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-   -   15 Months Post Op Labrum repair - Serve help (http://tt.tennis-warehouse.com/showthread.php?t=441867)

Javizzle 10-02-2012 12:52 PM

15 Months Post Op Labrum repair - Serve help
 
Hey guys,

So, I had surgery for a torn labrum about 15 months ago. I did all the rehab and stuff, and i have full strength and range of motion back.

I'm back to playing full tennis and everything (took a long time to progress the serve). But I find when i really try to pop a serve, it doesn't feel great. It's definitely wayyyy better (Now 2/10) from before (Pain level on serve around 7/10).

My serve is the weakest part of my game right now, so are there any tips on how to just make make shoulder slightly stronger so I don't have trouble on big flat or slice serves?

Also, maybe some techincal tips that might reduce pain?

Thank you!

Say Chi Sin Lo 10-02-2012 01:22 PM

Which labrum? Shoulder or hip?

If it's shoulder labrum, I can provide some insight. My posterior labrum was repaired for a partial tear and have since made a full recovery (and then some :) ).

Javizzle 10-05-2012 03:41 PM

Shoulder labrum, I just find that I can't get enough pop on my serve, and if I do it hurts...

floridatennisdude 10-06-2012 04:05 AM

Quote:

Originally Posted by Javizzle (Post 6937961)
Shoulder labrum, I just find that I can't get enough pop on my serve, and if I do it hurts...

Hmmm, that's a long time post op. I was serving lightly 5-6 mos post op and competing 9 mos after it. It was about a full year until I felt like my serve could be a weapon again. Are you near 100% rom in all other aspects? Still doing some throwers 10 2-3x a week?

One change to my swing that I made was to concentrate on keeping my elbow in a little bit more and really focus on swinging up. Tough to explain in words, but all I can say is do some experimenting. It makes sense to re-tool the service motion because that was likely the cause of damage.

Javizzle 10-06-2012 11:14 PM

Quote:

Originally Posted by floridatennisdude (Post 6938841)
Hmmm, that's a long time post op. I was serving lightly 5-6 mos post op and competing 9 mos after it. It was about a full year until I felt like my serve could be a weapon again. Are you near 100% rom in all other aspects? Still doing some throwers 10 2-3x a week?

One change to my swing that I made was to concentrate on keeping my elbow in a little bit more and really focus on swinging up. Tough to explain in words, but all I can say is do some experimenting. It makes sense to re-tool the service motion because that was likely the cause of damage.

Yeah, i'm still doing strengthening. I am 100 ROM. I find that when my toss is slightly forward it helps, but i find that weird given that you like at people like Fed and they are making almost a slightly angled straight line on contact. I'l try to take a vid at some point soon.

Also, it wasn't necessarily my technique. I was only breathing through my mouth for almost a decade which caused my neck and shoulders to get really tight. With the combo of tennis the labrum just popped.

Chas Tennis 10-07-2012 05:20 AM

Quote:

Originally Posted by Javizzle (Post 6940176)
.......................................I find that when my toss is slightly forward it helps, but i find that weird given that you like at people like Fed and they are making almost a slightly angled straight line on contact. .................................................. ..
.................................................. ....

Racket Angle from the Video Side View. Recently I've started to look more at high speed video of serves from the side view. The pro servers that I looked at had their arms and bodies angled forward at impact. The racket axis component viewed from the side was near vertical. The servers very frequently, to my surprise, were not looking at the ball at impact, maybe to relieve stress on the neck.? Unfortunately, from the videos I usually can not determine, with any confidence, the type of serve, flat, slice, kick, etc. that they have hit.

Racket Angle from the Video Behind View. From behind the pros have an angle between the axis of their arm and the axis of the racket. This angle, β, is needed to utilize internal shoulder rotation (ISR). Search internal shoulder rotation & serve on this TW forum.

See β on the Federer serve in the #1 reply, OP, Toly.
http://tt.tennis-warehouse.com/showthread.php?t=361610

Long thread discussing ISR (ISR is widely mislabeled 'Pronation' used in forum tennis discussions.)
http://tt.tennis-warehouse.com/showt...nation+science

High speed video view from behind of internal shoulder rotation just before impact. Look at the rapid rotation of the elbow bones, that's ISR.
https://vimeo.com/27528701

The ISR technique is currently used by all current pro servers. It is relatively safe if done properly by a conditioned athlete.

Unfortunately, after your injury and operation your shoulder is an unknown factor. For ISR, the humerus does axially rotate very rapidly and forcefully at the labrum.

Suggest that you study the serve thoroughly and take high speed videos of your serve. Since your shoulder is an unknown factor be very careful in imitating the pro serves and even more so in developing your own technique.

Be sure to understand this video by Todd Ellenbecker on the shoulder and its injury risks in tennis. At minute 8 he describes shoulder orientation on serving to minimize the risk to the shoulder. He also has conditioning exercises especially for the external rotators that stop the racket and arm in the follow through - if the external shoulder rotators are weaker and if they lack endurance the injury risk goes up because the ball of the humerus is not held stably.
http://www.tennisresources.com/index...2&ATT=&reso=hi

floridatennisdude 10-07-2012 05:48 AM

Quote:

Originally Posted by Javizzle (Post 6940176)
Yeah, i'm still doing strengthening. I am 100 ROM. I find that when my toss is slightly forward it helps, but i find that weird given that you like at people like Fed and they are making almost a slightly angled straight line on contact. I'l try to take a vid at some point soon.

Also, it wasn't necessarily my technique. I was only breathing through my mouth for almost a decade which caused my neck and shoulders to get really tight. With the combo of tennis the labrum just popped.

Yes, a toss out front is something I do too. Tossing behind for a kicker is kind of a thing of the past for me. The reach I needed to connect on that serve puts a lot of strain on my shoulder. Stinks not being able to kick it as high, but I'll avoid another operation like the plague.

LeeD 10-07-2012 10:42 AM

you gotta post vid.
Maybe you swing slow.
Maybe you never had POP.
Maybe you are favoring the shoulder.
Maybe your technique is just plain wrong.
Maybe your serves go 140, but it's not good enough for you.

LeeD 10-08-2012 03:12 PM

Reading thru the replies again, are both you guys 3.5's?
Seems you don't understand the technique involved in serving, or even the tactics.
If your technique is correct, then you can only serve as hard as your physical ablilities of that moment allow.
If your technique is flawed, the problem could be any number of factors.
I don't blame you if you let this thread die.

floridatennisdude 10-09-2012 07:34 AM

We know, Lee. We are terrible and you are a tennis immortal.

LeeD...when he works out, the machines get stronger.

charliefedererer 10-09-2012 09:49 AM

Chas gives some great suggestions for you, but the references are so technical, I am not at all sure you will pick up on them.


First of all, having strong rotator cuff shoulder muslces, particularly of the rotator cuff, will help protect the labrum from further damage. The following is the "best" set of shoulder exercises that I have seen:
Thrower's Ten Exercise Program http://www.muhlenberg.edu/pdf/main/a...throwers10.pdf

These exercises specifically work the muscles of the rotator cuff.



It is not important for you to know the names of these four muscles, or how each one of them works.

It is only important for you to know that they completely surround the shoulder joint, and provide the strength to keep your shoulder together.

Keep your shoulder together?!!!!!!


Does this mean your shoulder can fly apart?


Yes!!!!




The shoulder is the only joint in the body that is so weak as a joint.


Most joints have the bones at least partly interlocking to keep the bones from flying apart with violent motions like running, jumping and bashing a tennis ball.


But the arm bone (humerus) just loosely touches the surface of where it is attached to the body at a shallow cavity (glenoid fossa).
The labrum sits around the outside edge of this shallow cavity (glenoid fossa), giving that bony cavity increased depth.


The labrum is the white ring in the picture above. The rim acurally is attached around the outside of the glenoid fossa, but is shown here not attached to emphasize how flimsy it looks compared to the strong arm bone that the labrum is supposed to help slipping off the glenoid fossa.

The increased depth the labrum gives to the cavity means the arm bone is less likely to slip off the shallow cavity.

But the labrum is relatively easy to injure because it is made of just fibrous tissue and cartilage - easy to break through by something as hard as the end of an arm bone.



So why do we have such lousy shoulders, with such a lousy labrum?


Answer: amazing range of motion.

We can swing our shoulder through an amazing up and down and out to the side and all around.

There is no other joint that comes close to the range of motion of the shoulder joint.


But this amazing range of motion comes with a cost:
lousy stability.

Lousy stability means the arm bone can slide too far on the shallow cavity it rests against.

Sliding too far means the arm bone can injure the thin ring of cartilage and fibrous tissue known as the labrum.



And to complicate matters, the biceps tendon is attached to the top of the labrum.



The biceps muscle is the big muscle of the upper arm that is quite strong - it is easily strong enough that it can exert enough force to pull so hard on the labrum, that it can tear the labrum.



A. Normal attachment of biceps tendon to the top of the labrum
B. The biceps tendon has pulled the top of the labrum off the underlying bone, tearing it loose.



For the life of me, I can't understand why many more tennis players don't have labrum tears.
After all, everyone knows that to really smoke a serve you have to swing as hard as you can.
And everyone knows that to bash an ace, you have to reach way up high and crush that ball down into the court.

Right?

Wrong!!!!


None of the best servers reach up high to serve!

Yes, none of the best servers reach up high to serve!!!!!!!!!!!


They all hit the ball with their arms out to the side of their body!


They just turn their bodies so the side of their body is pointed straight up!!!!!!!!!!!!!!!!!!!

charliefedererer 10-09-2012 10:14 AM



I can only post 4 images in a response, so I am dividing this response into a second part.

And I am starting with this image of Roddick serving at the point of contact, with his body turned so his arm sticks out from his side, not with his arm reaching up.


Todd Ellenbecker in the video that Chas has posted above ( Rotator cuff injury (20:25 ) http://www.tennisresources.com/index...2&ATT=&reso=hi )
points out there is something "magical" about the arm being extended out from the body at 90 degrees.



There is much more power that can be transmitted from our arm musculature at this angle.

That is why "overhand" major league pitchers keep their arm (shoulder) angle this low.




Same for football quarterbacks:


Chas Tennis 10-09-2012 10:28 AM

Those illustrate the stretched internal shoulder rotators (ISR). The ISR muscles are stretched by external rotation caused by the leg thrust among other motions.

In addition, for the tennis serve the raising up the hitting shoulder, as Roddick has done, according to the Manual of Structural Kinesiology can additionally stretch the ISR muscles.

....the stretch may be increased by abducting the shoulder fully while externally rotated and then laterally flexing and rotating the trunk......

That lateral flexing (of the spine) is what has put Roddick's shoulder up so high.

charliefedererer 10-09-2012 10:37 AM

So maximum power can be developed by keeping the shoulder angle such that the arm is straight out from the side of the body.

But in addition, the arm bone at this angle is much less likely to put stress on the labrum and rotator cuff muscles at a 90 degree angle.

So anyone with a history of labrum and rotator cuff problems should be especially careful to maintain this angle into contact, not just pros like in the picture of Roddick above.

And to do this, they have to "drop the left shoulder" just as "TennisOne.com Editor Jim McLennan explains some serving techniques to generate power and protect your shoulder." http://www.youtube.com/watch?v=lTRvxaBMh8s

Do as Jim McLennan says and "drop the left shoulder" and your serve at contact will look like Roddick's above, and like the following pros:


Kim Clijsters


Andy Murray


Sam Stosur

Chas Tennis 10-09-2012 10:58 AM

Notice that 2 of 3 servers in those illustrations are not looking at the ball at impact. The percentage not looking at impact probably depends on the type of serve. Still, first guess is that half are not looking at the ball at impact. ?

Another of my personal tennis myths bites the dust............

LeeD 10-09-2012 11:49 AM

When you lead with the head, it feels like you use it to lever your shoulders through for more pace.
Try throwing a ball facing sideways, or even at your release point. It locks your shoulders there.
Try throwing a ball facing your target (meaning your head, not your torso or legs), and your rotation is much cleaner and easier to do
You KNOW where the ball is, you tossed it up?
You need to look at the incoming groundie, because your adversary hit it to you.,


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