Introduction
Shoulder tendonitis, or rotator cuff tendonitis, is a common source of shoulder and/ or arm pain. It results when the rotator cuff rubs against the bony parts of the shoulder in an unnatural way due to overuse, incorrect movement or trauma. This condition can result in intense and uncontrolled pain as well as reduced mobility and strength within the arm.
Fortunately, there are steps you can take to both reduce your risk of incurring this condition and to heal it if it has already developed. Arming yourself with knowledge on types of tendonitis, prevention methods, early detection signs and various treatment options is the best way forward in proactively treating your shoulder tendonitis now, or preventing an occurrence in the future.
The remainder of this guide will discuss each of these topics in depth to help you on your journey towards optimal health for your shoulders:
- Types of tendonitis
- Prevention methods
- Early detection signs
- Various treatment options
Causes of Shoulder Tendonitis
Shoulder tendonitis is a common condition that can cause discomfort and pain in the shoulder joint. It usually occurs when the tendons around the shoulder joint become irritated or inflamed.
The condition can be caused by
- repetitive stress
- improper technique while exercising
- poor posture
Knowing the causes of shoulder tendonitis can help you take action to prevent it from happening in the first place.
Overuse
Shoulder tendonitis is an inflammation of the tendons in the shoulder which occurs due to repetitive motion. This type of injury is often referred to as overuse injuries because they are a result of the same motion being repeated over and over again. Common causes can be related to sports, hobbies, occupations that require repetitive upper body movements such as painting, carpentry, gardening, lifting and throwing.
Other possible causes could include trauma or injury to the shoulder joint such as a dislocation, fractures or direct blow to the shoulder joint itself. It can also occur due to arthritis or rheumatoid conditions that cause inflammation in other areas of the body including in and around the joints which then lead to inflammation of the tendons. Poor posture and muscle imbalances resulting from long periods spent sitting down have been found to be associated with shoulder tendonitis as well.
The best way for people suffering from this condition is physical therapy. Physical therapy involves exercises designed specifically for strengthening and stretching of muscles involved in movement around Shoulder Joints as well for increasing joint range of motion (ROM). The goal is also regaining flexibility throughout entire affected area in order for patient to eventually return back any activities whether it’s hobby-related activity, occupation or sport with minimal risk recurrence of pain associated with shoulder tendonitis.
Poor posture
Poor posture can be a major cause of shoulder tendonitis. Poor sitting and standing postures can put extra strain on the shoulder joints, tendons and muscles and can cause inflammation of the tendons. People who sit for long periods, such as when working at a desk, or those who slouch when standing may be particularly vulnerable to shoulder tendonitis.
To reduce your risk of developing tendonitis due to poor posture, it’s important to maintain good posture while you’re seated or standing. Sitting in a chair with a backrest is the best way to ensure good posture while seated, and avoiding activities that require awkward positioning of your arms or shoulders will help protect your joints from damage.
Injuries
Injuries are a common cause of shoulder tendonitis. Repetitive motion, heavy lifting, and falls can lead to weakened tendons that are unable to handle the stress placed on them. Shoulder tendonitis can also develop from cycling, swimming, lifting weights or other activities requiring arm motion. Poor posture when sitting at a computer or holding a phone for long periods of time can also contribute to shoulder pain and joint conditions leading to difficulty with movement.
Other causes of tendonitis include:
- Overuse injuries: Tendinitis may be the result of overuse injuries that have occurred over a period of time. People who engage in activities that involve repetitive motions with their arms may be at greater risk for developing tendonitits in the affected area. Examples include golfing and tennis as well as throwing sports such as baseball or hammer throwing.
- Traumatic injuries: In some cases, tendonitis can be caused by a one-time traumatic event such as falling on the shoulder or any direct impact to the area. This is more often seen after car accidents or contact sports like football or hockey where physical safety is not always guaranteed.
- Arthritis: Arthritis is another cause of shoulder pain and weakness which leads to pain in surrounding tendons. Osteoarthritis is more likely causing stiffness in joints while rheumatoid arthritis results in inflamed tendons throughout the body including those in shoulders due to systemic inflammation from disease process.
- Age-related changes: As we age, our bodies naturally break down collagen cells faster than they can create new ones leading to weakened joints surrounded by weaker connective tissue. This provides an additional force on already weakened tendons around shoulder making them tear easily during activity.
Diagnosis
Diagnosis of shoulder tendonitis is important in order to determine the best course of treatment. It usually starts with a physical examination and might involve imaging tests such as x-rays, MRIs or CT scans to look for signs of inflammation or tears. Your doctor may also order blood tests to check for signs of an underlying infection or inflammation. With the right diagnosis, you can start getting the best care for your condition.
Physical examination
The first part of your physical examination for shoulder tendonitis involves an orthopedic examination. Your provider will check your range of motion and ask about any pain, weakness, or stiffness you may be feeling. They may ask you to move your arm and shoulder in different directions and perform strength tests. They will also check how far you can move your upper body both forward and backward and up and down while lying on a flat table.
Your provider may also check to see if certain areas are tender, red, warm, or swollen. Many times they will press around the area where the tendon is inflamed as well as the joint above and below it in order to feel for any additional sources of pain or inflammation. X-rays may be taken, but since tendonitis is a soft tissue injury they’ll rarely show any abnormalities.
If all other options for diagnosing shoulder tendonitis have been exhausted, an MRI may be recommended in order to rule out any underlying issues that could be causing the pain such as a tear in the rotator cuff or bursitis.
Imaging tests
Imaging tests are an important part of diagnosing shoulder tendonitis. Your doctor may order an X-ray, ultrasound, magnetic resonance imaging (MRI) scan, bone scan or computed tomography (CT) scan.
- X-ray: X-rays produce images of bones and soft tissues that can help reveal if there is any damage to the bones in your shoulder.
- Ultrasound: An ultrasound uses sound waves to create an image of the internal structures of your shoulder joint and its surrounding muscles and tendons. This test can be helpful for diagnosing soft tissue injuries like rotator cuff tears and tendinopathies.
- MRI Scan: An MRI uses a powerful magnetic field to create detailed images of the internal structures in your shoulder. This test can detect any damage or inflammation in your tendons or cartilage that is not visible on an X-ray or ultrasound.
- Bone Scan: A bone scan is used to detect any abnormal activity within the bones in your shoulder joint, such as fractures or arthritis. A radioactive tracer is injected into a vein before taking pictures of the affected area with a special camera to identify areas of increased activity that could indicate disease or injury.
- CT Scan: A CT scan takes multiple X-rays from different angles and combines them into cross-sectional images to provide detailed 3 dimensional views of tissue inside the body like bones, joints and organs including tendons, ligaments and muscles inside the shoulder joint. CT scans are useful for detecting calcifications within soft tissues that can indicate tendonitis in some cases.
Treatment
Shoulder tendonitis can be a painful condition, but thankfully there are many treatments available that can help. Treatments may include rest, physical therapy, and certain medications. In addition, certain lifestyle changes, such as maintaining correct posture, avoiding carrying heavy loads, and adjusting one’s workstation can prevent aggravation of the condition.
Let’s look at the different treatments for shoulder tendonitis in detail:
Rest
Resting your shoulder is one of the most important things you can do to promote healing. If conservative treatments such as rest, over-the-counter pain medication and exercise fail to reduce symptoms within 3 weeks, you may need to consider more aggressive treatments, like physical therapy and corticosteroid injections.
To reduce pain and inflammation in your shoulder, try:
- Frequent breaks of activity or limit activities that cause pain.
- Using ice or a cold compress on the area for 15 minutes at a time, several times a day to help alleviate discomfort.
- Avoiding sleeping on the affected side if at all possible and consider using an arm sling when necessary to take strain off: follow your physical therapist’s advice as needed.
- Keeping up with stretching or warm-up exercises prescribed by your doctor before engaging in activities that require movement of the shoulder joint.
Pain relief medications
Pain relief medications may be prescribed for people with shoulder tendonitis to treat the inflammation and reduce their pain. These may include non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen, or COX-2 inhibitors such as Celebrex. Corticosteroid injections are another option, as well as medication to reduce inflammation around the shoulder joint known as cortisone shots.
You should only use pain relievers after consulting with your doctor and following any directions provided to you. It is important to ensure that you use the correct dose of medication and do not take more than is recommended. Taking too much can lead to increased risk of internal bleeding and kidney damage, so it is important that you speak to your doctor before starting any form of pain relief medications. You should also avoid drinking alcohol while taking any type of treatment for tendonitis.
Heat therapy or cold therapy can also be used effectively in combination with these medications, depending on what works best for your condition. Applying ice packs shortly after activity helps reduce inflammation and minimize damage, while using heat before activity increases blood flow which helps relax muscles, tendons and ligaments thus reducing the risk of injury. Heat therapy aids in helping tendons heal faster and it allows stretching without causing further injury so speak to your doctor about what will work best for you before starting any form of treatment plan.
Physical therapy
Physical therapy is a type of medical treatment that seeks to improve movement and function in people who are suffering from physical disability or chronic illnesses. The goal of physical therapy is to restore the patient’s normal movement, strength, and function so they can return to their daily activities.
It involves the use of manual techniques such as joint mobilization, manipulation, soft tissue massage, sprain and strain stretching, therapeutic exercise regimens, muscle re-education exercises, and activities of daily living training. Physical therapists may also provide patient education on safety awareness and measures to help prevent recurrence of the problem. To ensure a successful treatment experience for the patient, physical therapists may also use electronic stimulation or heat treatments.
Physical therapy has been found to be effective in treating a number of conditions from arthritis to sports injuries.
Surgery
Surgery is a common treatment for many medical conditions and injuries. It may be the only option, or there might be other treatment options available. Depending on the procedure, surgery can be an open or minimally invasive procedure. Open surgery involves a large incision at a body site to gain access to and remove or repair an affected area or tissue, while minimally invasive surgery often has much smaller incisions made at one or more sites that allow a surgeon to use instruments such as laparoscopes and endoscopes.
Before having any surgical procedure, the doctor will evaluate your medical history and physical condition, perform diagnostic tests if needed, and make sure you are clear about the purpose of the surgery, risks involved with it, how long recovery may take and what type of lifestyle changes you should expect after it is completed. Your health care team will discuss all aspects of your care with you before surgery so that you can make informed decisions about your treatment plan.
The type of surgery used will depend on the health issue being treated; some procedures are for diagnosis purposes only, while others are for repairing damage caused by injury or illness. During certain surgeries, such as hysterectomy or phlebectomy, internal organs may be completely removed. Other procedures may involve stitching tears in muscles in order to repair them rather than removing any part of them. Surgery can also be used to replace defective heart valves or replace failing organs with donor organs.
No matter what type of procedure is performed, its primary benefit is restoring normal function in a person’s body so they can live healthier lives.
Prevention
Shoulder tendonitis can be a painful and annoying condition to deal with. However, the good news is that through preventive measures, you can avoid this condition altogether.
There are many ways to prevent shoulder tendonitis, from changing your daily activities to taking specific exercises and stretches. In this section, we will discuss the different preventive measures you can take to avoid shoulder tendonitis:
- Changing daily activities
- Exercises and stretches
Warm up before activities
Warm up before engaging in any activity or sport. Start with a light aerobic exercise such as walking or jogging to help increase the temperature of the muscles and joint capsules and improve flexibility. Take some time to do some dynamic stretching of the shoulders. Perform exercises that move the shoulder through its range of motion, such as:
- Arm swings
- Circles
- Full-arm circles
- Hugging yourself tight and then releasing
- Arm holds in extended positions (e.g., overhead arm holds)
- Squeezing a ball between your hands to strengthen muscles controlling the shoulder blade
Stop if you feel any pain or discomfort during your warmup.
Proper posture
Having the correct posture when performing activities is essential for avoiding shoulder tendonitis. Posture helps maintain the proper alignment of your body, which helps reduce the pressure on your muscles and tendons. Pay particular attention to your neck and back, as they can have a huge effect on how your shoulders move.
Ideally, you should keep your head up with your chin pointing straight ahead while also ensuring that your ears are in line with your shoulders and hips, as this will help you maintain a neutral spine. While standing, ensure that your chest is open, and avoid slouching or hunching forward. When sitting at a desk or any other activity that requires prolonged sitting, make sure to employ an adjustable chair to reduce strain on your neck and shoulders by providing good back support.
- Keep in mind to regularly stand up and move around if you’ve been sitting for extended periods of time – this will help break up long bouts of stillness before they can cause issues.
Strengthen shoulder muscles
In order to prevent shoulder tendonitis, it is essential to be proactive and strengthen the shoulder muscles. This can be done through a variety of exercises and stretches. A healthcare provider or physical therapist can help build an individualized plan to suit your specific needs.
Generally speaking, strengthening exercises include arm raises, rowing exercises with both a barbell and resistance bands, lateral pull-ups among others. These exercises should all focus on improving not only muscle strength but also flexibility of the joint as well as stretching any tight muscles in the area. Once basic form and technique are mastered then additional weight can be added as strength increases.
In addition to strengthening work, enough rest gives muscles a chance to repair themselves leading to improved performance when assessing Arm Strength Testing (AST).
Conclusion
In conclusion, shoulder tendonitis is a common and painful condition that can be managed with rest, exercises, and strength and conditioning. If the condition does not respond to conservative treatments, medical professional interventions such as surgery may be necessary.
The key to recovery is patience and consistency in following an appropriate exercise program. It should also be noted that lifestyle factors like diet can influence the rate of healing, so changes in diet may need to be made in order to facilitate the recovery process.
Finally, although shoulder tendonitis can cause pain and discomfort, early intervention is key for a successful outcome.
