Shoulder injuries and diseases


Tennis sports and shoulder


Introduction: the shoulder and tennis sports:
Tennis is one of the best sports to be analyzed scientifically due to shoulder injuries. Injuries and overload are very common in tennis sports. The shoulder is the - anatomically - central region in tennis sports. Besides back/ vertebral problems and problems of the thigh the thirdmost affected area in tennis players is the shoulder.


Normal shoulder adaptions in tennis sports:
Shoulder´s range of motion of the dominant arm in professional tennis players is changed in that way, that external rotation is increased while internal rotation is diminished. The overall range of motion is diminished at the dominant arm. A lot of motion comes out of the thoracic spine. Muscular dysbalancies have to recognized and treated early.


Tennis and shoulder sprains:
Due to overload a lot of muscular and ligamentous sprains happen, mostly in young tennis players.


Tennis and internal impingement of the shoulder:
In professional tennis players internal impingment is one of the main problems. Which means that structures like the posterosuperior labrum and supraspinatus tendon are impinging between the humeral head and bony posterosuperior glenid rimb, while turning the arm and shoulder to the side combined with an external rotation. In that way partial tears of the supraspinatus tendon and wear of the glenoid labrum occur. A concomitant instability might be observed, also. Working in and above shoulder level is painful for these tennis players. Treating these pathological changes arthroscopically about 80% of the players can return to tennis sports and get their preinjury activity level.


Tennis and shoulder instabilities:
Another main group are shoulder instabilities. Complete dislocations are rare. Most of the instabilities develop due to overloading and microtraumata over years. A wear of the glenoid and / or stretched anterior or posterior shoulder capsule will deveolp. Multidirectional instabilities are a special subgroup. Main symptoms are pain, snapping, instability feeling or numbness in the affected shoulder and arm. Cracking or snapping might occur, also. Special therapy programms are created to treat these instabilities. Otherwise, if nonoperative therapy fails an arthroscopic operative procedure will be performed. Arthroscopic treatment like capsular plication, rotator cuff debridement, labral suturing are used, depending on the individual pathology.


Tennis and biceps tendon problems:
About 8% of all tennis players, especially the older amateur, are showing a rupture of the long head of the biceps tendon. Most of the these biceps tears are compensated by the human body. Rarely, diminished range of motion or loss of power will be observed in these patients.


Tennis and nerve compression / unclear shoulder pain:
Sometimes a nerve compression of the suprascapular nerve occurs in tennis players. A concomintant cyst may be the reason for it. This is called a compression neuropathy. Diagnosis is made by exclusion.


Tennis and arthritis of the shoulder:
Recent studies have shown that longtime tennis players might experience an arthritis of the shoulder.


Tennis and SLAP lesions:
Another reason for shoulder pain in tennis players might be a SLAP lesion.


Tennis and the scapula / bladebone:
An important area for shoulder pathologies is the bladebone / scapula, also.
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