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Health & Exercise Forum

Prevention of Shoulder Injuries in Tennis: Stabilizing the Shoulder. Part II of III

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May 10, 2009

Dr. Paul MackareyThe winter and spring seasons present a great opportunity to work on your tennis game. You may be able to do this even if you’re busy with other sports in order to prevent serious shoulder problems when you jump back into tennis full force for the spring, summer and fall seasons. In a sport that relies so heavily on the use of the shoulder, it is very common to develop occasional shoulder pain or a more chronic problem such as shoulder rotator cuff tendinitis.

Last week, in part one of “Prevention of Shoulder Injuries in Tennis,” I presented the basics principles of strengthening the large muscles of the shoulder. This week will demonstrate how to stabilize the important scapula muscles and smaller muscles of the shoulder such as the rotator cuff.

The shoulder stabilizer muscles connect the arm to the torso. They serve as the foundation of the arm helping to stabilize the arm to the torso. The many stabilizing muscles include the trapezius and the rhomboid muscles. Exercise for theses muscles include: shrugs, T’s and Y’s.

Shoulder Shrugs Standing

Holding a 5-10-15-20# weight in both hands

Keep arms at side with elbows straight

Shrug shoulders up, hold 5-10 seconds & repeat

T’s

Lying on belly in crucifix position – shoulders at 90 degrees

Hold 1-2# weight in each hand with palms down

Keep elbows straight and pinch shoulder blades together. Your shoulder blade muscles will lift your arms up off table 4 inches, making a "T."

Hold 5 seconds & repeat.

Y’s

Lying on belly in crucifix position

Except shoulders are at 120 degrees (not 90)

Hold 1-2# weight in both hands with thumb up

Keep elbows straight and lift arms up toward the ceiling, making a "Y."

This will lift your arms up off table 4 inches.

Hold 5 seconds & repeat.

The rotator cuff muscles have many functions. They are essential for the stability and proper function of the shoulder joint. In tennis they serve to work in cooperation as the accelerators and brakes during the backswing, impact and follow-through of the forehand, backhand and serve. Exercises for the rotator cuff muscles include internal and external rotations.

NOTE: These muscles are very weak require only light weights or light resistance bands at slightly faster speeds to improve strength.

Shoulder Internal Rotation

Turning the arm in is stronger than turning out and usually requires 50 to 75% more weight/resistance. Start with red or green band/tube.

Tie resistive tube to a doorknob.

Standing with arm at side, bend elbow at 90 degrees.

With band on outside, turn arm in toward belly

Shoulder External Rotation

Turning the arm out is weaker than turning in and usually requires 50 to 75% less weight/resistance. Start with yellow band/tube.

Tie resistive tube to a doorknob.

Stand with arm at side, bend elbow at 90 degrees.

With band on inside, turn arm out away from belly

Training

Training should be performed every other day with a day’s rest in between. A ten-minute warm-up such as light jogging followed by mild stretching is suggested before playing. Also, after exercise and hitting, a ten-minute cool down with an ice pack is valuable to prevent pain and inflammation.

While exercise is essential for conditioning the shoulder in the off-season, it is important to talk to your tennis professional to develop a graduated hitting program focusing on proper form and technique. It is also important to ask about proper grip size, racket style and string tension.

Visit your doctor regularly and listen to your body.

Contributor: Gary E. Mattingly, PT, PhD: Professor, University of Scranton, Dept. of Physical Therapy, Shoulder Rehab Specialist, Mackarey & Mackarey Physical Therapy