By Robert Lim, PTA
What is Calcific Tendinitis?
Calcific tendinitis is a condition caused by calcium deposits building up in a person’s muscles or tendons. If calcium builds up in a particular part of the body, most people might feel pain and discomfort in the area. This condition can occur in other parts of the body, but the most common area for calcific tendonitis to develop is the rotator cuff.
What are the most common symptoms of Calcific Tendinitis?
Most people with calcific tendonitis have steady reports of increasing shoulder pain that can become severe within time. The most common symptoms of calcific tendonitis are shoulder pain, most severe with movement, pain at night that can interfere with sleeping, and difficulty lifting the arm away and up from the body.
What is the cause of Calcific Tendinitis?
The quick answer, the cause of calcium deposits that have resided within the rotator cuff tendon has not been understood. Calcific tendonitis usually progresses predictably and sometimes resolves without surgery. The typical course of progression is the following:
- Pre-calcification stage: Patients usually do not have any symptoms at this stage. At this point, the site where the calcifications tend to develop undergo cellular changes that predispose the tissues to develop calcium deposits.
- Calcific stage: During this stage, the calcium is excreted from cells and then forms into calcium deposits. When seen in an X-ray, the calcium looks chalky. Once the calcification has formed, a so-called resting phase begins, and usually is not painful and may last a varied length of time. After the resting phase, a resorptive phase begins–this is the most painful phase of calcific tendonitis.
- Post-calcific stage: This stage is usually not painful. As the calcium deposit disappears, replacement occurs with a more normal appearing rotator cuff tendon.
Common Treatments for Calcific Tendinitis
Treatment of calcific tendonitis usually begins with RICE, medication, and physical therapy. The RICE protocol is listed here:
When these simple steps are ineffective, more invasive treatments, including surgical treatment, can be prescribed. First, we will take about the nonsurgical treatment for calcific tendinitis ( physical therapy ). On your first physical therapy appointment, your therapist will take a history of your injury and determine which movements in your everyday life, such as sleeping and reaching, cause your discomfort. Physical therapy can be very effective in decreasing the pain and the inflammation caused by this injury. During physical therapy, your treatment may include electrical modalities such as ultrasound and electrical stimulation.
Your treatment may also involve massage around the shoulder and shoulder blade to help assist with improving movement. A big part of the treatment will focus on regaining the range of motion, strength, and coordination in your shoulder. Due to the initial pain you may feel, the range of motion exercises will be passive range of motion exercises. Maintaining a passive range of motion is very important in the early stages of treating calcific tendonitis because the pain associated with this injury often limits you from using the shoulder when performing tasks.
The next part will be regaining any strength that you may have lost. Strength training will include using bands and weights. These movements will help you regain functional movements that will assist you with daily living and a functional activity inside and outside your home.
To schedule physical therapy at JOI Rehab, please call 904-858-7045.
To read more on shoulder injuries, please read these related articles on Infraspinatus tendon tears, Shoulder Tendonitis,
Concentric and Eccentric contractions and Exercises for Shoulder Pain.
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To make appointments with JOI Rehab, please call 904-858-7045.