shoulder

  With the US Open over, it is now time to focus on any shoulder problems you may have and how to play injury-free in a sport that you may be playing all year round. Tennis injuries can occur in players at all skill levels.  One of the main causes of injuries is the inability of a body part to withstand the demands placed on it, which often results from either lack of training or training too much.  In my last column I wrote about tennis elbow, which is usually seen in novice players, as opposed to advanced players, because it is likely to be caused by either improper technigue or equipment - things that you learn with time and guidance.  Here are a few tips on how to prevent injuries from occurring on the courts:

1. Make sure you have the right grip size and string tension with your racquet.  This can minimize a great deal of the stress put on your shoulder and elbow.

2.  Do some gentle shoulder stretches to warm up your muscles, holding each stretch for 30 seconds.

3.  Next hit tennis balls inside the service boxes to help build racquet heard speed and control, to prepare for hitting longer swings from the baseline.  

4.  Strength training is essential in the shoulder, both of the shoulder blades and the rotator cuff muscles. 

5. Prepare for the ground strokes with good footwork.  Avoid hitting the ball too late to prevent stress on your shoulder by swinging back the racquet early.  

6.  Shoulder injuries are very common in tennis.  As with overhead athletes like basketball players, tennis players often lose internal rotation range of motion, which can predispose the shoulder to injury.  Stretching exercises are critical.  

7.  Target Muscles: The muscle groups targeted in this conditioning program include:
     • Deltoids (front, back and over the shoulder) 
     • Trapezius muscles (upper back)
     • Rhomboid muscles (upper back)
     • Teres muscles (supporting the shoulder joint)
     • Supraspinatus (supporting the shoulder joint)
     • Infraspinatus (supporting the shoulder joint)
     • Subscapularis (front of shoulder)
     • Biceps (front of upper arm)
     • Triceps (back of upper arm)

8. Here are a few of exercises to begin with:

1.. Standing Row ____________________________________________________________________
Main muscles worked: Middle and lower trapezius 
You should feel this exercise at the back of your shoulder and into your upper back 
 Equipment needed: Use an elastic stretch band of comfortable resistance. As the exercise becomes 
easier to perform, progress to 3 sets of 12 repetitions. If you have access to a  tness center, this 
exercise can also be performed on a weight machine. A  tness assistant at your gym can instruct 
you on how to use the machines safely.
Step-by-step directions
• Make a 3-foot-long loop with the elastic band and tie the ends 
together. Attach the loop to a doorknob or other stable object.
• Stand holding the band with your elbow bent and at your side, as 
shown in the start position.
• Keep your arm close to your side and slowly pull your elbow 
straight back.
• Slowly return to the start position and repeat.
Days per week
3
Repetitions
3 sets of 8
Tip Squeeze your shoulder blades together as you pull.

2.. External Rotation With Arm Abducted 90° ___________________________________________
Main muscles worked: Infraspinatus and teres minor 
You should feel this exercise at the back of your shoulder and into your upper back 
Equipment needed: Use an elastic stretch band of comfortable resistance. As the exercise becomes 
easier to perform, progress to 3 sets of 12 repetitions. If you have access to a  tness center, this exercise can also be performed on a weight machine. A  tness assistant at your gym can instruct you 
on how to use the machines safely.
Step-by-step directions
• Make a 3-foot-long loop with the elastic band and tie the ends 
together. Attach the loop to a doorknob or other stable object.
• Stand holding the band with your elbow bent 90° and raised to 
shoulder-height, as shown in the start position.
• Keeping your shoulder and elbow level, slowly raise your hand 
until it is in line with your head. 
• Slowly return to the start position and repeat.
Days per week
3
Repetitions
3 sets of 8
Tip Make sure your elbow stays in line with your shoulder.

elbow problems

The best way to prevent tennis elbow is to stretch and strengthen your arm muscles so that they are flexible and strong enough for your tennis game.

Try warm-up activities for your arm:  finger oppostion: touch your thumb to each finger, one finger at a time.  Repeat 20 times.
Next place your forearm on your thigh, palm up in a very light fist and make slow controlled circles.  Repeat 20 times.  Lastly, place your hand palm down on your
thigh.  Flip your hand over so the back of your hand rests on your thigh and your palm is up.  Repeat 20 times.
Next is a stretching exercise:
  1. Extend your arm in front of you with your palm up.
  2. Bend your wrist, pointing your hand toward the floor.
  3. With your other hand, gently bend your wrist further until you feel a mild to moderate stretch in your forearm.
  4. Hold for at least 15 to 30 seconds. Repeat 2 to 4 times.
Strengthening exercises are:

Ball or sock squeeze

  1. Hold a tennis ball (or a rolled-up sock) in your hand.
  2. Make a fist around the ball (or sock) and squeeze.
  3. Hold for about 6 seconds, then relax for up to 10 seconds.
  4. Repeat 8 to 12 times.
  5. Switch the ball (or sock) to your other hand and do 8 to 12 times.

Wrist deviation

  1. Sit so that your arm is supported but your hand hangs off the edge of a flat surface, such as a table.
  2. Hold your hand out like you are shaking hands with someone.
  3. Move your hand up and down.
  4. Repeat this motion 8 to 12 times.
  5. Switch arms.
  6. Try to do this exercise twice with each hand.

Wrist curls

  1. Place your forearm on a table with your hand hanging over the edge of the table, palm up.
  2. Place a 1- to 2-pound weight in your hand. This may be a dumbbell, a can of food, or a filled water bottle.
  3. Slowly raise and lower the weight while keeping your forearm on the table and palm facing up.
  4. Repeat this motion 8 to 12 times.
  5. Switch arms, and do steps 1 through 4.
  6. Repeat with your hand facing down toward the floor. Switch arms.

If you are feeling soreness or elbow pain, please don’t hesitate to contact me.
Sherry Madding, MS. MA, RPT, ATC
415-279-0092