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2. Tennis Injuries - Rotator Cuff Tendinopathy

The Rotator Cuff is a group of 4 muscles and their tendons, which act to keep the upper arm inside the socket of the shoulder. These 4 muscles also allow you to rotate and lift your arms. In tennis, the shoulder, including these muscles, is involved in all strokes and is particularly prone to injury during serving and overhead movements. Shoulder injuries can be acute or from overuse, and rotator cuff tendinopathy can be classed as an overuse injury which tennis players are particularly prone to. This condition is the cause of between 30-70% of shoulder pain disorders!

What is Rotator Cuff Tendinopathy? 

As mentioned above, the rotator cuff is a group of 4 muscles located around the shoulder joint, 3 of the muscles sit on the shoulder blade, and 1 runs underneath the shoulder blade. They all attach onto the top of your arm bone, which forms the part that sits in the socket of the shoulder joint. When one or more of these tendons becomes irritated, it can cause pain, and left untreated can become a tendinopathy. This means that the tendon does not recover properly after exercise, in this case tennis, and can become more of a long-term issue if not managed correctly.

What Causes Rotator Cuff Tendinopathy?

This condition often develops over a long period of time and there may not be an initial injury that causes the symptoms to start. Tennis players and those who play sports that require lots of overhead movements can be particularly predisposed to developing rotator cuff tendinopathy due to the repetitive strain on the tendons.

Some other risk factors for developing rotator cuff tendinopathy are:

  • Prolonged awkward postures at work

  • Heavy lifting

  • Working with the hands above shoulder height

  • Being overweight

  • Muscle imbalances

  • Decreased flexibility

  • Lack of rest - this is very important to consider in tennis players!!

What are the Symptoms?

The main symptoms/features to look out for are:

  • Pain in the area of the rotator cuff tendons and tenderness in the shoulder joint - the pain will usually be dull in character and exacerbated in overhead reaching and reaching behind the back

  • Sleeping on the affected shoulder will likely be painful

  • Pain will not be sudden and will be of a gradual onset and will progressively increase 

  • You may notice some weakness of the affected shoulder, and there may be some swelling to the area

By taking a thorough history of the shoulder pain and performing some special tests, a sports therapist will be able to determine whether it is likely that the rotator cuff is the cause of shoulder pain and form an appropriate treatment and management plan.

How do we manage this issue?

The first step is to reduce pain, and it is very important that any activities that increase the symptoms are avoided in the initial stages. Sports therapists are equipped with several skills and techniques that can help with this! Once pain has settled, the next aim is to achieve normal movement and strengthen the shoulder and surrounding muscles. This should be done in a gradual and appropriate manner, as it is important not to overload too much too soon. Progressed incrementally, the exercises given by a sports therapist will become more sport-specific in the aim to get back to the tennis court!

Did you see our Tournament Ready Tips article? Click here to read it!

Here at SV Sports Therapy, we can help everyone dealing with tennis elbow by assessing their individual needs, using a variety of treatment methods and providing bespoke rehabilitation and management plans to get them safely back to normal activities, whether this be tennis or the day job!

Give us a call to book in with Emily on 02034944343 or email or you can also book online here.

She used to play county and regional Tennis and had a few trials for national and would love to serve you!


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