Shoulder Pain in Tennis Players

Tennis is a sport that demands an incredible amount of strength, stability, and performance out of one of the most unstable joints in the human body… the shoulder. Not only do you need to drive your shoulder through some truly incredible velocities with something like a serve, but you need to be able to control that power through finely tuned movements in multiple planes of motion with an almost endless list of types of swings. 

The demands on the shoulder are pervasive in tennis and because of this we have successfully treated endless amount of shoulder related injuries from the tennis players we see at Athletes’ Potential. However, through all these injuries that we’ve worked with, we have started noticing some trends in common strength deficiencies and biomechanical limitations that, when addressed, can have serious impacts on reducing injury risk and improving performance.  

Trend #1: Inadequate Shoulder External Rotation Range of Motion 

Arguably the most violent swing in tennis is the serve. To generate the amount of torque required for this swing, you need to have an appropriate amount of external rotation at your shoulders. 

The video below goes over a quick and easy drill to assess your shoulder external rotation. Essentially you should be able to lay on the ground and get the back of your wrist to the ground while keeping your low back pinned to the floor. 

Some common mistakes to avoid when doing this assessment include:

• Hitting the floor with the back of your hand and your wrist bent
• Letting your low back come off the ground 
• Not having your shoulder at 90 degrees (elbow at the same height as your shoulder) before externally rotating 

If you can’t bring your wrist to the ground, or you have pain when you do or feel like you really have to fight to get there, then try some of my favorite drills to improve shoulder external range of motion. 

Drill #1: Front Rack Opener

​Drill #2: Lat Stretch

​Drill #3: Upper Back Mobilization

Trend #2: Upper Back Strength 

In order to have a strong, effective swing you need to have a strong back. This may seem a little counter-intuitive, but let me explain. Your body is innately intelligent and it’s not going to let you produce more force than it feels it can control. Therefore, to have a better swing, you need to have a strong back to be able to eccentrically control your arm as you go through the swinging motion. 

Some of my absolute favorite exercises to make sure you have a strong upper back are listed below. 

Exercise #1: Deadlifts​

​Exercise #2:  Pendlay Row

Exercise #3: W, Y, Negative ​

Trend #3: Lack of Rotational Core Strength

Your power in your swing comes from having a strong core. If you don’t have a strong core, then you have no foundation to deliver a strong swing, and if you are trying to have a strong swing without a solid foundation, well, you’re begging for an injury. Check out my favorite exercise to improve rotational core strength. 
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Exercise #1: Med Ball Rotational Throws

​Exercise #2: Deadbug Pallof Press

​Exercise #3: Landmine Twists

If you’re a tennis player struggling with shoulder pain (and yes, even elbow pain) or are looking to improve your performance, these drills are a great place to start. They are the three main problem areas that we find ourselves addressing with the tennis athletes who come to us for help. However, If you’re dealing with an injury and want more guidance and help, reach out with any questions. We design and implement rehab and performance programs to help our athletes, whether you’re someone who doesn’t know where to start or has had an unsuccessful rehab experience. It is our goal for the people we work with to return to their sport or activity performing better than they did before.
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Thanks for reading, 

Dr. Jake, PT, DPT, CSCS