Squash & Healthcare


Squash is often described as the quickest of all racketsports. Opposed to other racketsports, squash is played in a closed environment in which both players aren’t separated  from eachother by a net. The rubber squashball is hit directly or indirectly towards the front wall.

Squash is a sport with an average to high intensive interval impact which requires a lot of the aerobic stamina. Top level games consist for 50% of rally’s which last longer then 10 seconds. Pauses between rally’s are short and last about 8 seconds. The heartbeat rises quickly during the first minutes of the game and remains stable at a high level (150 -170 bpm). Temperature and metabolism wise, squash can be compared to an intensive stamina and running training.

Squash is a dynamic sport in which 2 players, further limited by the racket in their hand, have to share the same space constantly in quickly changing movement patterns, from spring to turning, constantly needing to adapt.


Impact analysis

Squash is a sport with an average to high intensive interval impact. Not only the hartbeatfrequence, but also the metabolism response while playingblood glucose,  squash can be compared to running. While playing, one will experience an increase in blood glucose, catecholamines, free fatty acids, growth hormones and a moderate rise of lactates.

During a game of squash, the body temperature will rise. To regulate this rise in temperature, heat is dissipated through evaporation on the skin surface, commonly known as sweating. The loss in fluids required to do this, has a negative impact on the ability to perform. For instance, a reduction in weight of about 2% (which is approx. 12 liters of fluids for someone weighing 70kg) would result in a performance loss of about 20%.

Cardiovascular aspects

There are indications that regular physical exertion can play a role in preventing cardiovascular diseases and could reduce the chance of a stroke. Several risk factors, such as blood pressure, bodyweight, cholestorol level and stress,  are influenced positively by practising sports.

Since when playing squash heartbeat frequencies of up to 90% of the predicted maximum heartbeat frequence can be found, over longer periodes, it might not be advisable for people with coronary diseases to play squash. People who might be in the risk category should be made aware of the dangers of over exterion. Consulting a physician for a checkup and a doctors sign of approval is recommended for the older squash player.
People of middle age with no former regular experience with sports, of a negative medical history, especially regarding coronary diseases, who wish to start playing an intensive sport like squash, could be considered a risk, especially if squash is a means to improve fitness. The intensive nature of squash, combined possibly with an agressive active demeanor on the part of the unpractised player, could result in overstepping the physical limits. In general, for people of middel age or above, a more relaxed demeanor is advised and playing up to and beyond the physical limits should be avoided.
Regular checkups, warming-up properly and a progressive buildup of stamina are important.
Every sport contains a risk element: for squash just as much as for other sports. Players with at least one risk factor (obesity, smokers, coronary diseases, family history of cardiac diseases) should be advised to take preventive measures to improve their stamina in general, warm-up properly and not smoke shortly after playing a match.

Overall, get fit to play squash, don’t play squash to get fit…

Injuries and squash

Nature and location of injuries

Several factors can influence the nature and location of injuries. These can be summarised in individually determined factors, training factors and environmental factors.
Individual factors consist of sex, age, experience, current stamina level and overall health. Training factors consist of technical prowess, duration and frequency of play. Environmental factors consist of equipment, floor and wall condition, circumstances, playing style, tactics and the behaviour of the opponent. Injuries can be classed in:

  • injuries originated from the racket (own or opponents)
  • injuries originating from the ball
  • injuries originating from other causes

Contact injuries

In squash, the players are close to eachother and have no own half of the court. Therefor, when swinging the racket, either before hitting the ball or on the follow through, a player can hit himself or the opposing player. This, depending on the speed of the swing and where the rackets hits the player can cause an injury.

Being hit by the ball is another common injury. Although painful, this commonly doesn’t result in a serious injury, with the exception of being hit in the eye. A squashball will fit in the eyesocket and cause great injury when hitting the eye. Furthermore, the ball on impact can cause a vacuum effect which could suck the eye out of the eye socket.

Players wearing normal glasses can  sustain injury to the eye when being hit by racket or ball. Wearing protective eyewear is a common and safe solution.

Finally, due to the close proximity of the other player, players can accidentally knock eachother over or trip one another.

Non-contact injuries

Injuries suffered while playing squash, not resulting from contact injuries, most frequently are sprained ankles and muslce injuries.


Regarding muscle injuries, typically the calf muscle, hamstrings or back mussles are effected. A ruptured achilles tendon also is not uncommon. Especially older players run a greater risk. Typically, the group of players ranging 40 and older are more prone to these types of injury.

A large portion of injuries suffered by over exertion are chronic back pains, chronic wrist pains, shoulder problems and the so called tennisarm. For the lower part of the body these comprise of knee pains, inflamed achilles tendon and chronic ankle pains.

Remarkable is that for the upper body, the most common overexterion injury is related to the wrist. Using an incorrect technique when hitting the ball, by using the wrist which leads to overstretching is the cause. Given that, however light, a squashracket has more weight then say a badmintonracket, and the squashball weighs more then a shuttle, overstraining occurs on the backside of the wrist.

Causes of injuries

The relavite high amount of injuries suffered in squash is causes by several factors. First of these is the natures of the game itself; 2 players in a small space while handling a racket, constantly needing to adapt to changing patterns of movement. The rules provide in stopping rally’s and requesting a let or stroke when one of the players feels the safety of himself or his opponent could be compromised. Unfamiliarity with these rules can lead to injuries, as players will risk injury to not lose a point, eventhough such risk, given the rules, is not required.

Another cause is the short recuperation time between rally’s. Officially, the time between two games (a game is analog to tennis’ set) is 90 seconds, which is the only time for real recuperation.

Injuries at novice level usually as caused by unfamiliarity with the rules, poor technical skills, inexperience and unadequate stamina. Injuries at advanced levels usually are caused by overexterion during play and training.

Preventing injuries

The most important preventive measures are:

  • beter awareness, knowledge and application of the rules
  • increased knowledge of and tactics and improved skills in hitting and moving
  • a strict and well balanced trainingprogram
  • wearing suitable shoes of the right quality

Squash shoes should provide plenty of support to the foot, the sole should have shock absorbing qualities. The profile of the sole should be such that it is non-intefering with quick turning movements. Most squash shoes have a circular profile on the sole.

The role of tapes and bandages remains uncertain. For players with chronic instability of the ankle, such measures can be of use. Warming up, cooling down and taping of sensitive, vulnerable joints can help improve performance.

Preventing eye injury, whether or not the player wears glasses, can be achieved by wearing protective eyewear. Protective eyewear can either be a pair of protective glasses or a full protective mask.

 Squash glasses Squash mask
Although most players are aware of the risk of eye injury, few wear protective eyewear. Most players feel this eyewear limites the field of view. Therefor, most players balance the small risk of a however grave injury and the advantage their opponent could have not playing with such eyewear in favour of not wearing protective eyewear themselves.

bron: sportzorg.nl