With the Australian Open going on now, I have been thinking more about my love of tennis!

Tennis is a great workout and a stress relief.


–          Increasing bone density

–          Lowering percentage of body fat

–          Improving flexibility, coordination, balance

–          Strengthening muscle and improving muscle tone

The reason why I love this sport is because there are so many muscle groups being utilized in the upper and lower body.  It’s the best experience to feel the burn of your gluteus muscles, hamstrings, calves, quadriceps, pectoralis muscles, trapezius, biceps, triceps, forearms and shoulders.

Along with the benefits of tennis, injuries may also occur.  Andy Murray just announced his possible impending retirement due to a chronic right hip injury. My hope is that he holds out for a surgery after Wimbledon that could possibly stall his retirement!

There will be more about the hip later but I want to talk about the shoulder joint (glenohumeral joint), one of the most mobile joints in the body.   

Most shoulder injuries in tennis happen because of the excessive force that can be placed on the muscles, tendons, and ligaments associated with the shoulder joint.  If the shoulder muscles are weak or tight, or if there are imbalances, the motion in the shoulder does not happen correctly and the constant repetitive forces of tennis strokes may create problems and injuries over time. In 2008, Maria Sharapova took a hiatus from tour and withdrew from the U.S. Open Championships after undergoing surgery to repair her rotator cuff.

What bones make up the shoulder?

The clavicle (collar bone), humerus (upper arm) and scapula (shoulder blade) are the three bones that make up the shoulder.  This “ball and socket” joint is positioned between the scapula and humerus.

What muscles are important for shoulder movement?

The rotator cuff muscles are essential to helping with basic shoulder movement like raising your arms over your head, brushing your hair or serving in a match. The rotator cuff muscles are:

–          Supraspinatus 

–          infraspinatus

–          Subscapularis

–          Teres minor


An individual should seek attention for shoulder pain if there is difficulty raising the arm, trouble carrying or lifting objects, pain that lasts a few days to weeks, swelling or bruising around the shoulder, signs of infection( fever, redness or warmth of the area) or deformity of the shoulder joint.  A physician will do a thorough physical exam and may order imaging studies like an X-ray, ultrasound or MRI for a diagnosis.

In the shoulder, the muscles and tendons of the rotator cuff are surrounded by bone.  Injury to the muscles between the bones in the shoulder space may cause shoulder weakness and difficulty with maneuvers such as arm extension.


1) Rotator cuff problems- There may be inflammation of the tendons (tendonitis) connecting the muscles to the upper arm area or inflammation of the bursa, which is a fluid filled space causing bursitis 

rotator cuff tear may occur when the rotator cuff tendons disconnect from the bone.  Most individuals may notice stiffness and a limited range of motion with activities like throwing.   An achy sensation may be experienced at night or the individual may be awakened from sleep from the pain.

2)      Adhesive capsulitis or frozen shoulder- This syndrome is characterized when the joint capsule made of connective tissue is thickened and tightens around the shoulder. This may lead to loss of active range of motion (your own movement) and passive range of motion (motion with someone else is manipulating the arm). Pain may become constant eventually but sometimes may resolve over time.  

Individuals who have Diabetes or have recent surgery causing restriction of shoulder movement are at risk for this condition.

3)      Calcific tendonitis- Calcium crystals can sometimes settle within the rotator cuff tendons.

4)      Biceps tendonitis- Can occur at the front of the shoulder and pain is exacerbated by repetitive lifting and activity requiring raising objects over the head. Be careful with lifting weights!

5)      Biceps tendon rupture-A serious condition where there is acute worsening of pain, bruising and swelling as the biceps muscle separates from the joint. An audible “popping sound” may be heard.


6)      Osteoarthritis- The disintegration of smooth cartilage may result in bone spurs that may limit mobility.  Sometimes crepitus, a grinding or clicking sensation can be felt due to the rough cartilage surface.

7)      Rheumatoid arthritis- An autoimmune disease which can cause joint redness, swelling, stiffness and deformity.  See my previous blog for more information.

8)      Superior labrum anterior posterior tear or SLAP tear- This condition is common in athletes such as tennis and baseball players who throw overhead.  Swimmers and individuals who fall when the hand is extended can also sustain this injury.

9)      Polymyalgia rheumatica- This disorder which usually occurs in older individuals can cause muscle pain and stiffness in the neck, shoulders and upper arms due to inflammation but may also be accompanied by systemic symptoms like fever, weight loss and fatigue.

10)   Septic arthritis- Infection of the joint that can cause damage to the bone and cartilage. Draining the joint or surgical intervention as well as antibiotics are needed for treatment.

11)   Other serious causes may include heart attack, nerve injury, dislocated shoulder or tumor.


It depends on the cause for the shoulder pain. Individuals must seek medical advice before engaging in a treatment program. 

a)      Rest– Most of the time, this will be the first line of treatment to allow some acute inflammation to resolve however, prolonged periods of inactivity may lead to severe shoulder restriction like frozen shoulder.

b)      Heat can relax the muscles. Ice may reduce swelling but a physician or physical therapist should be consulted first

c)       Physical therapy may be important in alleviating pain and restoring strength, flexibility and function to the shoulder.

d) Nonsteroidal Anti-Inflammatory Drug (NSAIDs) like naproxen or ibuprofen may be used for a limited period under the guidance of a practitioner to treat bursitis, tendonitis, sprains and arthritis.

e)      A steroid injection in the shoulder may be recommended in some cases to help with reducing inflammation.

f)    Surgery may be recommended by a surgeon. 

I’m often guilty of carrying my heavy handbags while I am on the go around NYC which sometimes aggravates my shoulder. I’m sure you ladies can relate. I also need to make sure to be more aware of my repetitive shoulder movements when practicing my strokes and serves during tennis practice. Until the next Major Championship…..


Plum B et al. British Journal of Sports Medicine 2007; 41 (11)760-768.

Current Diagnosis in Rheumatology Second edition

Disclaimer:  This information is for educational purposes only, not as medical advice or as a diagnosis. This blog contains my personal opinion based on personal and clinical experience, tips from trainers, health coaches and lastly research. You should always consult with a doctor, nutritionist, or other healthcare professional to discuss your own health and lifestyle goals and regimen based on your medical history.  Please see your physician should you have any questions, symptoms, or any concerns. Thank you for reading!

Disclaimer:  This blog contains my personal opinion based on personal and clinical experience, tips from trainers, health coaches and lastly research.  This blog does not endorse specific treatments, procedures, products.  You should always consult with a doctor, nutritionist, or other healthcare professional to discuss your own health and lifestyle goals and regimen based on your medical history.  Thank you for reading!