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Tennis Anyone? Served with or without Pain?

Have you ever tried to power a tennis ball over the net? That overhand serve isn't as easy as it looks. Try doing hundreds of them each day and see how your shoulder feels.

For a small number of tennis players, this kind of repetitive motion causes damage to the shoulder. In particular, there is a tendon that can get pinched on the back (posterior) side of the shoulder joint. Shoulder pain starts when this tendon, called the supraspinatus tendon, gets pressed against the rim of the joint. Most players grin and bear it. Many are helped by nonoperative treatment such as physical therapy. For some, surgery is needed.

One study of 28 tennis players looked at the results of surgery for this problem. The doctors removed the torn tendon and smoothed the joint where the tendon had rubbed against the outer rim.

The final outcome was not ideal. Only half of the patients could return to tennis. Almost all of the patients who did return to the game had quite a bit of pain while playing. Why the poor results? Doctors think there may be other unseen damage in the shoulder joint.

There is new information about shoulder injuries in tennis players. Serving the ball overhead can cause the deep surface of the supraspinatus tendon to get pinched. Surgical treatment for this problem has not been very helpful. Doctors think there may be more to the problem than meets the eye. Better treatment will evolve as more specific information about the damage to the shoulder joint is uncovered.

References: Bertrand Sonnery-Cottet, MD, et al. Results of Arthroscopic Treatment of Posterosuperior Glenoid Impingement in Tennis Players. In The American Journal of Sports Medicine. March/April 2002. Vol. 30. No. 2. Pp. 227-232.

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