Just yesterday, the tennis world was shocked with the news that Serena Williams had to withdraw(opens in a new tab) in the first round of Wimbledon due to an injury. It initially was thought that she may have suffered an ankle injury when she slipped on the grass courts during her match. However, later on in the day, it was suggested that it was in fact a hamstring injury as opposed to ankle  injury.  

The hamstrings are comprised of a group of 3 large muscles: semimembranosus, semitendinosus, and biceps femoris. These muscles run from the pelvis, down the back of your leg, and insert  just below the knee joint. In general, these muscles function in knee flexion and hip extensions  and rotation. As with any muscle, a sprain occurs when more force is placed on the muscle than it can handle or when it is overstretched. This is most frequently seen in sports that require a quick acceleration or deceleration and jumping such as tennis, soccer, basketball, and track. Some predisposing factors that increase the risk of a hamstring strain include poor  flexibility/mobility, muscle imbalances, and prior hamstring injury. In Serena Williams’ case, there were likely multiple factors at play. Less than one month ago, during the French Open, she had the right thigh heavily taped, which is the same leg that was injured yesterday. Additionally, the quick stopping and starting required in tennis, plus the slippery surface of the  grass courts, could have led to excessive stretching and strain of the hamstring. 

Risk Factors

Interestingly, many of these same risk factors for hamstring injuries contribute to foot and  ankle injuries as well. For example, it is not uncommon for student athletes or active individuals who sit for prolonged periods of time at school or work to experience lower leg injuries such as  a hamstring strain, tendinitis, or plantar fasciitis. Whenever someone sits for a long period of  time throughout the day the muscle in the front of your hip called your hip flexors tighten, your  gluteal muscles weaken, and your hamstrings shorten and tighten. When this happens, your pelvis tilts forward causing the legs to rotate inward and your foot to roll in. It is this rolling of  the foot, otherwise known as pronation, that can lead to injuries such as plantar fasciitis and  tendinitis. In addition, having proper muscle balance can improve the stability around your joints and prevent muscles from getting overstressed and injured.  

Tips to Prevent Future Injuries

Therefore, it is important to address these issues early to prevent future injuries. It is important to work on mobility and flexibility, not only of the hips, knees, and ankle, but also the spine. This  can be done with various stretching exercises, in addition to using a foam roller and/or massage stick on a regular basis. Also, if there are prolonged periods of time spent sitting, try to get up to stretch and walk around at least once an hour or more if possible. Keep in mind, stretching should not be painful. Do not try to achieve an increase in flexibility by overstretching the muscles. It is also important  not to neglect strength and core training. Make sure to have a well-rounded training program in  order to ensure that the certain muscles are not overworking or being overstressed. There are also small muscles in the foot called intrinsic foot muscles that need to be strengthened to help with foot stability as well as provide better support for the rest of your body. Finally, don’t forget those  rest days. It is during this time that those muscles get a chance to recover from the damage they sustain during your workouts. If you don’t give them a chance to recover, they will be  more likely to get injured. This is something that Serena Williams is certainly going to need over  the next couple of days and weeks. Remember, everything is connected and must work together. If one area of the body is overly tight, weak, and not functioning properly, the body has to compensate elsewhere which is when an injury