Strong Shoulders, Strong Game

Mahalo to Connor Hyde, DPT from Jaco Rehab for sharing this article with us.

The shoulder requires a delicate balance of stability and mobility to meet the demands of the tennis game. The shoulder acts to help accelerate the racquet head as well as slow the racquet head down. The more you play tennis, the more important it is to build strong and resilient shoulders to maintain your longevity. A consistent regime will help build healthy shoulders to improve your tennis performance.

What is the shoulder?

The shoulder is the most mobile joint in the body. This complex structure is defined as a ball and socket joint made up of 3 bones: the humerus (the ball), the shoulder blade (the socket) and the collar bone. The head of the humerus fits into the socket of the shoulder blade like a golf ball sits on a tee. Surrounding the socket, or the tee, is the labrum made of a rubbery tissue which increases the contact area of the joint to aid in stability. Key muscles of the shoulders involves the four rotator cuff muscles: supraspinatus, infraspinatus, subscapularis and teres minor. Other muscles include the biceps, deltoid, and the muscle in the upper and middle back, which attach to the shoulder girdle. All muscles play a key role in timing and sequencing for proper shoulder movements.

Importance of the Shoulder

The shoulder is heavily involved with every stroke. It is a key component of our body’s kinetic chain to transfer power generated from the lower extremity to the arm and racquet head. Strokes in tennis involve generating repetitive forces and motions that are of high intensity and short duration. When Andy Roddick won the US Open in 2013, he averaged 7.8 serves per game which came out to over 1000 serves over two weeks — a pretty substantial number when you realize that’s not accounting for all his forehands, backhands and other shots. With the high degrees of stress placed on the shoulder during practices, matches and game play, the importance of maintaining shoulder strength combined with flexibility is critical.

Common Shoulder Problems

In tennis, the shoulder requires a balance between stability and mobility. Not enough strength and the stressful forces of playing may cause overuse injuries. Not enough mobility and the shoulder may have a mechanical breakdown leading to irritation within the joint. Both problems can stem from technique flaws, which is why learning the basics and having a good coach when learning tennis is important. Strengthening the shoulder to prevent future injuries means strengthening the entire shoulder girdle: from the back muscle supporting the shoulder blade to the rotator cuff muscle supporting the arm. These muscles all play a key role in having proper muscle recruitment and activation throughout your shots, without overusing or underutilizing certain muscles.

Causes of Shoulder Injuries

  1. Microtrauma: Most tennis injuries are due to repetitive forces of tennis strokes. This leads to overuse, the most common shoulder injury in tennis players. During the deceleration phase of serving or swings, cumulative loads on the muscles slow the racquet head down. This can lead to overloading the muscles and tendons, which attach to the shoulder and lead to microtrauma.

  2. Impingement: There is minimal space at the top of the shoulder where the rotator cuff tendons pass through. With improper technique, or when muscle fatigue or become inflamed, this space can narrow, leading to a pinching sensation.

  3. Rotator Cuff Weakness: The infraspinatus, 1 of the 4 rotator cuff muscles, is primarily an external rotator. This is extremely important for racket preparation and controlling deceleration. It is important to keep this muscle strong.

  4. Muscular Asymmetry: We typically have stronger muscles in the front of our bodies than in our back. Stronger muscles in the front means pulling the arm and shoulder blade into a forward position. This leads to incorrect movement patterns and poor alignment. This is especially true for our back muscles which support our shoulder blade movement. The lower and mid back muscle are typically not recruited as much, which can lead to timing issues.

  5. Rotational Deficit: Tennis player typically have increased external rotation of the shoulder with deceased internal rotations. While this is typically not a problem, not enough shoulder rotation can lead to tightness behind your shoulder, causing improper alignment and pinching.

Two Phases of Shoulder Rehab

When I see clients, no two are the same. We all have different capabilities, strengths and weaknesses. This means training should be unique to each individual. Generally speaking however, there are two main groups of people I see: the recovery phase for people dealing with pain and the performance group who are looking to maximize their abilities.

Recovery phase

This phase is for those who have shoulder soreness during or after playing tennis, pain when reaching their arm overhead or a pinching at the top of the shoulder. This phase focuses on pain-free mobility and rotator cuff activation.

  1. Assisted Elevation: Place your affected arm on top of a stick or golf club. Using your opposite arm, slowly elevate your affected arm as high as you can tolerate. Keep your affected arm as loose as possible; all the work should be done by the opposite arm.

  2. Elevation Negatives: Place your therapy band under your foot to ground it. Grip the band with both your affected and non-affected arm. Use your non-affected arm to help raise both hands to about shoulder level. Next, let go so just your affected arm is holding the therapy band and slowly lower back down to your waist.

  3. External Rotation Walkouts: First place a towel inside your elbow to insure proper shoulder alignment. Take the therapy band with your palm. Take 2-3 steps out. Hold this position for 5 seconds while keeping your hand straight ahead. Slowly return to starting position.

  4. Sidelying External Rotation: Lay on your side with your affected side up. Again, place a towel under your elbow. With a light weight, slowly rotate your hand up.

Performance phase

This phase is for players who have no shoulder pain during or after tennis. These exercises will target the rotator cuff muscles and back muscles, which stabilize the shoulder blades. This will build strong shoulders to help prevent injuries and maximize muscle activation for all shots.

  1. Resisted Uppercut: With your arm elevated to shoulder height, externally rotate your hand until it is perpendicular to the ground. Next raise your hand towards the ceiling. Slowly lower, internally rotate and repeat.

  2. Bilateral Rows + External Rotations + Press: With both arms, perform a row by squeezing your shoulder blades together and bringing elbow back until they are in line with your torso. Next, rotate both arms until your hand points towards the ceiling. Then perform an overhead press straight into the air.

  3. Snow Angels: Pull the therapy band straight down to your sides. Next, raise both arms, keeping your elbows straight until your hands are overhead, just like how you would make a snow angel. Slowly lower and repeat.

  4. Wall Ladder: Wrap the therapy band around both hands. Place hands and elbows on the wall, directly in front of you. Starting moving each arm up the wall, making an imaginary ladder. Each movement up make a “C” shape to properly target all muscles. Keep elbows to the wall the entire time.

  5. Three-Cone Shoulder Blade Hurdles: Place three cones about equal distance apart on your side. Lay your stomach flat. Slowly elevate your arm over head cone. Feel the muscles in your mid-back squeezing to assist the movement.

Final Take

The shoulder is a complex structure but that does not mean training has to be. A simple program a few times a week for 10-15 minutes to focus on your rotator cuff and back muscles will go a long way. Start light and focus on perfect form. A good tennis player is well-rounded on and off the court. These exercises will help take your off-court preparation to the next level.

For any questions, or if you would like your shoulder screened by a specialist, please visit or contact us at

About the Author:

Connor is a New Hampshire native and state champion tennis player with over 20 years of experience playing and teaching tennis. A college tennis player at University of Redlands, he now resides in Honolulu and practices physical therapy at JACO Rehab.

For any questions or if you have an injury you want evaluated, please visit or email them at


Cools AM, Johansson FR, Borms D, Maenhout A. Prevention of shoulder injuries in overhead athletes: a science-based approach. Braz J Phys Ther. 2015;19(5):331–339. doi:10.1590/bjpt-rbf.2014.0109

Johnson CD, McHugh MP, Wood T, Kibler B. Performance demands of professional male tennis players. Br J Sports Med. 2006;40(8):696–699. doi:10.1136/bjsm.2005.021253

van der Hoeven H, Kibler WB. Shoulder injuries in tennis players. Br J Sports Med. 2006;40(5):435–440. doi:10.1136/bjsm.2005.023218

Christine Nip