The shoulder girdle is the anatomical link between the arm and the body which transmits

force from the lower body and torso to the racket. This joint plays a pivotal role because

of its tremendous range of motion. It is precisely because of this reason that the shoulder

is prone to injury. The shoulder joint has more range of movement then any other joint in

the body. It is also the least stable, and therefore most sensitive, of our large joints. The

shoulder moves in three dimensions allowing for a swing path which is non-linear. This

in turn creates racket trajectories during ground strokes and particularly serves that can

impart both spin and pace to the ball. In order to generate the pace of a professional

caliber serve the shoulder must rotate roughly through an arc of motion of 120-180

degrees! 130 mph plus serve velocity is achieved by generating tremendous torque in the

shoulder which accelerates the racket head rapidly through this range of movement. It is

the repetitive forces during these movements that can potentially lead to injury.

The most common cause of shoulder injury is repetitive overuse. Overuse can be the

result of too much play in a short time interval, too long of a season, or poor stroke

mechanics. Acute injuries caused by a single traumatic event are far less common.

Repetitive overuse interacts with other factors such as age, general fitness, and genetics

to produce a range of injuries. The cycle of repeated trauma can lead to a vicious cycle

which ultimately can lead to soft tissue injury of the muscles, tendons, and ligaments.

Treatment for strain injuries consists of relative rest, icing, analgesic medications and

physical therapy. Rest from the offending cause is mandatory; however, the patient is

encouraged to continue pain free exercises so that fitness can be maintained. Medications

typically include over the counter or prescription anti inflammatory drugs aimed at

reducing pain and swelling.

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