| By Dr. Robert G. Silverman

I treat a lot of tennis players with shoulder pain, usually from rotator cuff issues. My goal is always to get them back on the court quickly without drugs, injections or surgery—and to keep them there by avoiding re-injury. For fast, effective, non-drug treatment, I rely on some proven nutritional supplements that work extremely well to help painful shoulders heal.

To understand why tennis players are plagued by shoulder injuries, let’s look at the way your shoulder is put together.

Your shoulder joint is easy to injure because it’s complicated. It’s made up of three bones: The upper arm (humerus), shoulder blade (scapula) and collarbone (clavicle). A number of ligaments attach the bones to each other. In addition, four muscles from your upper arm and back connect to the shoulder bones. The ball of the humerus is held in place in the shoulder blade socket by the rotator cuff—the area where the tough tendons of all four muscles come together to cover the head of the upper arm bone and attach it to the shoulder blade. So, your rotator cuff basically holds your shoulder joint together.

A common shoulder injury for tennis players is a tear in one of the tendons of the rotator cuff. The tear is usually the result of repetitive stress from motions such as hitting or serving a tennis ball, which stress the muscles and tendons in the shoulder of your dominant arm. Because tennis involves so many overhead strokes, tennis players are particularly vulnerable to rotator cuff tears from overuse.

Conventional medical treatment of rotator cuff injuries calls for powerful prescription anti-inflammatory drugs and painkillers. These drugs are risky for a lot of reasons, including digestive upsets and the chance of addiction or misuse. If the tear is a big one, you might be told you need surgery to repair it.

My patients with rotator cuff tears come to me because they’ve done their homework. They’ve learned that cortisone shots into the area risk making the problem worse, not better. They’ve also learned that after shoulder surgery for a rotator cuff tear, the shoulder is almost never as strong and stable again. My patients want to return to full activity and stay with their tennis. They turn to me instead for non-drug, non-surgical treatment.

Treating the rotator cuff

Most rotator cuff tears don’t fully heal on their own, and that could mean months of pain and sitting on the sidelines. To speed up the healing process, the first weapon in my arsenal of non-drug techniques is nutritional supplements to reduce the inflammation caused by the tear. Pain and swelling—inflammation—are your body’s normal response to any injury. That’s a good thing, but only up to a point. Too much inflammation for too long can actually damage the tendons, leaving you with long-term loss of strength and mobility in the shoulder and a greater likelihood of re-injury.

The right nutritional supplements can be very helpful for managing inflammation and bringing down the pain. For the acute phase—the first 72 hours when the injury is usually most painful—I recommend:

►Proteolytic enzymes, including trypsin, chymotrypsin and bromelain. Proteolytic enzymes are a natural way to reduce swelling. They’re very effective and don’t upset your stomach.

Natural anti-inflammatories, including Boswellia, turmeric, ginger and vitamin C. These nutrients bring down the pain and swelling. They work well without causing digestive problems.

Nutrients to relax muscle tissue, including calcium, magnesium, lemon balm and valerian. To protect the damaged area, the muscles around it contract, causing additional pain. These supplements relax them without making you groggy.

After four days, these supplements have almost always brought down the pain and swelling quite a bit.

For many of my patients, the difference between a rotator cuff tear that heals well and one that doesn’t is a supplement containing THIAA (tetrahydro iso-alpha acids) and berberine. These natural substances give your body the underlying materials it needs to build healing enzymes called matrix metalloproteinases (MMPs). Boosting your MMPs production is very helpful for speeding up the way your body rebuilds and remodels damaged tissues. I have my patients start taking this supplement on the fourth day after the injury and continue for another eight weeks. During this time, I also recommend 2,000 IU of Vitamin D every day. Many people are low on Vitamin D, which is vital for normal healing.

Once the injury is healed, we want to retain that restored tissue integrity to prevent re-injury. Going forward, I have my patients take a high-quality daily multivitamin with minerals formula, a phytonutrient formula, and fish oil to maintain their gains.

Dr. Robert G. Silverman is a White Plains, N.Y.-based sports chiropractor and certified clinical nutritionist, specializing in functional medicine and the treatment of joint pain with innovative, science-based, nonsurgical approaches. He is also on the advisory board for the Functional Medicine University and a health contributor to various major TV networks. He is the author of Amazon’s Number One Best-Seller, Inside-Out Health. In 2015, he was honored with the prestigious Sports Chiropractor of the Year award by the ACA Sports Council. He can be reached by phone at (914) 287-6464, e-mail Info@DrRobertSilverman.com or visit DrRobertSilverman.com.