04 July 2017
Q: I’m a keen tennis player but I’ve had to stop playing due to shoulder pain. It is really painful when I play tennis, especially when I serve. Will resting improve it?
A: Tennis and other overhead sports place significant strains on the shoulder joint. Professional athletes incorporate core stability and specialist shoulder strengthening exercises into their training regimes in order to protect their shoulders. However, most club level tennis players do not, and many will pay the price.
The most common source of pain is the rotator cuff - a group of muscles and tendons which surround the inside of the shoulder joint. Their main role is to stabilise the shoulder joint, particularly during forceful overhead movements such as the tennis serve. Pain may be caused by cuff weakness leading to subtle instability or impingement, or by an injury to the rotator cuff tendons. Impingement occurs when the tendons are squeezed between the ball of the shoulder and the overlying bone as the arm is moved upwards.
It is essential to differentiate between a gradual onset of pain (either during or after playing tennis) and sudden shoulder trauma. With the latter, it is important to consult either a doctor or a physiotherapist in order to rule out a rotator cuff tear or other significant injury which may require early surgery. With more minor injuries, rest will often allow the pain to subside. However, an appropriate rehabilitation programme, preferably under the supervision of a physiotherapist will reduce the risk of a recurrence when you do gradually return to playing.
If your symptoms persist beyond six weeks, you should seek a medical opinion in order to obtain a firm diagnosis and consider further treatment options. A scan or an X-ray may be appropriate. If a rotator cuff injury is confirmed, you may require surgery, but in the vast majority of cases this should be a keyhole operation.
Mr Duncan Watkinson is a Consultant Orthopaedic Surgeon practising at Spire Portsmouth Hospital.
The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.