NY Times; How to fix a bad tennis shoulder. There is more to shoulder pain than you think.
The NY Times article on shoulder pain regarding How to Fix a Bad Tennis shoulder focuses on the shoulder, the rotator cuff (the four muscles surrounding the shoulder and the fact that most tennis players have some arthritis in the shoulder joint but do not have pain, while others who play more casually and do exercises designed to improve the way the shoulder works tend to get shoulder pain. While there are classical strengthening regimens for the shoulder such as these on our web site (click here), as well as other procedures you can do such as capsule stretches (watch here), many people still experience shoulder pain.
If it is not arthritis, then what is making us hurt? To understand shoulder pain (you will not find the answer in the NY Times article because you need to look beyond the shoulder), you need to understand there is more to shoulder movement than just the shoulder. The shoulder relies on movement from the scapula which sits on top of the posterior part of your ribs and is responsible for the way we use the shoulder, the forces placed upon the shoulder by other structures and the movement of the ribs.
Most doctors follow the classical point of view from the NY Times, however, all joints need to move to allow the shoulder to work properly. Your core and the way it functions is also important because if the core tightens, or your pelvis is distorted, your abdominal muscles will pull the shoulder forward and place tension on it. This disallows the ability to abduct (bringing the shoulder either up laterally or in front of you). If there is tension from rib misalignment’s caused by tension from the pelvis, the shoulder will also not move smoothly and you may experience popping since the shoulder is attempting to move against tightness.
The result of tension and improper function of the shoulder are conditions such as tendinitis, tendonosis, bursitis (rare, but this is usually tendonosis misdiagnosed) and even impingement which usually results over the long term in tears of the supraspinatus muscle or tendon.
By understanding that there is more involved, you can more wisely select the care you choose to receive since you are more informed. Many people choose to visit an orthopedic who will look at where you hurt, but not why, order an MRI or some other test and may even refer you for therapy. Another choice you can make can be to visit your local sports chiropractor. Most people would never think of the chiropractor first since they are neck and back doctors, however, chiropractic sports physicians either certified or diplomate will look at not only where you hurt but why. Without understanding the mechanism behind the shoulder pain, you cannot solve the problem effectively. Most sports chiropractors will look at the shoulder, how the ribs move, your posture, the pelvis and even your feet. A more thorough evaluation is the only way to resolve a shoulder problem effectively. Once the problem is fully understood by both the doctor and you (shoulder problems are not that difficult to explain), most people can be rehabbed, and given the exercises they need for a full recovery. Often, there is a gait imbalance involved as well (asymmetry in the way you walk) which can be offset by placing off the shelf or custom foot orthotics in the athletic or tennis shoes which will improve the way the pelvis and shoulder works.
To resolve shoulder problems, and the pain and stiffness in the neck that comes with it, you need to look at the entire mechanism of shoulder movement, not just the rotator cuff. Since the body takes movement from many different areas to create the tennis swing, a loss of movement in the hips, the shoulder, the shoulder joint capsule, the scapula as well as the abdominal musculature will not only help you get out of pain, but in tennis as in any sport, your game will markedly improve since the movements of your body is what propels the ball, not just your shoulder.
What do you think? As always, I value your opinion.