you are welcome to a six-month membership from May 1 through October 31 of $200 for a single membership and $350 for the family.

When not on the pickleball courts, other amenities to enjoy as you escape to paradise include enjoying award-winning on-site dining, heading out to the beach and finding unique treasures as you take advantage of the prime location for shelling, splashing around with the family at the resort waterparks, visiting with your pickleball friends at Turtle’s Tiki Bar, going on an adventure with kayaking, paddle boarding and other watersports, and so much more.

Visit SundialResort.com for details about upcoming tournaments and to book your pickleball island getaway! Be sure to reserve your rooms as soon as tournaments are announced to not miss your chance to stay at this highly-sought-after pickleball resort.

Oops, I Gained the Quarantine 15: Five Tips for Pandemic Weight Loss.

Oops, I Gained the Quarantine 15: Five Tips for Pandemic Weight Loss.

The Importance of Balance Proprioception In Pickleball

The Importance of Balance Proprioception In Pickleball

As most of us know, the key to being successful when playing pickleball is creating scenarios where your opponents are compromised in order to gain an advantage during the rally. Moving the ball around the kitchen and getting your opponents off-balance is a great way to create unforced errors. So, in order to be successful on the court, improving your balance and reaction strategies can help you stay in a point longer, and possibly avoid making unwanted mistakes. But what is balance, and how can you train it?

There are three main systems in our bodies that control our balance: visual, somatosensory (our brain’s awareness of touch, pressure, and body position [also known as proprioception]), and vestibular. We mostly rely on visual feedback during regular activities since our eyes are very good at judging depth and informing our brain on movements needed to balance. However, when playing pickleball, our heads move a lot, therefore making it harder to rely solely on vision since our eyes are constantly tracking the ball. Therefore, we have to use our vestibular system (inner ear) and somatosensory information (pressure through our feet) to compensate.

So how does each system affect our balance?

As mentioned earlier, the visual system is our primary feedback mechanism for balance. Our eyes convey most of the needed information to function in our daily activities. The vestibular system is based in our inner ear. We have two separate components in our inner ears: one that senses linear motion (for example, the feeling of going up and down in an elevator, or accelerating in a car), and the other that senses rotational motion (for example, during a somersault).

The somatosensory system takes all input from touch, pressure, heat, and proprioception to give our brain information about our position in space.

It’s important to know that no matter what your current balance level is (poor, fair, good), it can always be improved with targeted exercises. If you find that you lose your balance on a daily basis with basic activities or when playing pickleball, then incorporating balance exercises in your daily exercise routine will help you over time. Below you will find various exercises that will work on and challenge your balance. Remember, always start with the easy version, and progress as you feel comfortable. If you do not feel comfortable doing these by yourself, then seek out a physical therapist who will be able to help you with personalized attention.

For all the exercises listed below, there is a common progression:

Step 1: Eyes open, with hand support (holding on to something)
Step 2: Eyes open, no hand support
Step 3: Eyes closed, with hand support
Step 4: Eyes closed, no hand support
Step 5: Performing the previous 4 steps on an unstable
surface (such as a foam pad or a pillow)

Once again, always start with the easy step for each exercise, and progress to the next level if you are successful.

Exercise 1: Tandem Stance. Start at the kitchen counter with your hands on the counter. Place one foot in front of the other so that your heel from one foot touches the toes from the other foot. Make sure both feet are nicely lined up. Stand nice and tall, and try to maintain the position. The goal is to hold the position for 1 minute without loss of balance. Go through the progressions listed above, making sure to switch your feet position to work on both sides.

Exercise 2: Standing on One Leg. This might seem easy, but you would be surprised how many people struggle with it. The goal is to hold for 1 minute without any loss of balance.

Start at the kitchen counter with your hands on the counter. Stand nice and tall, and pick up one leg. At first, maintain your vision on an immobile object with your hands touching the counter. To progress this, perform without holding on. Then try it with your eyes closed (remember this will be more difficult since we are taking vision out of it), holding on with your hands. Then finally, eyes closed without holding on. Once you get good, you can also incorporate single leg balancing during some of your daily activities such as brushing your teeth.

Exercise 3: Stepping Up on a Step. This is a progression from Exercise 2. Be sure to feel comfortable with Exercise 2 prior to performing this one.

To perform the exercise, grab a medicine ball or a weight (start light and progress as you get better and more comfortable). Face a staircase or step stool, hold the medicine ball (or weight) close to your chest, and step up on the step with one foot. Maintain your balance on the foot without putting down the second foot, and hold as long as you can, then come back down and switch the lead foot. To progress this, as you step up on the step, extend your arms so that the medicine ball is farther from your body (the farther you reach, the harder it will be). Finally, you can also perform this same exercise by performing a sidestep up onto the step. Be sure to work both sides.

If you work through the progressions, you will see how difficult it becomes when you take vision out of
the equation, as well as when you stand on an unstable surface (take out sensation). However, every time you progress the exercise, you are challenging different parts of your balance systems, and therefore training them in various ways. Since your eyes are focused on the ball during a pickleball game, improving your other balance systems will help you feel more confident with your overall game and you will be in better positions on the court to be successful.

If you incorporate these exercises into your routine, and work through the progressions, you will see improvements over time, and you will become more confident in your ability to be balanced. This will translate into your pickleball game, especially as you add more dynamic variations to the balance exercises. Be creative, and if you think of innovative ways to challenge your balance, please post a video of you doing it on The Pickleball Doctor’s Facebook page.

If you have any questions, do not hesitate to reach out to thepickleballdoctor@gmail.com.



Posture of Pickleball

Posture of Pickleball

Sitting and standing tall are easy…not! If they were, few would end up with pickleball shoulder, neck, back, hip or knee problems.
Think of your body as a house. Picture an earthquake—I call it “Life happens”—where you are shaken to your foundation. None of your doors and windows (joints) open or close correctly any longer. Basically, when life happens, tissue issues begin to break down your parts. Add pickleball to the mix and (Presto!) your body starts to sustain injuries. If you’re younger (18-49), your rate of injury and repair is much shorter
than the 50+ group. If you’re over 70, surgeries can be inevitable.

When you build a structure, walls are even; floors and ceilings don’t slant. There is equal tension on stabilizing beams. The doors and windows glide open and closed. That’s the way your body is supposed to work as you age. Yes, we all have aches and pains and soreness, especially after playing pickleball, but reducing injuries by doing some preventive work is necessary.

Let’s go through some body parts and the effect of poor posture on each. Start with forward head, where your nose enters the room first and your chest is attached to the train tracks. The weight of your head pulls on your neck and back. Between pickleball games you may sit on those terrible chairs you bring to the court. Check your sitting posture—that posture becomes your life posture as your neck and back tighten and eventually wear out. Forward shoulders are next. When reaching for those high pickleball shots, if you’re using your neck muscles instead of back muscles, the rotator cuff and long head of the bicep tendon are being sawed off.

Dinking and bending for those low pickleball shots can ruin your hips, back and knees. If your hip flexors are getting tighter each time you play and if stretching is not in your repertoire every evening, the hips can become out of alignment with your femur (leg) bones. Either the hip socket bones or back, or both, start to wear down. The knees are two bones balanced on top of each other. If your feet or hips don’t balance, neither do your knees. Also, if your hip muscles are so tight that they don’t glide when you walk, then you’re using your knees as hip sockets. That kind of movement wears away at your knees.

The key is to stretch, stretch, stretch, which helps to repair the tight tissue from all that playing. Sit and stand tall. Your balance can improve and some of the body pain can subside. The chance that you’ll play stronger and safer pickleball increases because your balance is better, and you integrate more correct muscle strength.

Sit and stand tall. Your head is attached to the cable car wires. Your chest enters the room first. Your arms hang from your back, not your front. You’ll look slimmer, taller and younger with a brain that gets more oxygen. Your balance can improve and some of that body pain can subside. Give good posture a try. I’ll bet you’ll be happy with the results.


Stay Court-Ready with Immune-Boosting Foods

Stay Court-Ready with Immune-Boosting Foods

No doubt about it, COVID-19 put quite a block on pickleball play this year. While the future of the virus is unpredictable, one thing we do have some control over is how we take care of ourselves, including what we choose to eat.
Much like consistent pickleball practice improves abilities over time, healthy eating habits increase immune function over time, not overnight. Perhaps more accurately, a diet deficient in nutrients can weaken your immune system. A dedicated commitment to eating a varied, plant-strong diet, including foods with the following key nutrients, will give you your best shot at staying well and court-ready.

PROTEIN
We need adequate protein to build everything in our bodies including immune system cells and antibodies. High-quality protein can be found in both plant and animal sources. The average recreational player needs about .9 grams of protein per kilogram of body weight daily.
Best Shots: Beef, poultry, fish, eggs, dairy, beans, peas, lentils, quinoa, nuts, whole grains

VITAMIN C
Vitamin C is important for healthy tissues including skin and muscles. It plays a role in the immune system by taming wayward molecules that might otherwise do damage, and by stimulating antibody production. Fresh fruits and veggies are the highest sources of vitamin C; cooking or storing produce too long reduces vitamin potency.
Best Shots: Papaya, peppers, broccoli, strawberries, Brussels sprouts, pineapple, oranges, tomatoes

VITAMIN A
Some forms of vitamin A including beta-carotene can increase immune cell function and help keep tissues healthy. Orange and yellow fruits and vegetables tend to be highest in vitamin A.
Best Shots: Pumpkin, sweet potatoes, carrots, red and yellow peppers, apricots, dark green leafy vegetables, winter squash, chili peppers

ZINC
Important for T-cell function, deficiency in this mineral can reduce immune abilities quickly. Luckily symptoms can be reversed once zinc is reintroduced. Try keeping pumpkin seeds in your pickleball bag for a post-play snack.
Best Shots: Beef, lamb, pumpkin seeds, sesame seeds, chickpeas, hummus, lentils, quinoa, turkey, shrimp

PROBIOTICS and PREBIOTICS
Probiotics and prebiotics are important for gut health, an essential part of your immune system. Probiotics
are the good bacteria that help us digest food, make nutrients, and fight pathogenic bacteria. Probiotics can be found in cultural fermented foods. Prebiotics are the food probiotics need to thrive and are found in high-fiber foods like whole grains, vegetables, and some fruit.
Best Shots: Probiotics – cultured yogurt, kefir, fresh miso, fresh sauerkraut, kimchi, tempeh, kombucha tea; Prebiotics – bananas, leeks, garlic, onions, Jerusalem artichokes, asparagus, jicama, beans, whole grains

VITAMIN D
If you’re looking for an excuse to play more outdoor pickleball, this one is legit. Vitamin D is a hormone that humans make when our skin is adequately exposed to the sun’s ultraviolet light. We need D for immune system regulation, and for healthy bones and muscles.
Under ideal circumstances, it only takes 10-15 minutes of daily UV sun exposure to make enough vitamin D. Unfortunately, we face limiting factors including time of year (any season other than summer), living north of the 37th latitude (check your map), skin color (darker tones block UV rays), age over 65, and the important cancer-preventing use of sunscreens. These factors block vitamin D production like a Newman at the NVZ.
Because it’s hard to get enough vitamin D from food, this is one nutrient I often recommend supplementing. Ask your doctor what dose is right for you.
Best Shots: Summer sunlight, supplementation, wild-caught salmon, UV-exposed mushrooms, fortified foods like milk, soy beverage, orange juice, and cereal

GET THE WHOLE PACKAGE
Your favorite pro would never win gold with a strong serve alone; to make it happen, she also needs the drop, drive, volley, dink and that little bit of unexplained magic that the rest of us would love to get from a
bottle. The same rule applies to vitamins. Good-quality supplementation can help in a pinch, but even the best supplements can’t replace healthy food. Eating a wide variety every day is recommended so that you get the whole package, including those magical nutrients we haven’t discovered yet.

Immune-Boosting
Stuffed Peppers

High in protein, prebiotics, and vitamins C and A, this recipe is versatile, so you can make it your own way!
6 large fresh peppers (Hatch, poblano, or bell
peppers)
2 cups cooked protein (quinoa, ground beef, or
chicken)
1 small onion
4 cloves garlic, minced
1 cup cooked rice (brown or white)
1 cup cooked beans (black, pinto, or small red) 15 oz. can diced tomatoes
1 packet taco seasoning (or season your way to
reduce sodium)
1 cup cheese (Monterey Jack, cheddar, Pepper Jack, vegan)

Halve peppers lengthwise, removing stem, seeds and ribs. Pre-roast cleaned peppers on an oiled baking sheet at 350F for 10-15 minutes, or until somewhat softened. While peppers are pre-baking, sauté onion and garlic in 1 tablespoon cooking oil until softened. Add protein, rice, beans, tomatoes, and taco seasoning; heat through, mixing thoroughly. Fill prebaked pepper halves evenly and sprinkle with cheese. Return to preheated oven and bake until peppers are softened to preference and cheese is melted, about 15 minutes.








A Sight for Sore Eyes

A Sight for Sore Eyes

Eyewear not only protects players’ eyes from the ball or a partner’s paddle, it can protect you from long-term overexposure to the sun’s UV rays.

Across the sports landscape, eye health and eye safety during play has become an increasingly serious topic of discussion. Not surprisingly, this discussion has recently come to pickleball. The ability to both play safely and win is affected by how players see the ball, the court, their partners, and their opponents. As with many other ball sports that are played mostly outside, pickleballers face two distinct hazards to their vision when they play: impacts to the eye from the ball, their partners’ paddle, or their partners themselves; and overexposure to UV rays from the sun. Over time, exposure can result in cataracts (clouding of the eye lens) and macular degeneration (deterioration of the central portion of the retina), both of which can lead to loss of vision.

A lot of play happens at the kitchen line, which means that players are usually only 14 feet from their opponents’ next shot. Even a speed-up moving at just 20 mph in the kitchen leaves a player with 0.5 seconds to react. If players don’t have protective eyewear, all they have is their reactions to keep from getting hit. Most people seem to think that eye injuries happen, but not to them. The problem with this kind of thinking, though, is that oftentimes getting hit in the eye is out of a player’s control, and when it happens, it can be incredibly serious—from detached retinas, to orbital blowout fractures, to even ruptured eyeballs.

The immediate solution to these problems is high-quality eyewear with polycarbonate lenses. While eye injuries from impacts can be serious, the good news is that 90 percent of these injuries can be prevented by wearing the proper eye protection (i.e. polycarbonate lenses). Not only that, but these lenses also block 100 percent of harmful UV rays. If the sunglasses are wrap-style, it’s even better. This extended curve helps prevent UV rays from reflecting off the inside of the lenses directly into a player’s eyes.

While protecting players’ eyes, the right eyewear can simultaneously enhance performance if its features are suited for the pickleball environment. Eye protection does not mean players should sacrifice on performance. With the proper tint, players can enhance the ball’s contrast against the court, improving their depth perception, timing, and reaction speed.

Recently USA Pickleball has partnered with RIA Eyewear, a startup based in New York that launched earlier this year. The new company’s first sports sunglasses line features polycarbonate ZEISS™ lenses that enhance the contrast of the pickleball against the court and blocks 100 percent of harmful UV rays. These proprietary lenses are housed in Italian-made frames that weigh less than 1 ounce and feature an interchangeable lens system to account for different light conditions.

RIA’s mission is to prove that eye protection doesn’t have to come at the expense of performance and, in fact, it can help players perform better. Its products have already gained traction with top professional players, partnering up with Michelle Esquivel and Rob Cassidy, founders of Ultimate Pickleball Academy, as well as Aspen Kern. “As an instructor, teaching long consecutive days under the sun can be brutal on the eyes. Quality sunglasses are essential,” said Cassidy. “From a player’s perspective, part of playing your best is playing without fear. Proper eye protection truly allows you to play with no fear.”

PICKLEBALL—A Sport for Creative Athletes!

PICKLEBALL—A Sport for Creative Athletes!

SickTrx is a group of top pro players and ambassadors who have displayed the art of trick shots on the largest competitive stages around the world. Here, Brian Ashworth, Joey Farias, Ben Johns, Vicki Love, Irina Tereschenko and Kyle Yates share and reflect on some of their favorite SickTrx.

What is SickTrx, one might ask. SickTrx is a “pickleball philosophy”—a way of life, if you will—that puts imagination, creativity, fun and mentoring as core values for growing your game and the sport. Becoming a better pickleball player at any level is not just about drilling, discipline, 10,000 hours of deliberate practice, and trying to win at all costs. Pickleball is a unique game that unites and celebrates players of all individual styles, technical and physical skills. We commend all the players who are not afraid to bring some flare to their game and develop additional offensive options through the use of trick shots (or, as we fondly call them, SickTrx).

SickTrx is also a group of friends—top pro players and sport ambassadors—who have gotten pretty good at executing a large number of trick shots on the biggest competitive stages around the world and have a lot of fun sharing their skills with others during rec games, exhibitions, junior parties, and clinics. This article is an exploration and reflection on some of our favorite SickTrx. We hope it brings you joy and inspiration. Namaste.

Irina Tereschenko Top-Ranked Pro and 4-Time Pro Major Champion Team: Paddletek and Jigsaw Health Follow: sicktrx_irina (IG) and Irina Tereschenko (FB)

I am a big fan of the misdirection shots. This category really allows for individual playing styles and player personalities to shine as the options are almost endless: head fake, shoulder fake, inside out slice redirect, no-look flick, drop shot fake, lefty switch—you name it.

Every member of the SickTrx crew adds a different flair to the misdirection shots, and if you watch some of our matches more closely, you can definitely pinpoint the personal favorites! These shots are generally executed from the kitchen area (groundstroke or volley) and are designed to surprise your opponent, push them off balance, and set up the winner with the next shot.

I often disguise a drop shot from the kitchen as a powerful drive—especially when both or one of the opponents are back on the baseline—by taking a huge swing on a high ball but then letting the ball drop and gently placing it into the kitchen with tons of underspin. This is a very effective tactic at all levels if your opponent is not very quick and/or when you are trying to wear them down. Even if the opponent gets to the drop shot, they are very likely to pop the ball up and you are perfectly set up for a slam dunk as they fight to regain balance and re-establish themselves at the kitchen line.

Ben Johns 10-Time Pro Major Champion Team: Franklin Pickleball, Jigsaw Health, Fila Shoes Follow: benjohns_pb (IG) and Ben Johns: Pickleball (FB)

The “Jumping Erne” is my favorite trick shot. It distinguishes itself from a normal Erne shot (walking around the kitchen to stand right up close to the net) in that you can position yourself after your opponent makes contact with the ball by jumping. This makes it a difficult shot to avoid or see coming. If executed correctly, the shot is both effective and versatile. And bonus, it looks really cool!

The Jumping Erne can be played off any shot that gets too close to the sideline. This applies a lot of pressure to your opponent because it effectively shrinks their “safe” portion of the court by a couple of feet. It also has a wealth of placement options due to your contact point. The shot can be hit with a forehand or a backhand. I personally prefer to hit it from the left side with my backhand. Here are some keys to hitting the shot: 1. Jump with the foot that is closer to the sideline, landing on the leg that is closer to the middle of the court. 2. Attempt to time your jump so that your contact point with the ball is as close to the net as possible without going over it. 3. Make sure you turn your wrist DOWN to keep the ball in! You’ll often hit it long if you don’t, because of your close contact point and momentum.

Remember, it’s OK to look silly trying new things! Eventually you’ll start to feel the timing of your jump and when to go for it. Next time you go out to play, give this SickTrx a try!

Kyle Yates 12-Time Pro Major Champion Team: Paddletek, Jigsaw Health, PB1965 Follow: kyleyates.pb (IG), Kyle Yates Pickleball (FB) and Pickleball Vlog (YT)

One of my favorite shots in pickleball is the tweener! I’ve always had an affinity for exciting the crowds. A tweener, when executed in an effective manner, and at the right time, can surely get the spectators on their feet! The creativity involved with this shot is what truly defines it as a SickTrx.

Most of the time, some might consider this shot to be “unnecessarily flashy,” but I say NAY! Sometimes it’s absolutely necessary and an ideal option. As difficult as it may be, I’ve found it to be extremely useful on many occasions. For example, I recall pulling it off in a third set tiebreaker in the semi-finals of the US Open Pro doubles. The packed stadium roared in delight by what they’d witnessed. That crowd energy pushed us on to victory and ultimately the prestigious title.

Picture this: Your opponent has just hit a timely, well-struck lob over your or your partner’s head. You have no time to make a decision, and surely cannot jump high enough to immediately take the ball in the air. In a nanosecond, you swivel around to see the ball a half-court’s length away, and traveling quickly. Instinct kicks in and you make a beeline toward the ball as it bounces deep near the baseline. At this point, you can either call it out or run full speed, gain ground and catch up to the plastic ball as it reaches its apex, and begins to descend once again. You’ve got no time to concoct a plan. Once you reach the ball, you have no time, nor room, to move around the ball to take a normal swing; the ball is already between your legs. The only play is to simply keep your speed, and run right through/over the ball, and play it back right between your spread, galloping legs.

This delicate maneuver is not for the faint of heart, nor well-endowed. Simply getting the ball back over the net this way is a feat in itself… 25-30 feet away, full sprint away from the net, striking the ball between the legs, backward, and yet still dropping it perfectly, gently, over the net and safely into the kitchen. At this point, with the poise of a rocket surgeon, you must turn around and immediately return to battle and finish the point. It is SickTrx like this that really get my adrenaline pumping and reignites my passion for this great sport!

Vicki Love 0-Time “Pro” Major Champion Team: No affiliations Follow: Not applicable (Seriously, how am I part of this team?)

Any member of this team would be among the first to say that you should not be taking any pickleball skill advice from me. My playing style is…uniquely scrappy, and should not be replicated (unless you also thrive in chaos).

With that caveat, I’d have to agree with Irina that my favorite SickTrx shot is misdirection. For example, if you are in a cross-court dink battle and notice, using your peripheral vision, the player straight across from you is slowly moving toward the center of the court, then hide a last-second flick of the wrist (or push) to redirect the ball toward the body of the opponent in front of you or down the line. Hitting that player by surprise or “burning them down the line” is a potential way of keeping them accountable for protecting their side of the court and line.

Besides misdirection, I personally think that one of the best “shots” to master in an effort of elevating your game is not a shot at all. It’s simply being comfortable with letting out balls go.

Brian Ashworth
Winner of Numerous Silver Medals All Over the Globe and Founder of SickTrx Team: Pro-Lite
My favorite shot would probably be the drop-to-a-knee smash return. To execute this sorcery, first you need a well-placed pop-up to your opponent’s paddle hand and preferably close to the kitchen. Once you have executed this, you drop to your knee and get your paddle low. I do this because we have all been drilled to hit our opponent’s feet, so I place my paddle essentially where my feet would be. When your opponent smashes the ball, try your hardest not to smirk. Let your paddle hit the ball and let their force bring it back to them. Now is the time to chuckle but also stand back up. I promise you, no shot feels as satisfying as this one.

Joey Farias
Top Pickleball Pro Bronze Medal Specialist Team: Gearbox, Jigsaw Health, Tyrol Shoes, Black Ice Follow: jfariaspickleball on both Instagram and Facebook

The offhand flick is one of my favorite SickTrx shots. It’s a good way to add even more deception to your game, especially up at the kitchen by using your non-dominant hand to attack. I enjoy using it when I am dinking cross court for a while and faking my normal backhand dink while switching the paddle to my left hand and flicking the ball up the line to keep my opponent off guard.

The offhand flick should be used at the kitchen line due to most players’ lack of power with their non-dominant hand. From the kitchen line, deception can really affect the player, and not much power is needed if the shot is executed correctly. When trying to execute this shot, timing and accuracy are everything. You must pick the right time when your opponent either least expects it or has not seen it coming before. Accuracy is needed with this shot because you are trying to either hit your opponent’s weak spots, or keeping it away from their power side. Be careful trying this shot all the time, as players will start anticipating the attack.

Go home and enjoy trying to add this new SickTrx to your arsenal and keep bringing your own flare to pickleball.

SickTrx started with a group of young adult pickleball players who shared a common goal and vision for pickleball. They wanted to elevate the strategy and pace of the game by regularly incorporating SickTrx shots into competitive games. The idea is that by increasing the speed, unpredictability, and athleticism required to compete at the highest professional levels, this would increase the visibility, interest in, and passion for the sport from junior and younger athletes.

SickTrx has evolved from there with the aspiration that everyone can and should embrace the development of their own style and creation of their own SickTrx shots. We can all contribute to elevating the game of pickleball for all ages, levels and sexes by learning from one another’s creativity and pushing back on historical-based constraints that suggest there are only a few correct ways to play pickleball properly.

The SickTrx team is continually impressed and encouraged by the progress of the game, the increasing entrance of incredibly talented new players, and the heightened level and depth of competition. Keep trying different shots. Keep exploring your personal capabilities. Keep having fun in the creative process. And find that SickTrx style and shot that personalizes your game and separates you from the norm. Most importantly, when you successfully hit your SickTrx shot, shout “SickTrx” loud and proud.

Boost Your Game with Plant-Based Power

Boost Your Game with Plant-Based Power

On the courts and off, the topic of vegetarian nutrition is hot!

Whether it be for health, ethical, or environmental reasons, many players are looking for plant sources to meet their energy needs. And with farmers markets in their full summer swing, this is the most delicious time of year to drop more plant power into the kitchen.

From a dietitian’s point of view, this trend is no fad diet. The evidence of health benefits from a well-planned vegetarian diet continues to grow, even for athletes. But how do you know if going vegetarian is right for you?

It’s Not All or Nothing Some people don’t like the idea of going completely without animal products, and that’s OK! Any increase in whole plant foods will add nutrients and reduce nutrient-empty calories, especially if you’re eating them in the place of processed foods and meats. There is a wide variety of vegetarianism out there, so let’s define the basics:

• Vegans eat no animal products.
• Vegetarians eat some animal-derived foods like dairy and eggs.
• Pescatarians are vegetarians who additionally eat seafood like fish and shellfish.
• Flexitarians are vegetarians who sometimes add meat to their mostly vegetarian diet.

Notice that I didn’t include the term junkatarians, the folks who boast of eating no animal products but whose diet consists of mostly chips and processed foods with little nutrient value. Like any diet, the key to healthy vegetarian eating is planning, so that your body gets all the nutrients it needs, especially for those getting out on the court.

Enough Protein? Not a Problem!
Athletes tend to have concerns over getting adequate protein, and rightfully so. It’s important to get enough so that you can build and maintain muscle. With mindful planning, vegetarians can meet their needs without eating any animal products. Beans, peas, lentils, nuts, seeds, whole grains, and vegetables all contain some essential amino acids, the building blocks of protein. By eating a variety of these healthy foods, players can get what they need.

So how much do we actually need? There is a simple formula, which varies based on your weight, health and activity level. Here’s a very basic breakdown for average, healthy pickleball players:

Average Recreational Player
.9 grams protein/kg/day
Example: 80kg person x .9g = 72 grams of protein
Endurance Athlete (playing several hours daily)
1.2-1.7 grams protein/kg/day
Example: 80kg athlete x 1.2g = 96 grams of protein
Here’s an example of what over 100 grams of vegan protein might look like:

• ½ cup steel-cut oats (10 grams)

• 1 cup walnuts (12 grams)

• 1 cup firm tofu (20 grams)

• 1 cup of lentils (18 grams)

• 2 cups of soy beverage (16 grams)

• 2 tablespoons nut butter (8 grams)

• 2 tablespoons chia seeds (5 grams)

• 1 cup brown rice (4 grams)

• ¼ cup pumpkin seeds (8 grams)

Vegetarian sources that are high in protein include eggs and dairy products. One egg contains about 6 grams of protein while a serving of dairy can vary anywhere from 8 grams in one cup of milk to 14 grams in a 5.3-oz. container of Greek yogurt.

Other Nutrients to Consider
Becoming low in any nutrient can keep you from playing your best. It’s always a great idea to discuss any new diet plan with your doctor, who may want to monitor your blood levels for potential deficiencies. The following list includes nutrients most commonly missed in vegetarian diets. In general, you can meet your needs by regularly adding my suggested vegan, vegetarian, or pescatarian “Great Shot” recommendations to your kitchen. While the following nutrients can be of concern, you are likely gaining more vitamins and minerals from a plant-based lifestyle than you’d ever lose.

Iron
Iron deficiency can mean low energy because of a reduced ability to circulate oxygen. This can be a real problem for athletes, females of childbearing age, and people who are avoiding meat. It’s always important to talk to your doctor if you’re feeling run-down more easily on the court. Vegan sources of iron, or non-heme sources, don’t absorb into the body as well as heme or animal sources. However, pairing high-iron foods with foods high in vitamin C (like fruit, peppers and broccoli) significantly increases iron absorption. Think along the lines of chili beans simmered with tomatoes, or a spinach and strawberry salad. Cooking with an iron skillet also adds iron to the diet.

Great Shots: lentils, beans (especially white and soybeans), quinoa, tofu, dark leafy greens like spinach and chard, pumpkin seeds, dark chocolate, clams, mussels

Vitamin B-12 (also known as Cobalamin)
The 2.4 micrograms of vitamin B-12 most adults need daily is almost exclusively found in animal products, with the exception of fortified foods like cereal and nutritional yeast. It’s an important nutrient; deficiency can lead to permanent neurological damage. If you are nearly or completely vegan, be sure to take a good-quality supplement, verified for purity by a third party like United States Pharmacopeia (USP).

Great Shots: fortified nutritional yeast, fortified cereal, fortified soy beverage, third-party-verified vitamin B-12 supplements, eggs, Greek yogurt and other dairy products

Zinc
Zinc is essential to a healthy immune system, which is of even greater concern on the courts lately.
Great Shots: legumes, seeds (especially pumpkin seeds), chickpeas/hummus, whole grains like oatmeal, shellfish

Calcium
Calcium is essential for bone strength, and for that winning smile in your medal photos. Traditional American dairy sources can easily be replaced with plant sources.

Great Shots: broccoli, dark leafy greens like kale and collard greens, legumes, calcium-fortified beverages like orange juice and soy beverages, dairy products, canned sardines or salmon with bones

By switching to a plant-strong diet, you may just gain the edge you’ve been looking for on the court!

Brandi’s Summer Salad
1 can black beans, rinsed and drained
1 cup jicama
1 red pepper, finely chopped
1 cup baby spinach, chopped
1 cup fresh or frozen corn kernels
1 can chickpeas
Juice from 2 or more limes
Combine all ingredients, and season with salt and pepper. Chill and devour. Serves 4.
Nutrition Information: 12 grams protein, 3 mg iron, 52 mg vitamin C

Powering Your Brain for the Mental Game

Powering Your Brain for the Mental Game

You had another lousy day on the court. You keep yourself physically fit and practice dinking diligently, but for some reason your mind hasn’t been in the game. Maybe it’s time to focus on how you’re fueling your brain.

Decades of research supports the fact that people who eat healthfully feel better mentally. Athletes who regularly consume the following foods may just get the cerebral edge over a less kitchen-savvy player.

Water: Dehydration can affect psychomotor learning, exercise performance and mood. Simply staying hydrated will help you stay alert and may keep you from becoming that grouchy club member no one will play with anymore.

Best Bets: Your kidneys will thank you for drinking plain water, but most drinks count toward staying hydrated, including milk, juice, tea and even coffee. Sports drinks can be a good choice on longer-play days when you’re sweating a lot, especially if you’re not taking the time to replace electrolytes with foods.

​Healthy Fats: Omega-3 fatty acids help the nervous system run smoothly and can reduce inflammation in the brain. In the long term, this aids in prevention of mood disorders, Alzheimer’s disease, and dementia.

Best Bets: Walnuts, Flax Seed Meal, Chia Seeds, Canola Oil, High Omega-3 Eggs, Sardines and Salmon.

Carbohydrates—yes, they can be good: Carbohydrate is the brain’s preferred fuel source. Simple carbohydrates are easily digestible and can offer quick energy. This can be beneficial when athletes are using a lot of fuel on tournament days. However, too many simple carbohydrates can lead to health problems over time, including unintentional weight gain. Complex carbohydrates are slowly digested, doling fuel into the body steadily, thereby helping to control mood swings.

Recent research shows an incredible connection between gut health and mental health. A healthy gut has a balanced variety of probiotics, or beneficial bacteria. Many complex-carbohydrate foods are also “prebiotics” or “microbiota accessible carbohydrates” (MACs), fancy words for foods that feed probiotics. Without MACs, our probiotic friends can’t thrive and produce neurotransmitters that promote mental well-being.

​Best Bets for quick energy: Fruit, Pasta, White Rice, White Potatoes, Sweetened Sports Drinks.

​Best Carbs for Gut-Brain Health: Bananas, Apples, Raisins, Berries, Beans, Lentils, Jicama and Whole Grains.

​Other MAC Foods: Asparagus, Dandelion Greens, Tomatoes, Spinach, Onions, Garlic, Leeks, Artichokes, and Jerusalem Artichokes.

​Vitamins and Minerals: Along with the rest of your body, the brain depends on a wide variety of nutrients to function well, including vitamin E, B vitamins, and flavonoids. Our bodies generally process these best when they come directly from food. Scientists know there are a great number of nutrients in food that we haven’t yet discovered, which means you couldn’t possibly get the same benefit from a vitamin pill or powder that you would from a serving of broccoli. Think about supplements as the back-up plan, not as your main source of nutrients.

​Best Bet: A plant-strong, varied diet. The Mediterranean Diet and The Mind Diet are both excellent, scientifically proven diet plans.

​Routinely adding these foods to your kitchen can volley the clarity needed to drop the third shot, execute that Erne, and maybe even remember the score.

In a Pickle - Eating for a Healthy Recovery

In a Pickle - Eating for a Healthy Recovery

Hmph. That’s the pouty sound I make from the sidelines, nursing a knee injury. Here I sit waiting for surgery day, watching my husband use what was supposed to be my birthday present—boot camp classes with Tyson McGuffin. Hmph.

What can I do? Plot revenge for hubby’s birthday, of course. Then I’ll stop the pouting and plan meals for a healthy recovery.

Good food speeds healing. Here are some nutrients on which I’ll be focused, and lists of excellent sources for each. Some of the foods overlap, making them efficient options.

Protein - Extra protein is needed to repair injuries.
Sources: Beans, beef, chicken, chickpeas, dairy, eggs, lentils, pumpkin seeds, salmon, sardines, and soybeans

Vitamin C - Great for repairing tissues, including ligaments, tendons and wounds.
Sources: Asparagus, bell peppers, broccoli, Brussels sprouts,
papaya, pineapple, spinach and strawberries

Zinc - This mineral is important for keeping the immune system functioning well.
Sources: Asparagus, beef, cashews, chickpeas, lentils, oysters, pumpkin seeds, shrimp and spinach

Omega-3 - Healthy fats can help reduce excess inflammation.
Sources: Brussels sprouts, flaxseed meal, grass-fed beef, salmon, sardines, soybeans, walnuts

Fiber - Getting enough fiber fights constipation caused by pain meds and being more sedentary.
Sources (includes foods that feed friendly gut bacteria, a.k.a. prebiotics): Apples, artichokes, asparagus, barley, chickpeas, flaxseed meal, garlic, jicama, lentils, oats, onions, spinach, sweet potatoes and whole wheat

Thoughts on Supplements
While our bodies best absorb nutrients from real food, adding supplements may be helpful if we can’t meet recommendations. Choose products that have been tested for content by an independent third party, such as USP, and ask your doctor which supplements are safe for you.

See you back on the court very soon!

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Brandi Givens has been a registered dietitian since 2010. Questions
or comments can be posted to her blog at www.abitdietitious.com.

Pain in Your Shoulder - It Won't Just Go Away Magically

Pain in Your Shoulder - It Won't Just Go Away Magically

Pickleball has provided an opportunity for people who played sports in their younger years to get back out there and enjoy the thrill of competition, while playing a sport that is social, fun, addictive and accessible! I’ve seen patients in the clinic who come to me with complaints of shoulder pain, often describing it as a subtle pain that started a few weeks back, but they don’t remember doing anything that would have caused an injury. They forget to mention that they’ve been playing pickleball six times a week for two to three hours each day!

The most common category of shoulder pain is called shoulder impingement. Impingement can be primary or secondary. A primary impingement is when there are anatomical structures in the shoulder causing pinching of tendons, bursae, and narrowing of the subaccromial space. Conditions like osteoarthritis, bone spurs, and certain types of acromion can cause primary impingement.

A dynamically unstable shoulder causes secondary impingement. This means that a combination of excess motion and decreased strength and stability around the shoulder is present, which in turn can lead to structures being compressed.

The shoulder joint is one of the most unstable joints in our bodies. In order to understand how impingement pathology can lead to more serious problems, it’s important to get a visual of the shoulder anatomy. With this article is a simplified picture of a right shoulder.

As you can see, there are a lot of structures under the acromion, including the bursa, and one of the rotator cuff muscles (Supraspinatus). In 80 percent of rotator cuff tears, the Supraspinatus is the muscle involved, and the reason is that it’s lodged in the tight space under the acromion.

A combination of both primary and secondary impingement is not uncommon, especially in people over the age of 60. Symptoms of impingement usually include pain with movement, especially at shoulder height, pain at nighttime and with lying on the affected side, reaching for the seatbelt, and pain with reaching behind your back or hitting overheads.

It’s important to stop performing painful activities when you have these symptoms, and consult a healthcare professional such as a physical therapist. Impingement can be corrected through an individualized rehabilitation program, but it won’t go away on its own. It’s crucial to shut down painful activities and start the healing process in order to prevent aggravation and possible tearing of the rotator cuff down the line. Fixing the mechanics and increasing the stability of the shoulder are key to avoiding further complications.

Most people train their upper bodies focusing on the main pushing and pulling exercises such as push-ups, pull-ups, bicep curls, tricep presses, etc. These exercises are not inherently bad, but they’re not enough in order to maintain a healthy and stable shoulder. Rarely do I see athletes incorporate rotational movements of the shoulders in their workouts. It’s no surprise that over time, this becomes a problem as there is an imbalance between the demands placed on the rotator cuff structures by the sport (for example hitting an overhead), and the strength and stability of the rotator cuff musculature.

The rotator cuff is comprised of four different muscles: the Supraspinatus, Infraspinatus, Teres Minor, and Subscapularis, and are sometimes referred to as the “S.I.T.S.” muscles. These muscles surround the shoulder joint and provide stability of the humeral head inside the socket as our arm moves through the range of motion. Unlike the hip joint, which is a stable deep “ball-in-socket” type of joint made to bear a lot of weight, the shoulder socket is a very shallow joint that relies on ligaments and muscles for its stability. This means the rotator cuff musculature plays a vital role in stabilizing the shoulder during dynamic movements.

This is why it’s imperative to incorporate rotational movements in a strengthening routine, and to develop appropriate strength in the rotator cuff in order to avoid chronic shoulder pain and injury. If you would like to see some examples of rotational strengthening, visit www.thepickleballdoctor.com and go to the Strengthening tab to see a video demonstration of beneficial exercises. Always consult a professional, and preferably a qualified physical therapist, if you are unsure about how to strengthen your shoulder.

Playing pickleball with pain in your shoulder is not normal, and should be addressed. There are many techniques and treatments available these days to alleviate shoulder pain and get you back to playing without pain, and with improved strength and stability. Please don’t ignore the problem thinking it will get better with time. This method has been tested and doesn’t work. Be proactive and take control of your health—it’ll pay in the long run! If you have any questions, contact The Pickleball Doctor at thepickleballdoctor@gmail.com.