shoulder blade pain when serving

[tennisenthusiast]

Hi All,

I seem to be having left shoulder blade pain only on those days when I play singles or two sets of doubles i.e., when I serve a lot. Does anyone have reasons as to why I would have left shoulder blade pain when I serve intensely? BTW, I am a right-handed player.

Is it because of technique or spin serves or weak shoulder blade related muscles? If so, what are the remedies that I can try?

Also, what can I do to strengthen that area and surrounding area? I am doing thrower's ten exercises (with 1 pound weight) once a week and also doing theraband exercises once a week.

Thanks!

[mikeler]

Have a pro look at your form.

[Chas Tennis]

Is the pain within the shoulder blade outer edge (rotator cuff muscles) or outside it in the surrounding muscles that position and stabilize the shoulder blade?

https://www.google.com/search?q=rota...w=1334&bih=722

This Todd Ellenbecker video describes in detail the shoulder anatomy, function, rotator cuff muscles and the strain placed on them by the service motion. He says that the small rotator cuff muscles must stop the rapid axial rotation of the arm and racket and that strains them. Also, starting at minute 8, he describes the serving shoulder posture to reduce the risk of impingement injury. Many servers risk injury by not using the positioning that he describes.

http://www.tennisresources.com/index...2&ATT=&reso=hi

See also this thread and especially Charliefedererer reply #11.
http://tt.tennis-warehouse.com/showthread.php?t=441867

Take a video of your motion from behind to evaluate the service motion. 30 fps with a fast shutter is useful but repeat the serve videos to catch the racket in various positions (since the serve is fast you must assume that the serve is reproducible with 30 & 60 fps), 60p fps with fast shutter works better, high speed video with fast shutter catches it all. Shoot in direct sunlight so that the AUTO exposure will pick a faster shutter speed.

Injury can result from shoulder posture as pointed out to me by my physical therapist. He said that injured baseball pitchers often need correction of their shoulder blade posture. Search shoulder posture.

[charliefedererer]

Originally Posted by tennisenthusiast

Hi All,

I seem to be having left shoulder blade pain only on those days when I play singles or two sets of doubles i.e., when I serve a lot. Does anyone have reasons as to why I would have left shoulder blade pain when I serve intensely? BTW, I am a right-handed player.

Is it because of technique or spin serves or weak shoulder blade related muscles? If so, what are the remedies that I can try?

Also, what can I do to strengthen that area and surrounding area? I am doing thrower's ten exercises (with 1 pound weight) once a week and also doing theraband exercises once a week.

Thanks!

You may need to gradually increase the weight of the dumbbells up to 5 pounds, and increase the frequency of exercise up to three times a week.

From the USTA:

"Rotator Cuff and Shoulder Blade Stabilization

In this article we want to focus on the shoulder and muscles that stabilize that joint. When you talk about tennis and the shoulder the first thing that likely comes to mind is the rotator cuff. The rotator cuff is important in tennis, but often times strength imbalances exist within the rotator cuff that can lead to injury. Most notably, tennis players tend to be weak in the muscles that externally rotate the shoulder. External rotation is an outward rotation and is the opposite of the shoulder motion players make when they serve or hit a forehand. To improve strength of the external rotators you can perform the exercises described in this section of the web page. This exercise should be performed with the dominant arm, but should really be performed with both arms if time permits.

Not many people think of the upper back when considering how to strengthen and protect the shoulder. But try this simple drill. Place your hand on the shoulder blades of a player and ask him to raise his arms. Can you feel the shoulder blades move? Shoulder movement is very complex and involves movement of the shoulder blade as well as the actual shoulder joint itself. Weakness in the upper back muscles that stabilize the shoulder blades can cause the shoulder to function improperly and may actually contribute to shoulder pain. Exercises that train the stabilizers of the shoulder blade can help tennis players optimize performance and avoid shoulder injury."
- http://www.usta.com/Improve-Your-Gam...se_Techniques/



Just increasing the frequency of the thrower's ten and gradually going up on the weight of the dumbbells to 5 pounds may be all you need to strengthen your shoulder blade stabilizers enough to avoid pain in the future.

But you may want to consider other back upper back exercises to make the muscles there even stronger.
Pull-ups are great - but many can't lift their own body weight. Lat pull-downs can be a reasonable substitute. Bent over dumbbell rows are another exercise that will work the upper back if you don't have access to a machine you can do lat pull-downs on.




[Tennis is a great sport - you get conditioning and it's great fun to bash the fuzzy yellow ball.
But it leads to muscle imbalances - the hitting muscles get stronger and stronger, while the muscles that have to resist the hitting can get "stretched out". Plus, the muscles of the non-dominant side don't get near as strong as the hitting side, so there can be pulling across the back of the stronger dominant side over the non-dominant side.
For all these reasons I try to balance out the strength of my hitting and dominant side muscles by doing off court weight lifting.
I do my most serious lifting in the winter when I'm only playing tennis a couple of times a week, although I keep up a regimen year round.
You may want to consider doing some weight training.
Some think they will not get much out of it unless they are lifting heavy weights.
I contend that it is the first little strength gains that are by far the most important in preventing injury.
So you may want to consider devoting some time to a more complete body regimen than the thrower's ten.
At home you can do the following with dumbbells if you do not want to go to a gym (of course you could also do this regimen in a gym with barbells as well). Tennis Weight Training - Exercises of Weight Training for Tennis: http://optimumtennis.net/tennis-weight-training.htm
You can read more about WHY it makes sense to exercise to better play tennis with fewer over use injuries at this site, and even do the foundation strength workouts (the maximum strength/power phases are NOT necessary for injury prevention.) The Elite Approach to Tennis Strength Training http://www.sport-fitness-advisor.com...-training.html ]

[tennisenthusiast]

charliefederer - Thanks for your reply. Is it advisable to increase the weights upto 5 pounds for thrower's ten exercises as I have heard that increasing weights do not give enough "exercise" to smaller muscles? Is that still valid?

[Chas Tennis]

Blackburn Exercises were used in my physical therapy for mild rotator cuff tears of my supraspinatus. There was no operation. A physical therapist evaluated my shoulder posture and selected some of the Blackburn Exercises to correct my scapula issues. I continued them for a year or two beyond my recovery as they are a conditioning exercise for scapula positioning. I do them occasionally now. He said to use high reps and light weights, 2 or 3 lb dumbbells at most, and aim for the form and to build endurance. My opinion was that the exercises worked on the middle traps and the rhomboids lying under the traps and probably other muscles. I believe that tightening and pulling the shoulder blades together and holding for a delay, of say, 6 seconds, is important to the effectiveness of the Blackburn Exercises.
http://danblewett.com/2010/11/how-to...urn-exercises/

I do other very similar shoulder exercises such as bent over dumbbell raises using heavier dumbbells but I personally don't consider those to be for scapula conditioning and positioning but for rear deltoid strengthening. Two different exercises aimed at two different muscle groups.
For comparison, heavier dumbbell exercise for posterior deltoid strengthening, NOT BLACKBURN -
http://www.bodybuilding.com/exercise...-head-on-bench

Here is a site that describes an overall shoulder recovery scenario.
http://www.ioshospital.com/orthopaed...bilitation.pdf

Another report describing the overall diagnosis to treatment of some shoulder injuries.
http://www.rijnlandorthopedie.nl/upl...tsBurkhart.pdf

It is a mistake and risky to assume that treatments apply to any undiagnosed injury that you have.

[charliefedererer]

Originally Posted by tennisenthusiast

charliefederer - Thanks for your reply. Is it advisable to increase the weights upto 5 pounds for thrower's ten exercises as I have heard that increasing weights do not give enough "exercise" to smaller muscles? Is that still valid?

Good question.

If you are having pain, do not increase the weight.

But most would agree that going up to 5 pounds slowly would be safe.

Athlete Performance and Fitness Training:
"Use 5 pound dumbbells for every rotator cuff exercise. Going over 5 pounds will cause larger muscles like the deltoids, to begin firing. Firing the deltoids will deplete the effectiveness of a true rotator cuff workout."
- http://kbandstraining.com/arm-streng...der-exercises/

The Pitching Academy
"It is important to note that pitchers are not weight lifters. An athlete’s objective here is not to see how much weight they can lift while doing these exercises. In fact, most athletes start with 3 lbs weights. It is recommended that no more than 10 lbs. should be used while performing the following exercises. Most high school and collegiate athletes use 5 lbs. And feel it is sufficient weight for them. I have never used more than 5 lbs dumbbells and I am 6’4’ 225 lbs."
- http://www.thepitchingacademy.net/Ar...ator-Cuff.html

Sports Fitness Advisor
"Keep to a weight of 2-5 lbs (1-2kg) maximum. Complete 3 sets of 12-15 repetitions for the following exercises in the order below."
- http://www.sport-fitness-advisor.com...exercises.html

Body Building.com
"The muscles of the rotator cuff are very small. Even if you're pushing five bills on the bench press you'll still be using five-pound dumbbells for many rotator cuff exercises. So leave your ego at the door!"
- http://www.bodybuilding.com/fun/criticalbench24.htm