Tennis Shoulder Pain: Causes and Exercises to Relieve Symptoms

Your shoulder is one of the most active and complex joints in your body. It allows you to enjoy sports you love, like tennis, while also handling the practical tasks of daily life — whether you're tossing a ball to your dog or reaching for something on a high shelf. Your shoulders are very strong, but since they’re so busy, they are prone to occasional aches and pains. One common issue is discomfort that results from overhead or repetitive shoulder movements, often referred to as "tennis shoulder." 

Here, learn more about what causes tennis shoulder pain and how to treat it — especially with exercises from our Hinge Health physical therapists.

What Is Tennis Shoulder Pain?

Tennis shoulder refers to shoulder pain or injury that’s related to overhead or repetitive shoulder movements, says Dorian Logan, PT, DPT, a physical therapist at Hinge Health. It generally arises from overuse or strain on the muscles, tendons, and ligaments around the shoulder joint, which can lead to inflammation, tears, or impingement.

Tennis shoulder pain is common in people who play a lot of tennis and other sports or activities that involve similar arm movements, but it’s not exclusive to tennis players. “We often see tennis shoulder in people with specific occupations — for instance, electricians who work with their arms held over their heads for long periods of time,” Dr. Logan explains.

What Causes Tennis Shoulder Pain?

There are several different causes of tennis shoulder pain. Some of the most common ones include:

• Rotator cuff tendonitis. This is inflammation of the tendons in the rotator cuff, a group of muscles and tendons that stabilize your shoulder. It can lead to pain, weakness, and difficulty with shoulder movement.

• Bursitis, or inflammation of the bursa, a fluid-filled sac that cushions and reduces friction between the shoulder's bones, tendons, and muscles. It often causes pain, swelling, and difficulty moving your shoulder, particularly during overhead activities.

• Labral tear. The labrum is a ring of cartilage that surrounds and stabilizes your shoulder joint. This injury can cause pain, instability, and a sensation of catching or locking in your shoulder, especially during certain movements.

• Shoulder impingement. This occurs when the tendons or bursa in your shoulder become compressed or pinched during movement, typically between the bones of the shoulder. This can lead to pain, inflammation, and difficulty lifting your arm. 

• Osteoarthritis. This is the most common form of arthritis and is characterized by gradual cartilage changes in a joint. It can cause symptoms such as pain and stiffness in your shoulder that tend to worsen after activity. 

• A bad fall. Tennis shoulder pain is often related to overuse, or doing more than your body is prepared to handle. But it can also be related to an injury, such as falling on your shoulder. If a fall injures the ligaments that surround and stabilize your acromioclavicular (or AC) joint, it can contribute to tennis shoulder pain, explains Dr. Logan.

Tennis Shoulder Pain Symptoms

What are the symptoms of tennis shoulder? The most obvious one is shoulder pain, particularly when lifting your arm or reaching overhead (e.g., when serving a ball during a tennis match). But you may also notice that tennis shoulder pain causes the following: 

• Shoulder weakness and reduced strength, especially during activities that involve lifting or rotation. 

• Stiffness that limits your shoulder’s range of motion. 

• A clicking or popping sensation during shoulder movement. 

• Discomfort that spreads from the front of your shoulder to your arm. “It feels like a band at the top of your arm,” says Dr. Logan. 

• Shoulder pain that worsens at night, especially when lying on the affected side.

Pain may make you hesitant to move your shoulder, but targeted exercises are actually one of the most effective tools in managing tennis shoulder pain, says Dr. Logan. “It’s important to get started with gentle stretching and strengthening exercises right away.” Contrary to what you may assume, avoiding movement can actually lead to stiffness, weakness, and prolonged discomfort. But gentle, controlled exercises help strengthen your shoulder muscles, improve joint stability, and restore mobility. The above exercises recommended by Hinge Health physical therapists are a great place to start. 

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Tennis Shoulder Pain Treatment

Tennis shoulder pain can do more than just prevent you from playing tennis — it can keep you from doing many of your daily activities, whether it’s reaching overhead to grab something or even just scratching your back. But there’s a lot you can do to help yourself feel better, reassures Dr. Logan. Most of the time, symptoms resolve with gentle movement and a few simple, conservative measures.  

• Physical therapy. If the exercises mentioned above don’t help your symptoms, or if you’re in too much pain to even do those movements, a physical therapist can provide a more tailored treatment plan to increase your range of motion and build shoulder strength. “Your physical therapist can also show you ways to modify your daily activities so that they don’t aggravate your symptoms,” adds Dr. Logan. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

• Ice and heat. Either one can help — it just depends on what feels best for you, says Dr. Logan. You can start by applying ice to your shoulder for the first 48 hours after pain begins. This helps reduce inflammation. After that, heat may feel better. It increases blood flow to the area and helps relax sore muscles. 

• Massage. It can help to relax tight shoulder blade muscles that are contributing to your discomfort, says Dr. Logan. You don’t have to get a professional massage, either — sometimes just massaging your sore shoulder with a foam roller is enough. 

• Over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful for tennis shoulder pain. It's important to make sure that you are safely able to take these medications, based on your medical history. 

• Adjusting your sleeping position. If you fall asleep on your side and wake up with shoulder pain, it may help to try a different position when falling asleep. Try sleeping on your back or starting the night by sleeping on your non-painful side to see if you notice any improvements. 

PT Tip: Ease Into Activity Gradually

It can be tempting to be a weekend warrior and cram hours of tennis into your two days off of work. But this can set you up for a case of tennis shoulder pain. “If you’ve just started an activity, whether it’s tennis or something else, ease into it gradually,” advises Dr. Logan. “This will allow your shoulders to adjust so you can find your movement sweet spot.” Take your time enjoying a beautiful day outdoors, but instead of playing three hours of tennis, opt for an hour and then do something different — like going for a walk. 

How Hinge Health Can Help​​ You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program. 

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. 

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you. 

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here. 

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Silveira, A., Lima, C., Beaupre, L., Chepeha, J., & Jones, A. (2024). Shoulder specific exercise therapy is effective in reducing chronic shoulder pain: A network meta-analysis. PloS One, 19(4), e0294014–e0294014. doi:10.1371/journal.pone.0294014

2. Harmath, D., Kazemi, M., Côté, P., & Boynton, E. (2022). The one-week prevalence of overuse-related shoulder pain and activity limitation in competitive tennis players living in Toronto: a feasibility study. The Journal of the Canadian Chiropractic Association, 66(1), 33. 

3. Dixon, B., Kruse, D., & Simons, S. (2024, October 14). Patient education: Shoulder impingement syndrome (Beyond the Basics). UpToDate. https://www.uptodate.com/contents/shoulder-impingement-syndrome-beyond-the-basics/print

4. Simons, S., & Roberts, M. (2023, June 23). Patient education: Rotator cuff tendinitis and tear (Beyond the Basics). UpToDate. https://www.uptodate.com/contents/rotator-cuff-tendinitis-and-tear-beyond-the-basics

5. Koehler, S. (2024, June 25). Patient education: Acromioclavicular joint injury (shoulder separation) (Beyond the Basics). UpToDate. https://www.uptodate.com/contents/acromioclavicular-joint-injury-shoulder-separation-beyond-the-basics