Williams wore compression sleeves on both arms in Arthur Ashe Stadium but showed no visible sign of weakness as the world number one cruised to a 6-3 6-3 victory against the Russian.
She shot 12 aces with her faulty right shoulder and Makarova failed to create a single break point as Williams booked a second-round meeting with fellow American Vania King.
“No, I didn’t make too many adjustments,” Williams said.
“I didn’t hit my serves as hard as I normally hit them. I just went for more placement. I didn’t go for the big 120s, just the regular.”
Williams is bidding to win a 23rd grand slam title at Flushing Meadows, which would take her above Steffi Graf’s Open-era record and within one of Margaret Court’s all-time best.
She added a note of caution to any optimism about her fitness, however, admitting she increasingly feels pain the day after a match.
“Usually it’s the day of (playing that I feel it),” Williams said.
“But as time has progressed, and this past week it’s usually been the day after, so that’s a really positive thing.”
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