The Tennis Serve- from Shoulder Weakness to a Weapon through the help of a Physiotherapist 

Introduction

Mrs M has a passion for racket sports, particularly tennis. She had recently joined a new club, and had started playing more often. She decided to join the club league, which involved more match play, and therefore more serving than she had been used to in regular club sessions. She noticed after a couple of months of playing more often, that she was getting pain in her right shoulder, particularly when serving. She was also getting this pain sometimes when picking up her young kids, and her shoulder was feeling achy/heavy when sat at her desk at work. This pain had been worsening over the course of several months, and had not been improving with periods of rest and icing the shoulder, so she decided to see Natalie Carter, Physiotherapist at Proformance Clinics.

Following a thorough assessment, Mrs M was diagnosed with shoulder impingement syndrome, a painful condition of the shoulder that results from the inflammation and irritation of the structures (muscles and tendons) at the front of the shoulder; this is a common condition in racket sports players due to repetitive overhead movements, and often occurs with sudden increase in activity or overuse of the shoulder.

For Mrs M, a weakness of the rotator cuff muscles of the shoulder was identified, the assessment also highlighted increased tension around the shoulder blade and neck. This tension and weakness meant that Mrs M’s shoulder was not fully supported during overhead movements,  resulting in pain in the front of her shoulder when serving.

Hands on treatment

The initial phase of treatment focused on increasing the range of movement at the shoulder, neck and middle region of the back. Natalie used dry needling, sports massage and mobilisation techniques to decrease tension around the area and increase the range of movement at the joints. This treatment helped to improve movement and decrease pain, which allowed breathing room for strengthening work to be completed effectively; a light strengthening programme was also introduced at this stage.

Strengthening programme

Once the range of movement had improved after a few weeks, Natalie and Mrs M used the gym facilities at David Lloyd to further strengthen the shoulder. Mrs M was provided with a strengthening programme to focus on the strengthening of the rotator cuff muscles at the shoulder, but also to improve thoracic mobility (rotation of the middle of the back) and scapula (shoulder blade) strength, both are important in supporting the shoulder during the tennis serve.

End result

Mrs M took a graded approach back to playing tennis again, she started with 1 session a week and has now increased to 4 sessions a week. She is now pain free and reports she has more confidence in her serve than she has ever had before (she now considers it to be one of her best shots!!). Through advice, Mrs M has made sure she appropriately warms up her rotator cuff muscles before serving and she has maintained a shoulder strengthening programme twice a week, to reduce risk of injuring her shoulder again.