My midlife padel hobby left me with horrific shoulder pain – here's how I fixed it
Once upon a time a decade ago, around a luggage carousel far, far away, I lifted a suitcase at 'the wrong angle' and twinged my shoulder. (In the name of journalistic integrity, I should mention that the suitcase may have had a 'heavy' tag dangling from it because fabulous shoes are important on holiday.)
In true midlifer fashion, I ignored the twinge, had a few jolly good games of holiday tennis – and ended up with intense shoulder pain and an arm I could no longer move.
It took a week in a sling before my limb could take instruction from my brain again and I could sleep through the night, and several more weeks to be pain free. Then, for over a decade, my shoulder would flare up unpredictably like an erratic teenager, with varying degrees of pain and immobility.
After multiple visits to the GP, the physio and specialists, I'd started to accept having a bad shoulder was just part of getting older, but the shoulder pain never truly left me. Until my recent romance with padel forced me to confront it once and for all.
I'm one of 65,000 padel enthusiasts in the UK, a racket sport that's a cross between squash and tennis, played in doubles on a 10m by 20m court, enclosed in glass so that the ball can bounce off and stay in play. And when I first see shoulder consultant Professor Tony Kochhar, aka the Shoulder Doctor, I learn I'm one of many padel players with a dodgy shoulder. He tells me he's seen several that week – and we're all in the midlife age range.
If this midlife niggle sounds all too familiar to you, know that all is not lost. This is a midlifer's fairytale: six months on from hitting rock bottom with the padel pain, I believe I have defeated my sore shoulder almost entirely – here's how.
I first started playing padel about five years ago on holiday in Spain, where padel is a national passion, but it's only in this 'school year' that padel courts have started springing up near my home in north London. According to the Lawn Tennis Association (LTA) there are now 800 padel courts in the UK. It doesn't need as much skill as tennis itself so it's more accessible across ages and abilities – and it's also a bit of a hoot.
By the end of a super fast-paced rally, you're often breathless from exertion and laughter. So when there were suddenly two padel clubs within a 10-minute radius of my house, I was playing at least once a week: on Sunday with the kids, for a girls' night out, or even on Saturday night with another couple, followed by dinner. I could feel a low-level ache in my shoulder but it didn't bother me. Then one Sunday afternoon, while going in for a smash with all my might, I missed the ball (I didn't say I was good, just enthusiastic) and I felt a familiar pull deep in my right shoulder.
By Monday morning the pain was so excruciating I couldn't think about much else and my arm was immobile. At work, I could only type (slowly) with my left hand, but driving was out of the question. On the plus side, my share of kitchen duties were all but handed over to the rest of the family (and Deliveroo).
At first, a course of Naproxen from my GP helped ease the immediate pain. I also managed it with over-the-counter Biofreeze Gel, which felt miraculous in terms of cooling that intense soreness. Within a week I was over the worst of it, able to drive and type, and although it was still slightly painful and restricted, I was on the right trajectory to get my shoulder back to low-level niggle status. But this time – with the incentive of my amateur padel career as Britain's least brilliant but most enthusiastic midlife player – I felt determined to gain full recovery.
I assigned myself a dream team – along with consultant Prof Kochhar, physiotherapist Rob Madden, who counts Anthony Joshua amongst his clients (who, let's face it, needs his shoulder more than I do), as well as being physio to GB Olympic skiers and snowboarders. And then personal trainer Monika Kolb to keep me on track long term.
Those of us who are active and over 40 are, sadly, susceptible. 'In midlife we tend to focus on staying active but our tissues are starting to weaken, so we have to work harder to keep what we've got,' says Prof Kochhar, who explains that this process (sarcopenia) means we lose around four per cent of muscle per year. 'In midlife we're also taking up new sports, we might have more time as kids are older, we want to relive our youth… and that's where we hit that apex and get injured.'
Madden explains: 'The body can cope with more or less anything. But it has to get there in a smooth, slow and sensible way. Don't fear a new sport, but we must take things up slowly and allow our body to get used to it.'
According to Prof Kochhar, the rotator cuff, which is the group of muscles that make up the shoulder joint, is particularly susceptible to injury for active midlifers. 'Around other joints, like the knee and the ankle, the ligaments – which are the bits of rope that keep the joint in place – are primary for stability. But because the shoulder is so mobile, it relies on muscles to stabilise it. In the knee and ankle, the muscle only provides 10 per cent of stability, but in the shoulder it's more like 50:50 – so that muscle degradation has a greater impact on how our shoulders move and function.'
Shoulder pain is often down to some type of inflammation and irritation but the question of what's causing it is key, Madden explains. For me, an ultrasound reveals calcific tendonitis of the supraspinatus – a build up of calcium in the tendons of one of the muscles that make up the shoulder. The calcification was causing acute inflammation of the tendon, which was causing tightness and preventing it from working properly. A ten-minute 'barbotage' procedure was a key next step in my recovery (look away if you're squeamish). Using an ultrasound guided needle, the calcium was broken down and then sucked out of my shoulder with a tiny syringe, followed by a steroid injection to reduce the resultant inflammation. Thankfully, the thought was more painful than the procedure itself, which was slightly uncomfortable but didn't hurt.
Shoulder pain is often misdiagnosed by Dr Google as a 'frozen shoulder', says Prof Kochhar, but there are often other underlying causes creating the inflammation. The NHS defines a frozen shoulder as stiffness and pain that restricts movement of the shoulder for a number of months. Common wisdom is that with a frozen shoulder you have to wait 18-24 months for recovery and treatment, but Prof Kochhar disagrees: 'That was advice from the 1970s but with non-surgical treatment, good physio and perhaps a steroid injection, 85-90 per cent of patients are fully recovered in a matter of weeks.'
Whatever the underlying cause, Prof Kochhar says that any injection that reduces inflammation 'gives you a window to try to rebalance and rehabilitate.' This is where Madden comes in to work on mobility and strength – the vital next steps to full recovery.
I am 'prescribed' three exercises to do every other day – either at the gym using the cable machine, or with a resistance band at home. They are isometric exercises, which means they are static moves that focus on specific muscles, and between them they target various muscles around the shoulder. Band pull-aparts (where you stretch the band between your two hands) strengthen the mid-back and posterior shoulder muscles (rhomboids and posterior deltoid), which help improve shoulder and back posture. Single-arm horizontal band rows get into the posterior shoulder and rhomboids. Finally, diagonal high-to-low reverse flies strengthen the posterior deltoid and rotator cuff.
Hold a resistance band at shoulder height with straight arms
Pull it apart by squeezing your shoulder blades together
Return slowly
Anchor the band at chest height
Stand with feet hip-width apart
Pull the band toward your torso – don't let your shoulder shrug
Extend the arm slowly back to the starting position
Anchor the band above head height
With your arm extended in front of you, hold the band
Pull your arm down and out in a diagonal motion, squeezing shoulder blades
Together these exercises also create stability in the shoulder capsule. Madden describes the shoulder capsule as 'the wetsuit of the joint'. He explains: 'When you have a healthy shoulder, that wetsuit wraps around the shoulder and stays nice and soft, but when you get injured it can get stiff and restrictive.' So the rehab will help get my wetsuit stretchy again but also get the necessary strength back in my shoulder.
These three exercises would translate well across the majority of shoulders that are in need of strengthening, explains Madden, but he warns that there always needs to be a degree of individualisation so would recommend seeing an expert. After six weeks of getting full marks on my physio homework, Madden switches the 'band pull-aparts' for dumbbell external rotations. It gets deeper into that shoulder joint, which he recommends will get me padel ready.
Kneel next to a bench (or chair) with the knee closest to the bench on the ground
Position your arm at 90 degrees with your elbow pressing back against the bench holding a light weight
Slowly turn your arm up into external rotation and then lower back
At my 12-week check up with Prof Kochhar, it was time to see how far I'd come. 'There are no tests that are completely validated – the best way to get a sense of how your shoulder is functioning – and one that I give to my patients so they can manage their recovery themselves is the chicken wing test,' says Prof Kochhar. It simply involves putting your upper arms out to the side, bent at the elbow 90 degrees so your hands are pointing up in the air; then rotating the shoulder so that your forearms point forward, still with your elbow bent at 90 degrees. 'When your injured side is symmetrical with the healthy side, it means you're fully recovered,' explains Prof Kochhar. Both my forearms end up horizontal so I'm given top marks.
The hard work unfortunately doesn't stop there. Personal trainer Monika Kolb is an expert in rehabilitation and explains: 'Keeping your shoulders strong and healthy isn't just about working on mobility and strength in the shoulder itself, but in the upper back too. A strong back supports your shoulder by sharing the workload, so your body doesn't rely on your shoulder as the default mover. This helps prevent irritation, overuse, and injury.'
But strength alone isn't enough. 'Posture plays a huge role. Standing or sitting with poor posture – letting the upper back collapse or the shoulders round forward – can undo all your training. Unfortunately, many of us (especially women) develop the habit of shrinking ourselves – whether from shyness or simply from years of looking down at phones or hunching over desks.'
If you want long-term shoulder health, Monika's tip is: 'Be aware of daily habits. Pay attention to how you stand and sit and don't let your back get lazy. Practice holding yourself tall with an open chest and aligned spine. No amount of exercise will fix your shoulders if you're constantly reinforcing bad posture throughout the day.'
For Madden, my initial rehabilitation has been a success. He may not have given me the ability to throw a killer right hook like Joshua – or the skills to beat my kids to the bottom of a black run like Team GB ski – but I am ready for a summer of padel.
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