Preventing Shoulder Injuries with Dr. Brad Carofino

Hello USTA Mid-Atlantic! I’m Dr. Brad Carofino at Atlantic Orthopaedic Specialists in Virginia Beach. I am a shoulder and upper extremity specialist. I am excited to be assisting USTA MAS with my services for its members. My Athletic Trainer, Brice Snyder, MSAT, ATC, OTC is available at matches and tournaments throughout the 757 for consultation and appointment scheduling if you experience a shoulder or upper extremity injury.

Today I wanted to focus on some “shoulder health” education. As a shoulder specialist, I see lots of recreational athletes with overuse shoulder injuries. Tennis in particular places high demand on the shoulder joint. It has been cited that the humerus (the ball of the shoulder) spins into internal rotation at velocities reaching 2420°/s during the acceleration phase of the serve in an elite athlete.1 Another study analyzed data from a tennis pro competing at the US Open and found that he took over 1000 serves in a two-week period. Compare this to a professional baseball pitcher who throws at most 100 pitches every 4 days.2

Not everyone serves a tennis ball at those speeds or takes that many serves in a two-week time span. Do I commonly treat those types of professional tennis players? No. However, as a team physician for the Norfolk Tides I do care for many professional baseball players with similar injuries. More importantly, I see countless weekend-warrior type recreational athletes. Unfortunately most recreational tennis players don’t dedicate enough time to stretching and strengthening of the shoulder muscles. This can lead to overuse strains of the rotator cuff or even rotator cuff tears. The rotator cuff muscles are essential for arm motion above shoulder level.  Fortunately, many of these injuries can be prevented with appropriate conditioning exercises.

The biggest piece of advice I can give someone who plays tennis with USTA Mid-Atlantic is to perform an in-season maintenance program that focuses on rotator cuff strengthening and shoulder stretching.  This has been shown at all levels and types of overhead sports to be effective and manageable. There are many shoulder programs out there and the one I like the most is the “Throwers Ten” program. It is easy and requires minimal equipment.

Please visit my website: for more information on shoulder injuries. Also visit, for an instructional on the “throwers ten” program and for a printout of the program.  To learn about the rotator cuff visit

Contact 757-321-3300; 757-679-3407 (Brice, Athletic Trainer) to schedule an appointment or visit for more information


  1. Fleisig G, Nicholls R, Elliot al Kinematics used by world class tennis players to produce high velocity serves. Sports Biomech 2003251–64.
  2.  Johnson CD, McHugh MP, Wood T, Kibler B. Performance demands of professional male tennis players. Br J Sports Med. 2006; 40 8: 696– 699