Tennis Shoulder

March 20, 2021

By Josh Guyer, PT, DPT

tennis serve shoulder

Another aggravating injury similar to tennis elbow, tennis shoulder proves to be just as agonizing and debilitating when it comes to playing the game and can force any tennis player to miss the competition. Pete Sampras had to withdraw from the 1992 Australian open due to shoulder tendon issues. Andy Roddick was pulled in the 2008 French Open due to shoulder pain. Nadal from the Shanghai Masters in 2010. Novak Djokovic from the Western and Southern Open Final in 2011. Many competitive players may deal with this issue at some point in their careers. You dread playing your next tennis match because your pain is persistent and lingering, and it isn’t a question anymore of if it will present itself while you play, but how severely it will present itself and impact your playing time. Sure, you may be able to play through the pain on occasion, but eventually, you may decide that enough is enough. Physical Therapy may be beneficial to help improve your symptoms and return to playing tennis pain-free. 

What Is Tennis Shoulder?

Tennis shoulder is commonly an overuse injury to tendons in the shoulder due to repetition of activity. Swinging a tennis racquet repetitively, especially overhead activity including serving, can lead to inflammation of tendons which leads to prolonged, painful symptoms. Serving is one of the most energy-demanding strokes in tennis and can account for over half of all swings performed in competition. Instability, weakness, or even tightness of the shoulder can lead to these issues, with the demand of the activity outweighing the muscles’ capacity to tolerate the load that is placed on it. Continuing to participate in activities that aggravate the shoulder will continue to prolong inflammation and painful symptoms.

shoulder impingement

How Is It Treated?

Modifying the duration and intensity of activity will be important to allow healing of injured shoulder tendons. Continuing to overload the shoulder will prolong inflammation and worsen pain without proper healing of injured shoulder structures. Acute pain can be managed well with ice and over-the-counter anti-inflammatories, including Ibuprofen, with other topical agents for short-term pain relief a consideration as well. Following management of acute painful symptoms, a structured exercise program to improve shoulder muscle function will be necessary to improve tolerance of high loads placed on the shoulder during activity. An appropriate exercise program will involve activities that address specific deficits of the shoulder and upper extremity that may be discovered through a Physical Therapy evaluation.

How Can Physical Therapy Help?

A proper examination and evaluation are important to dictate the appropriate treatment of your current condition. An evaluation will look at treating the localized area and the surrounding body regions that may impact your painful symptoms. The evaluation could include range of motion and strength of the neck, elbow, wrist, chest and back, and the shoulder. Other examination metrics include posture, joint mobility, soft tissue tension, shoulder and swing mechanics, and special testing to rule in or out a major injury in the shoulder.

The shoulder is one of the most mobile joints in the body, and more mobility can sometimes equate to sacrificing stability which can be a major issue at the shoulder. The rotator cuff muscles in the shoulder are responsible for stabilizing the shoulder during active movements and can be compromised if they lack the appropriate strength to meet the demands of the activity. 

After determining that rotator cuff tendonitis is the potential culprit contributing to your painful symptoms, a progressive strengthening program will be implemented to meet the needs of your sports activity. Muscles and tendons were designed to be loaded, and often injury tends to occur due to too much load placed on them. An appropriate strengthening program will load muscles and tendons, beginning with a lighter load and progressively increasing load as they start to adapt to the resistive challenge. Other deficits will additionally be addressed, including exercises for shoulder instability, manual therapy for mobilizing tight joint structures and improving soft tissue tension, modalities and devices to manage pain including taping, and effective hands-on care for other deficits that may be present.

TRX row shoulder

If pain limiting your ability to play tennis call or text today for thorough evaluation and individualized treatment. We have two physical therapy clinics around Portland to serve you. Contact our Sherwood clinic or our Bethany clinic.

Josh Guyer grew up in Central Oregon and graduated from the University of Portland in 2013. His professional interests extend to tennis and golf with over 10 years of experience in both sports, winning an Oregon high school tennis doubles state championship. He has interests in orthopedics and sports medicine, treating athletes of all ages, prevention and wellness, and post-surgical rehabilitation. Josh has a strong commitment to promoting health and wellness and tailors his care to meet each patient’s needs and goals.

 

 

 

 

 

 

 

 

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