Rotator Cuff Tear in a Tennis Pro

Posted On: June 13, 2017

This is the fourteenth case review from my past practice. I am Dr. David Johnson a chiropractor and physical therapist in Highland Park and Lake Bluff. I am the director of North Shore Spinal and Sports Rehabilitation. I started as a chiropractor in Lake Forest, Il in 1988. I integrated physical therapy into my practice in 1990.

This is a case where a local teaching tennis pro came to see me because she couldn’t raise her arm. She was upset as both her ability to recreate as well as teach were effected. She was an A level player and her problem started after a particularly difficult match. She was in her early forties and had been playing tennis most of her adult life.

I examined her and indeed she could only raise her right arm out to the side to 70 degrees. Manual muscle testing revealed weakness and pain when I tested the supraspinatus muscle, which is a commonly injured muscle in the rotator cuff. None of the other muscles of the rotator cuff were involved. Passive range of motion of the shoulder was fine. She also had a positive drop arm response, which is an orthopedic test that points to a likely rotator cuff tear. I diagnosed her with a rotator cuff tear.

I surmised at the time that it was a partial tear as she still had pain with the supraspinatus test and the drop arm test. If those tests were pain free but still weak one likely has a full rotator cuff tear. Today I would order an MRI to confirm my diagnosis, but this case was back in 1988 and so I opted to treat.

I did gentle strengthening of the supraspinatus, ultrasound to the tendon and friction massage to the tendon. Over time, we progressed into more challenging exercise. As she responded we moved her back into tennis groundstrokes and eventually into serving. She responded fabulously.

As the result of me seeing is one patient many of the people she played with came into my office with various tennis related injuries. Over the years I have seen rotator cuff injuries, tennis elbows, tendonitis of the knees and even knee sprains al related o tennis.

This gave me a greater understanding of the game of tennis. I learned what proper form was and I understood how improper form and over use can lead to injuries. I am truly grateful to that first tennis player that came to see me for her rotator cuff tear.

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