Overhead Stability for the Tennis Player

The overhead athlete is a unique type of athlete to treat in physical therapy.  When I think about the different types of overhead athletes I include the baseball thrower, tennis player, and even the quarterback.  Each of the mechanics of these athletes is different and present unique challenges (load, speed, intensity, biomechanics, etc).  However, while each of these athletes are different, some of the exercises can be tailored to each sport.   
 

​Recently, I was working with a competitive high school tennis player.  He presented with a very stiff shoulder and diffuse pain.  When I say stiff shoulder, I mean he had very limited shoulder flexion, abduction, and inability to get into a 90/90 position without pain.  His postural presentation was a significantly lax R shoulder (hanging down), flat t-spine, and scapular winging. 
 
After some time working on pec minor, lat, and subscap tone he was able to start to recruit some of his scapular stabilizers (primarily serratus & low trap) much better.  However, his rehabilitation took off once he had good shoulder flexion ROM and we were able to start to work on overhead stability. 
 
So what overhead stability exercises did I use?

• Barbell Land Mine Presses
  • This is one of my favorites because not only does it start to reintroduce overhead strength without being completely overhead, but also it allows the scapula to move.
  • Just be sure to have patients stagger their stance to protect their lower back.
• Barbell One Arm Snatch
  • Again, this is great because it allows the athlete to produce force/introduce speed back
  • Must be set up in a T-bar position to be effective
• Walking KB Overhead Holds
  • Very effective for pure OH stability as well as core stability
• Half Kneeling Ball Flip backs
  • While usually reserved for baseball throwers, I find the eccentric cuff control to be very effective for tennis players because they have to slow down their rackets after serving
• Quadruped Stability Ball Holds with Rhythmic Stabilization
  • In an all fours position the athlete places one hand on an exercise ball that is on the wall.  The PT then applies perturbations while the athlete is looking down.  Very effective for control and OH stability.

 
What else do you use for overhead stability?  Comment below and let me know
 
- Dr. Brian Schwabe, PT, DPT, SCS, COMT, CSCS
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