Shoulder Pain : Tennis Injuries

The shoulder is an intricate part of the human body that provides motion for us via the shoulder girdle with ball (humerus) and socket joint of the shoulder blade. This girdle is made up of the collarbone (clavicle), shoulder blade (scapula), and shoulder joint (glenohumeral) bones that attach to the chest sternum, rib cage and spine, with four rotator cuff muscles and tendons that allow you to rotate your body. The shoulder is prone to injury in sports such as tennis because of the range of motion and the shoulder’s stability as a rotating platform also consisting of muscle forces, geometry of joints, and ligaments.

Symptoms of Shoulder Pain

Although not a condition, shoulder pain can be caused by shoulder instability, rotator cuff disorder, or frozen shoulder that affect different parts of the shoulder with separate sources of pain or discomfort. If you are playing tennis and you suddenly feel as if your arm is “dead" or “numb" with weakness or tingling, this may be a symptom of shoulder instability. More severe cases of shoulder instability involve pain when the arm dislocates out of position with swelling and bruising. Razor cuff is more easily identified because the pain is chronic and sudden, especially when reaching or lifting the arm above the head to serve the ball. Frozen shoulder occurs less rapidly and over time with aching, stiffness and increased pain at night, especially after a match. The stiffness sensations can worsen with muscle loss and limit use of the arm for normal daily activities.

Causes of Shoulder Pain

Striking a tennis ball involves a non-linear trajectory or swing path and repetitive force when hitting the ball that can cause stress to the shoulder girdle area and injury. Shoulder instability arises when the ball or humerus part of the shoulder joint is not moving properly in the socket of the shoulder blade due to an accident, or overuse and repetitive motion, like serving and splicing of the ball in tennis. Whereas rotator cuff is overuse of the tendon under the shoulder blade with inflammation caused by repetitive lifting motion of the arm. The cause of frozen shoulder is when the tissue surrounding the shoulder joint swells leaving less room for the humerous (ball) of the shoulder joint to move.

Medical Treatment and Prevention of Shoulder Pain

A medical examination by your local doctor or physiotherapist will provide diagnosis for the type of shoulder pain injury. Doctors discuss symptoms with you while identifying the areas of pain from arm movements. An X-ray may also be needed to isolate the cause.

Depending on the diagnosis, there are a number of treatments to consider, such as resting the arm, taking painkillers and anti-inflammatories, using an ice-pack on the pain site, doing physiotherapy to strengthen the muscles, and in severe cases to undergo surgery. Even though you can use paracetamol over-the-counter medication, it is recommended that you see a doctor to advise you on your current health status and what type of anti-inflammatory might best reduce the swelling and pain.

For frozen shoulder, corticosteroids injections are sometimes given into and around your shoulder joint to reduce symptoms. Some doctors also provide gentle exercising movements while under local anaesthetic to prevent muscle wastage by keeping the joint moving. If the shoulder is dislocated, the doctors may use reduction technique to reinstate the shoulder joint. Physiotherapists can provide thermotherapy or cold packs, massage and transcutaneous electrical nerve stimulation (TENS).

Surgery for rotator cuff and shoulder instability is a last resort. Always consult your doctor if you experience shoulder pain for the correct diagnosis and treatment to prevent severe shoulder injuries. Taking advice from a physiotherapist can also aid in understanding how best to rotate the arm and strengthen muscles to reduce injury.