Ask a PT

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Posted - 02/06/2007 :  19:47:31  Show Profile  Reply with Quote
Our user asked: "I've had a chronic pain in my right shoulder for the last 6 months. Anytime I try to raise it laterally, there is discomfort. This incident occured when I decided to play tennis last July and go for a monster serve. Please advise."

Ask a PT Response: "Experiencing discomfort with raising your arm up laterally can mean a few things. In your case, your mechanism of injury was with performing a monster serve with tennis. With a tennis serve, utilizing poor or improper mechanics can result in impingement of the supraspinatus tendon on the acromion process (area where your collar bone meets your shoulder blade bone) and cause damage to the supraspinatus tendon (the supraspinatus is one of 4 muscles which make up the rotator cuff). The main actions of this supraspinatus muscle are to help bring your arm out to the side (abduction) and to rotate it back (external rotation). This part of the rotator cuff is the most commonly area injured with this type of situation. Symptoms usually associated with injury to this muscle could include pain with range of motion, decrease range of motion and weakness. You may also experience marked tenderness at the anterior aspect of your shoulder as well, because the supraspinatus tendon inserts onto the greater tuberosity of the head of the humerus at the shoudler (this area is located at the anterior shoulder).

Since this injury occured over 6 months ago, hopefully you have not lost a significant amount of range of motion or strength. I'd recommend you consult with your physician or physical therapist for further medical attention. If you have torn your rotator cuff an MRI and special tests performed by your MD or PT can help diagnose this. Often times, conservative treatment such as physical therapy or cortisone injections may be tried first to rehabilitate the shoulder if your injury is not too severe. If you don't do something about it now, this could lead to further problems in the long run such as adhesive capsulitis, arthritis, further weakness, injury or pain elsewhere as a result of compensation or tendonitis at both affected and unaffected areas.

For right now, avoid activities which would increase your symptoms and inflame your condition. Perform gentle ROM or stretching exercises such as wand exercises or seated GH ROM exercises and gentle strengthening exercises such as GH isometrics (You can view these exercises on the exercise video page and learn more about rotator cuff injuries on the CyberPT website). Once you have sought medical attention your healthcare provider will be able to give you more specific guidance. I hope this helps and thanks for using CyberPT "Your Online Physical Therapy Resource"."