Shoulder Tendonitis

By: Ehren Allen, DPT, COMT

Please watch this informational video of why shoulder pain can't wait to be treated!

One of the more common conditions in the shoulder that is seen by physicians and treated in rehab clinics is shoulder tendonitis. This condition is typically involves the tendons in the rotator cuff thus it is commonly called rotator cuff tendonitis. Understanding what tendonitis is and why we suffer from it can help recovery from this painful condition.

To define tendonitis, this is simply a condition of inflammation or irritation in a tendon. When it occurs in the shoulder it is usually involves the supraspinatus tendon. This is one of the four tendons that make up our rotator cuff. It runs across the top of the shoulder blade and crosses over the shoulder joint, attaching near the top of our arm bone. Click Here to watch a quick video on the anatomy of the shoulder. 

Signs and Symptoms of Shoulder Tendonitis

Typically shoulder tendonitis presents with localized pain in the area of the upper front part of the shoulder where the rotator cuff tendons attach to the arm bone. Often pain is experienced at the onset of shoulder movements. As the shoulder warms up and adjusts to the activity the pain usually improves somewhat but then returns at a later time. It is also common to have pain at night while trying to sleep. Other symptoms of shoulder tendonitis can be: 

  • stiffness 
  • weakness
  • swelling 
  • sometimes feels warm to touch

Dr. Kamal Bohsali states, "Tendonitis is a general term that we use for inflammation of the tendon of a muscle. In the shoulder, this involves inflammation of the rotator cuff tendon tissue. Tendonitis is usually a result of repetitive overhead activity with the shoulder.  This may be due to a new exercise regimen or a work-related obligation. The initial management of this problem, assuming normal x-rays, is activity modification, over-the-counter anti-inflammatory medication, ice, and physical therapy.  Sometimes cortisone injections may be used to reduce the inflammation associated with tendonitis. Tendinitis can be acute or long-standing (chronic). Calcific tendonitis is one type of inflammatory process of the rotator cuff tendon that involves calcium formation within the tendon. It is uncommon for people to require surgery to address tendinitis of the rotator cuff."

Dr. Kamal Bohsali, is a board certified, fellowship trained orthopedic surgeon with special interests in the management of pathologic conditions of the shoulder and elbow.

JOI Shoulder TendonitisShoulder Tendonitis

Diagnosis of Shoulder Tendonitis

A diagnosis is typically made through an examination by a healthcare provider. This usually consists of a medical history regarding your: 

  • activity level with your shoulder
  • learning about your occupation 
  • hobbies and sports activities 

that may be related to your shoulder condition. Physical examination of your shoulder for strength, range of motion, stability, and tenderness is often performed. X-rays can be taken to rule out fractures or other conditions that cause pain in the area. Sometimes MRIs are performed if conservative treatment has not helped.

Causes of Shoulder Tendonitis

There are numerous factors that contribute to shoulder tendonitis. Usually it is related to overuse of the tendon either from repetitive activities/movements or from overloading it. Often times a person ramps up their workouts too fast and stresses out the tendons. Some times lack of strength of the supporting shoulder and scapular muscle leads to rotator cuff overload. And further more lack of shoulder mobility or tight muscle can contribute to rotator cuff strain and eventually tendinitis.

Anatomy of the Shoulder JointShoulder Joint Anatomy Picture

Treatment for Shoulder Tendonitis

1) Treatment for shoulder tendonitis initially involves rest or avoidance of the activities that initiated the shoulder pain (repetitive overuse or overhead activities).

2) Ice or anti-inflammatories are helpful to decrease the swelling and irritation in the tendon.

3) Stretches and posture exercises to decrease the strain on the rotator cuff tendons.

4) Sometimes formal Physical Therapy to help identify flexibility, strength, and postural deficits, and formulate a game plan to improve the conditions.

5) Slings in some cases may be of benefit

6) Injections of corticosteroids to decrease inflammation.

7) In rare cases surgery may be of benefit for debridement in shoulders with chronic tendonitis that have not responded to conservative treatment.

Please consult with your physician before doing an exercises for a torn rotator cuff. 

Prevention of Shoulder Tendonitis

To prevent developing tendonitis or other conditions in the shoulder such as bursitis or rotator cuff tears it is important to consider performing some type of warm up and stretches before engaging in vigorous activities using your shoulders. When exercising, try to slowly increase your exercise volume or intensity level. Minimize overhead reaching activities and consider breaking repetitive tasks into shorter intervals to allow for recovery and strain reduction. Try these shoulder exercises for a strain or to help prevent shoulder tendonitis.  

Also if you have recently had a shoulder surgery watch our video on How to Properly Put on an UltraSling 4 or Dressing the Upper Body After an Injury or Surgery

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