A Cross-Sectional Study Comparing Overhead Activities of Senior Tennis Players With and Without Shoulder Pain

Suegnet Meyer, MSc BPHYST MCSP  

MSc Sports Physiotherapy Dissertation

University of Bath, 2018


Study Design

Cross-sectional design


Repetitive overhead activity during tennis is a causative factor of shoulder pain. Age and playing years will influence shoulder movement and possibly result in shoulder injuries for throwers and hitting athletes. Literature assessing the shoulder movements of senior overhead athletes with shoulder pain exist, but correlation with serve kinematics is lacking.

Tennis player with motion sensors attached
Tennis player with motion sensors attached

This study compares the effect of shoulder overhead activities on senior tennis player – with and without shoulder pain. The differences between movement patterns by means of inertial measurement and shoulder clinical assessments were assessed and correlated with the effect of age and playing history.


Twenty-two advanced level senior tennis players were divided into 2 groups: Older Asymptomatic group (OA), (n=12; males : females = 6 : 6; aged 56.6 ±8.3 years; 24.8 ±16.5 playing experience years), and Older Symptomatic group (OS), (n=10; males : females = 7 : 3; aged 53.7 ±13.6 years; 38.7 ±16.8 playing experience years).

Capturing Range of Motion with Inclinometer

A Clinical assessment (using an inclinometer) of glenohumeral internal rotation (GIR), glenohumeral external rotation, total range of motion (TROM) and scapula upward rotation were recorded.

Shoulder XSens Motion trackers

A dynamometer determined muscle strength and ratios for shoulder Internal Rotators, External Rotators (ER), Middle and Lower Trapezius. Kinematics measures were collected during flat tennis serve by an inertial measurement system.

Motion tracking of tennis serve using Xsens

By comparing between-groups humeral acceleration (Hum_a), OS-Hum_a was significantly increased by 42% (p<0.001). Both OA and OS-groups presented with reduced TROM and GIR.  OS-TROM and OS-GIR were significant inverse correlated (p<0.05, p<0.01) with OS-Hum_a. OS-Scapular Angular velocity (Scap_ω) and OS-Hum_ ω were elevated.


Age and Pain may have caused the OS-group to modify their technique due to a reduced OS-TROM and OS-GIR and an increased OS-Hum_a, Hum_ω and Scap_ω, causing stress on the shoulder joint and musculature.  It is important to promote shoulder mobility by including sleeper and cross-body posterior shoulder stretches.


Tennis, overhead injury, kinematics

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Shoulder Study Poster


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The content of this article and dissertation – A Cross-Sectional Study Comparing Overhead Activities of Senior Tennis Players With and Without Shoulder Pain, is copyright © 2018 of Suegnet Meyer and Meyer & Associates. Transmission or reproduction of the contents, beyond that allowed by fair use as defined in the copyright laws requires the written permission of the copyright owners.