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Alex Robertson
By Alex Robertson on December 11, 2023

From Sprains to Concussions: Exploring Squash's Most Common Injuries

Recently, we've seen a few injuries sustained on the PSA World Tour by some of the best players in the world. Given what they put their bodies through, injuries aren't unexpected per se, but, depending on the severity of the injury, they can put players out of the game for long periods of time.

It's never good to see something like this, but, given that squash is a very fast-paced and high-impact sport, injuries aren't exactly uncommon. In fact, this is the case amongst players of all standards, not just the pros.

I know plenty of other club-level players who are currently injured as I write this.

I've never really written about injuries in this article, so, for this week's article, I thought that I would cover some of the most often-seen types of injuries in squash, the common risk factors, why they tend to occur, and give some tips on how to reduce your risk of sustaining them too.

The purpose of this article isn't to scare you, it's just to keep you informed and aware of the risks of the sport, which might hopefully prevent one of you from getting injured in the future...

Just quickly before I dive in, I don't claim to be an expert on this topic. I've done a lot of research around the web for this blog post, but, I will still be keeping it pretty basic and surface-level.

If you have any deeper concerns about injury (for example, if you think you currently have an injury that may be getting worse, or, if you're worried that you're at risk of a specific injury, I would highly advise speaking to a qualified physiotherapist).

Just before I begin, I want to quickly list some of the most common risk factors for injuries in squash. Nobody is immune from injury, but there are particular elements that make some players more at risk of certain injuries than others.

Age (generally people aged over 40), poor fitness level, poor technique, lack of protective equipment (such as eye guards), prior or current injuries, and time spent playing all play a big role in increasing your risk of sustaining an injury.

I will touch on some of these risk factors when talking about specific injuries below too. So, here are some of the most common types of injuries that we see among squash players...

1. Strains & Sprains

Strains and sprains are frequent guests in the world of squash. 

Strains involve the stretching or tearing of muscles or tendons, while sprains affect ligaments. They often stem from sudden accelerations and abrupt stops (both of which are very common in squash).

Overstretching is also another pretty common cause that many squash players are unaware of.

The most susceptible areas include the ankles and knees, as these areas take a lot of impact during the high-stress movements made in squash.

I've had a few of these myself and, although frustrating, they're thankfully not too serious. Just remember that anyone is susceptible to these injuries, I had my first sprain from squash when I was around 12 or 13 years old from rolling my ankle.

According to the NHS website, sprains and strains will feel better after around 2 weeks, however, it's important to avoid strenuous exercise such as running for up to 8 weeks, as there's a risk of further damage.

It's also worth noting that severe sprains and strains can take months to get back to normal, so make sure not to get back on court too fast and take it easy.

One of the best ways to reduce your risk of sustaining a strain or sprain is by maintaining flexibility through regular and lighter dynamic stretching and ensuring a comprehensive warm-up routine.

2. Tears & Snaps

Tears and snaps refer to the rupture of ligaments or tendons, often causing significant pain and immobility. These are generally a lot more serious than sprains and strains and the recovery time can be very long.

The most common causes of tears and snaps are very heavy directional changes and sudden stops. Again, this makes them very common in squash.

Let's say your opponent sends you in the wrong direction and you have to shift all your weight and momentum to move in the complete opposite direction (fast), all of that weight and momentum can get pushed onto a very specific area of your body such as your ACL.

An ACL tear is certainly common amongst squash players, I've witnessed a few myself and it's not a pretty sight. It essentially renders your knee to become very unstable and lose its full range of movement. This injury often requires surgery.

The ACL is a strong tissue ligament located in the knee that connects your thigh bone (femur) to your shinbone (tibia). Most players know when they have snapped it as they hear a loud pop noise. After this, the knee usually swells up.

An Achilles tendon rupture is the other very commonly seen injury in squash. The Achilles tendon is what connects your calf muscles to your heel bone, and again, when it snaps, players often hear a pop noise and it feels like an elastic band has snapped in their heel.

This is an injury that USA pro Amanda Sobhy has had a nightmare with recently. Back in 2017, Sobhy had to take 10 months off tour to recover from rupturing her left Achilles. Last week (six years on), she then experienced the exact same injury in her right heel during her Hong Kong Open final against Hania El Hammamy.

She is now in a wheelchair yet again and everyone here at Control the 'T' Sports is wishing her a very speed recovery. The US star bounced back incredibly well from her first injury, and, she is renowned for her awesome mental strength. I'm certain that Sobhy will bounce back yet again.

I should also mention that the legs aren't the only area of the body that is susceptible to tears and snaps in squash. The rotator cuff is group of muscles and tendons that surround the shoulder joint, making it an area that is also susceptible to tears and snaps when you're swinging through the ball.

Recovery times vary hugely for injuries like these, it can be from months to years. But, if you take Sobhy's first injury duration of 10 months, then that's a benchmark to start with. Just bear in mind, that she will have had the best experts and physicians to help her recover.

One common prevention strategy for tears and snaps is to engage in targeted strength training to fortify the ligaments and tendons, reducing susceptibility.

Also, working on your movement is a must. If you're landing very heavily (especially when changing direction), it can put you at higher risk.

3. Impact Injuries (Primarily To The Head & Eye)

I've been on the receiving end of my share of impact injuries either from players running into me or hitting me with the ball or their racquet.

Generally, less severe impact injuries consist of cuts and bruises. I can't tell you how many times I've scraped my knee on the floor when doing a low lunge or ran into the wall accidentally.

Realistically, these aren't going to have much of an impact on your game, but, they're still worth considering!

Often, these injuries aren't pretty, but, they come with the territory of squash. You're in such close quarters with your opponent during a squash match that contact is pretty common.

Injuries to the head and eye can range from cuts and bruises to more serious things like concussions (which may come from clashing heads with your opponent for example).

I've seen a few older players experience concussions from either tripping or running into the side or front wall. It certainly happens a lot more than most people would like to think.

I've been hit with a racquet from an opponent's wild backswing before and, even though I was a junior wearing goggles, I got a pretty nasty black eye that swelled up and closed.

I tried to be a hero and carry on the match, but I lost quite convincingly after that.

The use of protective eyewear in squash is the topic of some debate. In most countries and competitions, players under the age of 18 are required to wear them, which I think is a good thing.

It's a choice for anyone older than that. Retired English squash pr Daryl Selby began to wear eyeguards after he was hit in the eye by a ball when playing against another pro, showing that these incidents do happen at the top level too.

I would say that the majority of players don't wear eyeguards in the adult game, the reason being that they can just be an extra distraction from the match. They can also fog up if you don't have a very good pair.

However, this does increase your risk of getting more serious damage to your eyes from the ball or racquet which can even result in blindness.

Generally, there isn't much else you can do to reduce your own risk other than making sure your movement is smooth and doesn't infringe on your opponent.

However, if your opponent is a dodgy mover or has a crazy swing, then you might want to try to keep a bit of extra distance too. This might make things harder for you in a match situation, but it's certainly better than risking an injury.

With regards to injury time, usually, the cuts, bruises, and black eyes won't stop you from playing for more than a week or so. However, if you have something more serious like a concussion, it is important to see a medical professional and rest a lot.


Photo credit: Steve Cubbins

4. Blisters

This one might seem a little trivial, but, I've seen some pretty brutal blisters on squash players! 

A blister is essentially when fluid fills a space between layers of skin, caused by friction between the skin and equipment. Often, they look like a layer of dead or pale skin. This skin on top is actually a protective layer over the location of the damage.

Risk factors and causes include repeated friction, poor movement, bad or old footwear, improper socks, bad or old racquet grip, and just generally playing a lot of squash.

However, you can do everything right in squash and still suffer from blisters, so, don't beat yourself up if you get one.

Feet and hands are generally the most common locations in which blisters occur in squash.

They're usually pretty minor, however, if you've ever had a blister on the bottom of your foot, you'll know how painful they can be.

They can really inhibit gameplay, and, if you don't let them heal, they will just keep coming back and getting worse the more you play on them. Generally, it should take no longer than a week or two to recover from a blister.

Some good prevention strategies include ensuring proper equipment fit, wearing moisture-wicking socks, and applying protective padding to potential blister-prone areas.

If you already have a blister, blister plasters also work pretty well at further protecting the damaged area.

5. Overuse Injuries

Overuse injuries are arguably the most frustrating. They result from repetitive strain on a specific body part without adequate recovery.

Constant repetition of certain movements, like excessive swinging, heavy lunging, and changes of direction can all lead to overuse injuries. Elbows, shoulders, and knees are the areas that are most prone to overuse.

Overuse injuries often don't cause huge amounts of pain, but, just enough pain to be a distraction. This is why many players just try to 'play through the pain' which is never a good idea as it often just makes things worse.

Some examples of overuse injuries are tennis elbow, carpal tunnel syndrome, tendonitis, shin splints, and runners knee.

They're usually quite hard to self-diagnose, so it's important to see a physio if you can to get your injury checked out.

Recovery times vary but may range from weeks to months, depending on the severity and how much you try to play through the pain, or, if you come back to the sport before you've fully recovered.

Of course, that is much easier said than done as none of us want to be away from the squash court for too long.

Prevention is pretty difficult, however, incorporating adequate rest periods into your training routine, diversifying your exercises, and listening to your body are all good ideas.

6. Dislocations & Breaks

Dislocations involve the separation of bones from their normal positions, while breaks are cracks (fractures) on bones, they can also be complete snaps of the bone as well.

Traumatic impacts, falls, changes of direction, and collisions can result in dislocations or breaks.

Collarbones, knees, fingers, and wrists are more prone to dislocations, while bones like the wrist and ankle are more susceptible to breaks.

And, again, recovery times vary significantly based on the severity. Dislocations don't tend to be as severe as breaks (although this isn't always the case), but generally, you're looking at months or years to recover from either of the two.

I've seen a very nasty knee dislocation first-hand that put a good friend of mine off of squash for life.

He got sent the wrong way by his opponent and, when he tried to change direction, he put a lot of pressure on his knee at a strange angle and it completely dislocated.

I was just arriving at the club at the same time as the ambulance and had no idea what had happened.

When I walked in I saw my friend on the floor in a lot of pain shouting at his girlfriend to 'take a picture', because of how crazy it looked. When we talk about it now, we both find that part pretty funny, but, he also says it was one of the most painful experiences of his life.

Thankfully, I've never seen any full breaks on the squash court, but, I've certainly heard some stories!

However, dislocations and breaks are a bit more rare in the world of squash, but, there are still measures you can take to reduce your risk of experiencing one.

Focus on overall body conditioning, including strength and flexibility exercises. And, again, try to make sure your movement is fluid and efficient.

If you have experienced one in the past, make sure to exercise with caution as it does increase your risk of repeating the same injury again.

This article was taken from our On The 'T' Newsletter, if you're interested in receiving more content like this, please feel free to sign up using the subscribe section located at the bottom left of this page (or underneath the article if you're on mobile), thanks!

Published by Alex Robertson December 11, 2023
Alex Robertson