Shoulder pain in tennis players is a problem. Research has found that up to 50% of “middle aged” players and 24% of “juniors” will experience shoulder pain as a result of participating in tennis.
This is, in part, due to the huge amount of forces that are placed on the shoulder, primarily during the serve. The cocking (drawing the arm back) and acceleration (swing through) phases. The rotator cuff muscles are required to work in a number of ways to help provide stability to the shoulder joint as well as contribute to power generation and then slowing the arm down after making contact with the ball.
Types of Rotator Cuff Tear Injuries
There are four types of rotator cuff tear that affect tennis players:
- Articular sided tears – tears affecting the bottom side of the tendon. Can be linked to problems around “impingement” and are more commonly seen in younger players
- Chronic tendinosis, intra-substance or bursal sided tears – the rotator cuff tendons have been shown to consist 5 layers. Repeated stress can cause a splintering between the layers or a tear to occur on the top side of the tendon. Generally linked to overuse situations and more likely seen in the middle aged player
- Acute Tears – may be partial or full thickness tears that usually are linked to a specific serve or stroke. Most commonly affect the middle aged player
- Degenerative tears – may be partial or full thickness that typically affect the older player
Signs and Symptoms of Rotator Cuff Tear
Whilst signs and symptoms of rotator cuff tear will vary between age, type and severity there are some consistent findings. Primarily symptoms will be driven by pain, weakness of the shoulder, and increase in fatigue of the shoulder and a loss of range of movement in the more significant tears.
Specifically on court you may notice that your playing endurance reduces, your service speed reduces and you may notice a lack of ball control.
Location of the pain varies too. Pain at the back of the shoulder may indicate more infraspinatus and/or teres minor. Pain over the outside and top of the shoulder when lifting the arm often indicates supraspinatus involvement and pain at the front might suggest subscapularis
How Do You Treat Rotator Cuff Tear Injuries?
There are several factors that decide the best course of action when it comes to treating rotator cuff tear injuries. A persons age, sporting ambitions, level of pain, impact on function and the type of tear to name a few.
In most instances, beginning with a course of physiotherapy in order to start rehabilitation is the first port of call.
Rehabilitation will be centered around optimising tendon healing, improving strength and proprioception and restoring normal ranges of movement in the shoulder. It is also important to ensure that the lower limbs and core musculature is functioning well in order to reduce demands on the shoulder during play.
It is highly recommended that you consult a medically trained professional prior to commencing any rehab programme in order to ensure you are participating in the most appropriate exercises. Below are some videos that help to develop tendon healing and form part of the rehabilitation process and help to overcome rotator cuff tears.
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