Strength Exercises to Help 'Mitigate' Injury Risk in the Tennis Shoulder
Many in tennis associate shoulder health with resistance band exercises. Listen to coaches and trainers talk about shoulder strength or injury prevention with their players and you’ll surely hear things like “are you using your bands daily?” or “make sure to do ‘x’ or ‘y’ band exercise”. But do band exercises work in the manner that they’re spoken about?
I’d like to offer my take on the matter and suggest 2 other strength training methods - light weight and moderate/heavy strength exercises.
Let’s dissect the 3 categories mentioned to gain further insights:
Resistance Band Exercises - Keep or Ditch Em?
Look into most tennis players' bags and you’ll find a resistance band of some sort. These bands come in various shapes, sizes and resistance levels. Some have handles, others don’t but irrespective of that, it’s no surprise that players love their bands.
Many even credit the bands for keeping their shoulders ‘injury-free’. Let’s get one thing straight - injuries are multifaceted and extremely complex so I struggle with absolutist views like that. Perhaps a better approach is to to ask - do resistance band exercises help decrease injury risk in the dominant shoulder of tennis players? My answer to that question - maybe.
The thing is, the resistance that many bands offer won’t apply enough force to even come close to what the structures of the shoulder will experience during tennis hitting (like serving, for instance). To combat this, some use heavy duty bands - all this does is decrease the range of motion + the execution quality of the movement at hand.
That being said, perhaps band work is a starting point for players who are coming off an injury. That would make sense as we’d be progressively loading the muscles, tendons and surrounding tissues to further accommodate greater loading as rehab continues.
Similarly, younger players might benefit from bands to help teach certain rowing and pressing motions - they may also receive a strength stimulus from bands as they are untrained + weak.
But for the majority of healthy players out there, resistance bands offer little more than a warm-up benefit. As with any structure, when warming up, we’re opening up ranges of motion, activating muscles, increasing blood flow (+ heat) and so on. Ballistic activities pre-tennis have also shown to increase performance.
It therefore makes sense then to do something to warm-up the tennis shoulder prior to hitting/playing - whether you use bands or other modalities, doesn’t really matter much, as long as it gets done. But to say that a band will reduce the chances of injury is - in my books - farfetched.
Verdict: Personally, if players want/like to use them to warm-up, I don’t discourage it. But I no longer mandate them during warm-ups (and they certainly aren’t a staple of our strength training programs).
Alternative #1 - Light Weight Strength Exercises
Examples of light weight exercises might include lateral raises, front raises and shoulder internal/external rotation movements (see vids below). I would even include bicep/tricep work into this area as both have attachments onto the shoulder itself or surrounding structures (for example, the origin of the long head of the triceps is on part of the scapula - a key piece of the shoulder health puzzle).
Over the last decade or so, many in fitness have given these exercises a bad rep because of the notion that they are ‘non-functional’. The reality is, every structure has a function and performing single-joint / isolation exercises can help target certain muscles more specifically. During multi-joint movements, muscle fibers within these muscles may not reach full recruitment.
You see, if we perform a multi-joint exercise, like a pull-up - we will recruit a lot more muscle in general but we won’t recruit as much of the anterior deltoid as say, a front raise.
Another benefit to these exercises is that the energetic costs are more peripheral - i.e. the nervous system won’t be taxed as much as say, an olympic lift. On top of that, they target relatively small muscle groups compared to, say, a lat-pulldown. What this means is that we can perform these exercises to failure (or near failure) without having to sacrifice a lot of recovery time or incur a lot of soreness.
Verdict: I implement these early on in a player’s program and then get more specific to their needs as we get closer to competition time (and if we notice that certain structures need more attention). There is a point of diminishing return on these as tennis players don’t want/need to look like bodybuilders.
Alternative #2 - Moderate to Heavy Strength Exercises
Lastly, we have heavier strength exercises. These are multi-joint movements that target larger muscle groups (and more of them). Essentially, these are your big bang upper-body strength exercises:
Vertical Push - ex: overhead press variations
Vertical Pull - ex: lat pull-down or pull-up variations
Horizontal Push - ex: bench press variations
Horizontal Pull - ex: rowing variations
Note that these can be performed in unilateral and bilateral variations (i.e. 1-arm landmine press vs barbell overhead press).
I’m seeing more tennis players incorporating these into their programs (even though some are still reluctant, fearing injury, bulkiness or some other non-proven excuse). Those players and coaches that have made the shift, see these as ‘performance’ enhancing. While it’s true that many of these movements will have a positive effect on hitting power, they should also be viewed from the perspective of injury mitigation.
A simple 1-arm overhead press will recruit all 3 deltoid muscles to an extent - and beyond that, we’ll get some tricep activation, scapular rotation + elevation and even some movement at the ribcage (the serratus muscles playing a role here). This will allow the muscles to act synergistically and will likely have a positive effect on intermuscular coordination (almost acting like a symphony for optimal muscular recruitment and ultimately, shoulder movement).
And because the rep ranges are typically lower compared to the light-weight exercises we mentioned above, the improvements in strength + power will be more apparent.
Verdict: These should be the bread and butter of a player’s upper-body strength training program. If you’re not currently using these in your own program (or that of your players), start.
Matt’s Final Point
To reiterate, injuries are complex. Recall that tennis is a repetitive sport where certain tissues see A LOT of loading - particularly if you’re practicing and playing daily. On top of that, mechanics, fatigue and other variables can play a role in staying healthy. Ticking various boxes should help. Yet even if you include every method we mentioned above, there’s no guarantee that injury will escape you…but it’s still a good place to start.