Rehabilitation Incorporating a Stroke Efficiency Analysis in a Male Tennis Player with Scapular Dyskinesis - A Case Report

Sep 28, 2026

Uploaded by dabgoudw

A case report details a 23-year-old male tennis player with long-standing right shoulder pain associated with scapular dyskinesis and secondary shoulder impingement. The rehabilitation program used a four-phase, 16-week approach that integrated physical therapy with a Stroke Efficiency Rating Analysis/Injury Risk Assessment (SER/IRA) to identify serve-related biomechanical faults. After intervention, pain during and after play decreased markedly and functional scores improved with clinically meaningful reductions in disability measures, enabling return to pain-free tennis and activities of daily living for six months post-discharge.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages15

Reading Time38 min

AccessFree to download

Background

Case Description

Outcomes

Discussion

Level of Evidence

Introduction

Case Reports Rehabilitation Incorporating a Stroke Efficiency Analysis in a Male Tennis Player with Scapular Dyskinesis: A Case Report Cristina Leek, MS, PT, DHSc.1a, Katie Sell, PhD2 1 Physical Therapy, Long Island University, 2 Allied Health and Kinesiology, Hofstra University Keywords: tennis, serve, treatment collaboration, scapular dyskinesis [https://doi.org/10.26603/001c.154590](https://doi.org/10.26603/001c.154590) International Journal of Sports Physical Therapy Vol. 21, Issue 1, 2026 Background Scapular dyskinesis (SD) is a common co-morbidity with shoulder complex injuries. However, the presence of shoulder pain (SP) with SD is inconsistent, suggesting a need for individualized assessment and treatment approaches. The purpose of this case report is to describe the differential diagnosis of an athlete with SD and SP and a rehabilitation strategy integrating physical therapy (PT) with a Stroke Efficiency Rating Analysis/Injury Risk Assessment (SER/IRA) to identify biomechanical faults during the tennis serve. Case Description A 23-year-old male tennis player with right SP was referred to PT by his coach. The subject’s SP had been intermittent for nine years, presenting during and after serving and recently intensified, limiting his activities of daily living (ADLs) . The subject was diagnosed with secondary shoulder impingement with long head of the bicep and rotator cuff tendinopathy attributed to SD. He completed a 16-week, four-phase rehabilitation program incorporating the SER/IRA and revisions to the biomechanics of his service action, leading to symptom resolution and return to pain-free tennis and ADLs. Outcomes The subject’s pain level during and after playing tennis decreased from 8/10 to 1/10 following the intervention. The Upper Extremity Functional Score improved by 11 points, while the Disabilities of the Arm, Shoulder, and Hand Questionnaire (disability/symptom and work/sports modules) decreased by 20.87 and 56.25 points, respectively, reflecting clinically meaningful change. The subject returned to tennis and ADLs without pain and remained unrestricted six months after discharge. Discussion This case highlights the effectiveness of combining individualized stroke analysis with evidenced based rehabilitation for an individual with SD and SP. The SER/IRA provided insight into the subject’s movement quality, guided treatment progression, augmented rehabilitation, and facilitated collaboration between the physical therapist and coach. Such tools may help promote long-term pain reduction, expedite return-to-play, and optimize performance for players with SP and/or SD. Level of Evidence Level 4 a Corresponding Author: Cristina F. Leek, MS, PT, DHSc., CSCS, CTPS Department of Physical Therapy, Long Island University Post, Brookville, NY 11548, USA Phone: 516-299-4016 [Email:](Email: Cristina.Leek@liu.edu)[ ](Email: Cristina.Leek@liu.edu)[Cristina.Leek@liu.edu](Email: Cristina.Leek@liu.edu) INTRODUCTION Shoulder pain is one of the most common musculoskeletal complaints among tennis players, both recreational and elite level.1,2 The lower body is the most common region for injuries in tennis, followed closely by the upper extremity with the elbow and shoulder being the most frequently affected areas.2‑5 Like other overhead athletes, the repetitive, explosive, and forceful overhead motions involved in tennis make the shoulder susceptible to chronic overuse injuries such as internal impingement, Superior Labrum-Anterior to Posterior (SLAP) tears, and tendinopathies of both the shoulder and elbow are common.3,4 Scapular function is an important factor in optimizing the function of the shoulder by virtue of its effect on the glenohumeral and acromioclavicular joints.6‑8 During overhead motions, correct alignment of the scapula provides optimal muscle activation of the scapular stabilizers and rotator cuff, as well as efficient energy transfer from the hips and core into th

FAQs

What was the athlete’s main complaint and how long had it been present?

The athlete reported intermittent right shoulder pain that had been present for nine years, occurring during and after serving and later intensifying to limit daily activities.

What tools were integrated into the rehabilitation program?

The program incorporated physical therapy with Stroke Efficiency Rating Analysis/Injury Risk Assessment (SER/IRA) to identify biomechanical faults during the tennis serve.

What outcomes were reported after the 16-week rehabilitation?

Pain during and after playing dropped from 8/10 to 1/10, upper-extremity function improved, disability questionnaire scores decreased substantially, and the athlete returned to pain-free tennis and activities without restrictions for six months after discharge.

Sep 28, 2026

Uploaded by dabgoudw