Injury Prevention: Shoulder Health … Function Follows Form

September 22, 2010 | By Dr. Eric Price
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Proper form is essential to maintaining a healthy shoulder while playing tennis. During a tennis serve and stroke, power comes from the legs and transmitted to the racquet via what is known as the kinetic chain. Power is generated from the legs, passes through the core, then the shoulder, elbow, wrist, and ultimately, to the racquet. When players have poor form or a weak link in their kinetic chain, they compensate by trying to generate more power by using the shoulder and arm. Core and leg strengthening are essential for maintaining proper form and longevity in tennis. Exercises such as yoga and plyometrics serve as excellent complements to a player’s off-the-court training regimen as they will strengthen the core, and improve balance and power.

A healthy and strong rotator cuff is important for tennis. Exercises to target the rotator cuff with a resistance band or weights can improve strength; however, the shoulder cannot adequately compensate for a weak midsection and poor leg strength. The shoulder will become overtaxed, and ultimately, will suffer injury.

The best initial response to pain in the shoulder is rest, ice, and anti-inflammatory medicines (as allowed by your doctor). If these measures fail to relieve pain, a visit with an orthopedic surgeon who specializes in sports medicine is the next step. X-rays and usually an MRI will be done. Medicines may be prescribed, and a cortisone shot may be given. Physical therapy will often be prescribed in order to strengthen the muscles in the shoulder and the kinetic chain. Occasionally, an MRI will show a rotator cuff or labral tear. Surgery may then be recommended. Surgery may also be an option if patients fail to improve without surgery even if no tears are present.

The most common shoulder problems in tennis players are bursitis, rotator cuff tears, and labrum tears. The rotator cuff is a group of four muscles whose job is to elevate the shoulder. Surgery can be performed via a small surgical camera called an arthroscope to repair a torn cuff. The labrum is a tissue that surrounds the socket of the ball and socket joint that comprises the shoulder and if it is torn it can be repaired via arthroscopy. Occasionally, bursitis does not respond to physical therapy and can be addressed surgically as well. After surgery, physical therapy is essential for a full recovery.

Since poor form is the root of most shoulder pain, I recommend that those players who are serious about longevity in tennis evaluate their form via video analysis or a lesson with a tennis pro. Another way improve one’s form is to watch videos of a tennis professional whose style is similar to one’s own so that one can try to mimic their form. The key to avoiding shoulder injury in tennis is maintaining proper form, not playing through pain, and seeking the help of a properly trained specialist when an injury does occur.


Dr. Eric Price
Board Certified, Fellowship-Trained Sports Medicine Specialist

Dr. Eric Price is a board-certified, fellowship-trained sports medicine specialist with Orlin & Cohen Orthopedic Group. He takes care of all types of athletes, from pee-wee league players to pros and from weekend warriors to triathletes. As an athlete himself, he understands the need to get people back in their game. Dr. Price's expertise includes shoulder arthroscopy for repair of rotator cuff tears, dislocations, knee arthroscopy, including ACL and meniscus surgery. He also teaches shoulder arthroscopy as an Associate Master Instructor for the Arthroscopy Association of North America and as a Laboratory Instructor at several shoulder surgery conferences. For more information, call (516) 536-1212, ext. 213.

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