Tennis player, shoulder problems. Please help!

[toad]

i would agree with the above post, the diagnosis you have been given previously can all fit your symptoms but none of your treatment addresses any underlying cause for your pain.
As was already said muscle length, strength, muscle co-ordination and timing all need to be considered and assessed and a treatment program needs to adress these issues. The treatment you've had seems to be more addressed to your symptom's(pain) rather than dealing with the cause or source of the pain.
A specialist physio dealing with athletes should be able to design a rehab program for you.

[Hunter_PT]

yea...impingement, rotator cuff injury, bursitis, blah blah blah....they all mean the same thing. First you should definitely see a PT that specializes in athletes (overhead especially) and orthopaedic problems.

From what you described and in my experience as a Sports Medicine/Manual PT you most likely have weakness in your scapular/Rotator cuff musculature and MOST LIKELY tightness also (i.e., lattisimus dorsi, serratus anterior?, pectoralis major/minor). Thoracic mobility may be a problem also (do you have pain on the back of your shoulder blade). Also could be addressed is a median nerve immobility (do you ever have shooting pains down your arm?)

There are a lot of things that can be treatments for your shoulder but ultrasound, laser, massage, voodoo, magic wands are not any of them. (all of those modalities are crap and are worthless in treating your condition)


ALSO: since it does hurt during your service which is basically an abduction and external rotation motion it could also be a labral pathology. either/or....still treated just about the same.

p.s. - SIT UP STRAIGHT!

[Canuck Physio]

While hands off therapies are, I admit, an important part of acute and sub-acute therapy, there is no chance of return to top form without appropriate rehabilitation that primarily focusses around normal movement, and training (be it resistance, movement, fascilitated etc.). Your problems will only be solved when the muscles return to a normal pattern of movement, and then training occurs to return you to high level sports.

[msk101]

Hi there,

I'd agree with the advice that recommends you see a physio who can devise an exercise based rehab program for you. The manual therapies you've had may be ok to reduce some acute inflammation but it would seem that the cause of your problem would be a muscle imbalance. Also get your thoracic spine checked out (and perhaps mobilised if need be - as overhead shoulder action does require a certain amount of thoracic mobility).

A generic type rehab program would incorporate strengthening the rotator cuff in neutral and other degrees of shoulder abduction (levels of arm raise), and making sure that you hold your shoulder blades in the right position whilst doing this (i liken it to trying to squeeze a marshmallow in the middle of your back while doing the arm exercises). once you get the muscle coordination right you should be able to gradually increase the pain free range of movement you have with your shoulder. as a bonus, correctly stabilising the shoulder blades and strengthened rotator cuff (of which supraspinatus is one of the muscles) should mean that in the long run your serve and overhead strokes are more powerful and directional control will be better. Also you will be able to generate better power through ground strokes. ... essentially this is making the fulcrum more stable so you can move the lever arm with more control and power.

good luck. but find a sports physiotherapist who can address the muscle imbalance and teach you the correct re-training techniques.

Msk101

[Pedro_2008]

anybody based in the UK (preferably south) able to help my Son with a similar injury ?
pm please if you can help or know of anyone suitably qualified

Thanks in advance