Our Summary

This article discusses how rotator cuff injuries, common in tennis players, happen and are treated. Rotator cuff injuries in tennis players usually develop over time due to repetitive use and range from slight tears to complete tears. The majority of these injuries are slight tears, while complete tears usually happen to older players. Serving in tennis is the most strenuous action and makes up about half of all the strokes in a match, which increases the risk of overuse injuries and tears in the rotator cuff. Research shows a decrease in shoulder movement range and irregular shoulder blade movement even after a single tennis match.

The first approach to treating these injuries is typically conservative, involving rest, anti-inflammatory drugs, and a specific physical therapy program. Surgery is often reserved for older players or those who can’t return to the game after conservative treatment. Possible surgeries include cleaning up the rotator cuff with or without repairing the tendon, relocating the biceps tendon, and procedures on the labrum (a type of cartilage found in the shoulder joint).

However, unlike rotator cuff surgeries in the general population, these procedures in high-level tennis players don’t often allow them to return to their previous level of performance. The causes of rotator cuff tears in tennis players are many and often involve small injuries and internal pinching in the shoulder leading to slight tearing and fully torn rotator cuffs in older players. Surgery is only considered for players who are still experiencing symptoms after extensive non-surgical treatment, as the chances of returning to pre-injury levels of performance are only moderate at best. For slight tears in younger players, it’s usually preferred to clean up the rotator cuff rather than repair it to avoid restricting the shoulder joint and further decreasing the chance of returning to sport after surgery.

FAQs

  1. What are the common causes of rotator cuff injuries in tennis players?
  2. What is the typical approach to treating rotator cuff injuries in tennis players?
  3. How successful is surgery in returning high-level tennis players to their previous levels of performance after rotator cuff injuries?

Doctor’s Tip

A helpful tip a doctor might tell a patient about labral repair is to follow the post-operative rehabilitation plan carefully. This may include specific exercises to strengthen the shoulder and improve range of motion, as well as restrictions on certain activities to allow the labrum to heal properly. It’s important to communicate any pain or discomfort during the recovery process to your healthcare provider so they can adjust your treatment plan as needed. Following these guidelines can help ensure a successful outcome and a quicker return to normal activities.

Suitable For

Labral repair is typically recommended for patients who have sustained a labral tear in the shoulder joint, often due to trauma or repetitive overuse activities such as those seen in athletes like tennis players. Labral tears can cause pain, instability, and limited range of motion in the shoulder and can significantly impact an individual’s ability to participate in sports or daily activities.

Patients who are recommended for labral repair usually have not seen improvement with conservative treatments such as rest, physical therapy, and medications. They may have persistent symptoms such as sharp pain with certain movements, popping or clicking sensations in the shoulder, and a feeling of instability or weakness in the joint.

In some cases, labral tears can also be associated with other shoulder injuries such as rotator cuff tears or biceps tendon injuries, which may require additional surgical intervention. The decision to undergo labral repair surgery is typically made after a thorough evaluation by an orthopedic surgeon and consideration of the patient’s overall health, activity level, and goals for treatment.

Overall, labral repair is a common surgical procedure for patients who have sustained a labral tear and can be an effective treatment option for improving shoulder function and reducing pain in individuals who have not responded to conservative treatments.

Timeline

Before labral repair:

  1. Patient experiences shoulder pain and limited range of motion.
  2. Patient undergoes diagnostic tests such as MRI to confirm labral tear.
  3. Patient may undergo conservative treatment such as physical therapy and anti-inflammatory medications.
  4. If symptoms persist, patient may be recommended for labral repair surgery.

After labral repair:

  1. Patient undergoes labral repair surgery to repair the torn labrum in the shoulder joint.
  2. Patient goes through a period of post-operative rehabilitation to regain strength and range of motion in the shoulder.
  3. Patient gradually resumes physical activities and sports under the guidance of a physical therapist.
  4. Patient experiences improved shoulder function and reduced pain compared to before surgery.
  5. Patient may need to continue with exercises and follow-up appointments to ensure proper healing and prevent re-injury.

What to Ask Your Doctor

Some questions a patient should ask their doctor about labral repair include:

  1. What is a labral tear and how is it diagnosed?
  2. What are the different treatment options for a labral tear, including surgery?
  3. What are the risks and benefits of undergoing labral repair surgery?
  4. What is the recovery process like after labral repair surgery?
  5. What is the success rate of labral repair surgery in terms of returning to normal activities or sports?
  6. Are there any specific physical therapy exercises or rehabilitation protocols to follow after surgery?
  7. How soon can I expect to resume playing tennis or other physical activities after labral repair surgery?
  8. Are there any long-term implications or restrictions to be aware of after undergoing labral repair surgery?
  9. What are the chances of re-injury or developing complications in the future after undergoing labral repair surgery?
  10. Are there any alternative treatments or therapies that I should consider before deciding on surgery for a labral tear?

Reference

Authors: Alrabaa RG, Lobao MH, Levine WN. Journal: Curr Rev Musculoskelet Med. 2020 Dec;13(6):734-747. doi: 10.1007/s12178-020-09675-3. PMID: 32827301