Internal Impingement In The Tennis Player : Rehabilitation Guidelines

Ann M Cools ^1*, Geert Declercq ², Barbara Cagnie ¹, Dirk Cambier ¹ and Erik Witvrouw ¹

¹ Ghent University, Belgium
² Dreef van Zonnebos 13, 2970 's Gravenwezel, Belgium

^* To whom correspondence should be addressed. E-mail: ann.cools{at}ugent.be.

Accepted 24 September 2007

Abstract

Abstract. Internal impingement is a commonly described cause of shoulder pain in the overhead athlete, particularly the tennis player. Three shoulder dysfunctions, frequently correlated with internal impingement symptoms, need our attention in the rehabilitation strategy of internal impingement in the tennis player: 1/ acquired glenohumeral anterior instability, 2/ loss of internal rotation ROM, and 3/ lack of retraction strength. Based on recent literature, the following guidelines are proposed in the rehabilitation of the tennis player with internal impingement symptoms: 1/ shoulder rehabilitation should be integrated into kinetic chain training, not only in the advanced phases of the athlete¡¦s rehabilitation, but from the initial phases, 2/ angular as well as translational mobilizations can be used in the treatment of acquired loss of glenohumeral internal rotation range of motion to stretch the posterior structures of the glenohumeral joint, and 3/ in the rehabilitation of scapular dyskinesis, the therapist should focus on restoration of intramuscular trapezius muscle balance in the scapular exercises, with special attention to strength training of the retractors.

Key Words: exercise, internal impingement, rehabilitation, shoulder, tennis

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