Shoulder Injuries

In tennis players, as in all sports where the ball is above the head, there is excessive load on the shoulder joint and surrounding tissues. The shoulder and elbow joints are subjected to excessive stress during movements such as the serve and overhead shots. Athletes, especially in serving, overhead smashes, and long strokes, should be knowledgeable about effective utilization of the kinetic chain. The term “kinetic chain” refers to the coordinated connection between the entire upper extremity (arm, elbow, and wrist) and the lower extremity (thigh, leg, knee, ankle). In other words, according to the concept of the kinetic chain, problems in the hip, groin, or abdominal muscles can increase the risk of simultaneous shoulder and upper extremity injuries.

The rotator cuff, also known as the rotator cuff muscles, plays a role in keeping the shoulder joint in its socket during shoulder movements. Excessive force on the rotator cuff during overhead smashes and repetitive serving can result in an inflammatory condition called tendinitis, leading to limited range of motion and, if left untreated, a challenging process known as “impingement.” Impingement can render a person unable to perform even simple daily activities. Impingement can occur outside the shoulder joint (subacromial) or within the joint itself. In the latter case, severe painful partial tears can develop in the portion of the rotator cuff muscles facing the joint. In cases of internal impingement, it has been observed that the outward rotation of the arms increases while the inward rotation is restricted.

In treatment, priority should be given to strengthening the inward rotation movement, the posterior rotator cuff muscles, and the scapular muscles.