Arm Built More For Serving Than Pitching, Doctors Say

In a perfect straight-set shutout at the RCA Championships, Andy Roddick would serve 24 times.

In a grueling five-set match at Wimbledon or the U.S. Open, the world’s No. 3 player might unleash 240 serves, many of them approaching 140 mph.

Despite that workload, which could occur seven times in 14 days at a Grand Slam event, hard servers such as Roddick rarely suffer from the arm ailments that commonly afflict starting baseball pitchers who only throw in a game every fifth day.

Why? What makes hitting a serve 140 mph less stressful than throwing a baseball 90 mph?

Methodist Sports Medicine orthopedic surgeon Dr. Pete Sallay and physical therapist/certified athletic trainer Paul Mieling offer two explanations: mechanics, and wear and tear.

“The motion your shoulder and arm goes through throwing a baseball is a lot different than a tennis serve,” said Sallay, orthopedist for the RCA Championships. “The position a pitcher has to get their arm in to throw in that magical 92- to 100-mph range, it’s a much more extreme position and the forces exerted on the shoulder and elbow are tremendous.”

The standard shoulder internal rotation on a serve is about 2,300 degrees per second, Sallay and Mieling said, whereas the same number for a pitch is about 7,500 degrees per second. The elbow extends about 1,700 degrees per second on a serve, they said, compared to 3,500 degrees per second for a pitch.

“Plus the tennis player may serve five and then take a break (to return serve),” said Mieling, a former college pitcher whose career ended when he blew out his elbow in 1992.

Pitchers, in a quality start of at least six innings, typically throw 100 pitches and as many as 75 more during warm-ups and between innings. During troublesome innings, they might throw 30 pitches without rest.

“And when you”re pitching a baseball, you”re using your arm as the sole mechanism,” Sallay said. “With a tennis serve, you have a racket. You can generate a much higher level of pace with less effort because of that stick you”re holding.”

Roddick, who turns 22 in August, is about the same age Cubs ace Kerry Wood was when he needed Tommy John surgery. The RCA top seed said he uses treatment to offset wear and tear issues.

“I’ve just gotten into a habit, not only my shoulder, but various parts of my body I ice down,” said Roddick, who cruised into today’s semifinals. “After every match I”ll go in and I”ll ice it down and get a massage. I’ve just got into a habit of stretching before and after matches, icing various times during the day and taking as many proper precautions as I can.”

Ivan Ljubicic, a hard-serving Croatian who also advanced to the semis, says he rarely has problems with his elbow but constantly monitors his powerful right shoulder. After experiencing pain earlier in his career, he consulted doctors who advised him to develop muscles on the front and back of his shoulder.

“As a big server, I’m using my shoulder a lot,” he said. “I’m using full power almost every point. The muscles here in the front are working a lot. If you don’t work on the back side, your shoulder is slowly going to go in front. That’s where the problem is.

“Ninety percent of the guys have some kind of problem with their shoulder. The balls are much slower and heavier than they used to be five years ago. The rackets are heavier. That’s our choice, obviously. The balls are slower so we have to do something to make balls go. Physically we have to be stronger than the guys 10 years ago.”

Still, tennis surgeries are more rare than those for pitchers. Sallay has assisted fellow Methodist orthopedist Dr. Art Rettig on a Tommy John surgery — the procedure in which baseball players” elbows are reconstructed. He calls the procedure “an occupational hazard” for pitchers.

As for tennis injuries, the most common ailment related to the sport is considered a misnomer.

“Tennis elbow,” what Sallay described as an inflammation in the tendon attachment of the forearm muscles responsible for extending or flexing the wrist, is rare in tennis players. Less than 5 percent of those diagnosed are tennis players, and he said almost all are recreational and older players.

“At the elite level, like for the professionals here at the RCA tournament, that’s a very uncommon injury for them,” Sallay said. “They typically don’t get it.”

In fact, in seven years at Methodist, Mieling remembers only one tennis player needing reconstruction.

“He was just born with a bad elbow,” he said.