Shoulder tendinitis or shoulder tendon inflammation is common in which rotator cuff tendons become inflamed and swollen for some reason. Tendons help move the shoulder. If tendons are overused, they become irritated and inflamed. The cause of shoulder tendonitis is significant for treatment. Doctors determine the exact cause of shoulder tendonitis by examining the medical history. A physical examination is performed to check the symptoms, and if necessary, medical imaging studies (X-ray and MRI) are committed to preventing the possibility of tendon rupture.
What Is Shoulder Tendonitis?
Shoulder tendonitis, most commonly caused by overuse, is felt at the tip of the shoulder and often radiates down the arm when lifting or twisting.
The humerus, rotator cuff tendons, and bursa move back and forth in a narrow path called the coracoacromial arch. When the arm is overhead, it narrows the way and compresses the bursa and tendons. In frequent use, the area becomes prone to inflammation and damage.
Symptoms of Shoulder Tendonitis
Depending on the cause, shoulder tendonitis pain can start over time or suddenly.
It starts at the shoulder and often radiates up the arm, usually stopping at the elbow. Although you may not have symptoms until you stop using your shoulder, here are some signs that indicate shoulder tendonitis:
- Pain when moving overhead
- Pain at night when rolling over or sleeping on the side
- Weakness in the shoulder when lifting or holding something
- The pain spreads to surrounding areas, such as the upper arm or neck
If left untreated, these symptoms will persist and even worsen over time.
Shoulder Tendinitis Diagnosis
The therapist will perform an initial assessment and ask about your symptoms and the level of pain you are experiencing. The therapist may also perform the following tests during your evaluation:
- Range of motion tests
- Assessment of body posture while sitting and standing
- Strength tests
- Muscle imbalance
The therapist may also ask about your daily habits, hobbies, and job duties.
A physical exam is usually needed to diagnose shoulder tendonitis. Still, if physical therapy doesn’t resolve the problem, an MRI may be used to determine the presence of previously undiagnosed underlying disease.
What Are The Four Causes of Shoulder tendinitis?
Carrying out repetitive activities with hand and shoulder, severe and sudden accidents, or doing sports such as swimming, tennis, and baseball that require frequent shoulder movements are among the most critical factors that increase the risk of shoulder tendonitis.
The four stages of shoulder tendonitis are:
- Overuse Tendonitis: This is caused by repetitive shoulder movements and leads to burning, bruising, or even erosion of the tendon.
- Calcific tendonitis: Sometimes, long-term inflammation causes the accumulation of calcium in the rotator cuff tendon, and as a result, the shoulder suffers pain and loses its strength and movement ability.
- Tendonitis due to shoulder impingement: When the space between the rotator cuff and the coracoacromial arch narrows, the humerus puts pressure on the rotator cuff tendon arch. This happens if the cuff is weakened, and the bursa is swollen if a bone spur has formed.
- Rotator cuff tear: Severe tendon inflammation from long-term impingement, degeneration, or sudden injuries such as falls may cause a partial or total tear of the rotator cuff tendon. This complication causes pain, more severe weakness and movement, and functional disabilities of the shoulder.
Shoulder Tendonitis Treatment
Treatment is necessary as soon as symptoms of tendonitis appear. If left untreated, the tendon can degenerate and deteriorate over time, worsening the condition. Specific treatment for shoulder tendonitis will be determined by your doctor based on the following:
- Your age, general health and medical history
- The extent of the conditions
- Your tolerance to certain medications, procedures or treatments
- Your opinion or preference
Shoulder tendonitis is usually treated with conservative treatments, including:
Applying ice to the shoulder several times a day can effectively reduce inflammation. Instead of using ice or an ice pack directly on your skin, wrap it around a clean towel. Continue applying ice several times a day until your pain improves.
It is necessary to avoid sports or other activities that cause shoulder tendon inflammation and shoulder pain.
Resting with a good shoulder brace will help the shoulder tendonitis heal faster. Use a proper shoulder brace to treat tendinitis or shoulder tendinitis. The shoulder brace provides adequate, smooth support to relieve pain and swelling.
Anti-inflammatory medications, such as injections or oral medications, may be prescribed to control pain and to swell in the shoulder joint.
Corticosteroids and anti-inflammatory drugs provide rapid pain relief. Often, injections will relieve symptoms quickly, while other treatment options are slower to take effect.
Physical therapy for shoulder tendonitis can also successfully treat shoulder impingement tendonitis and tendinosis. Physiotherapy for shoulder tendonitis initially tries to reduce inflammation. Finally, physical therapy is designed to strengthen and prevent the recurrence of shoulder tendonitis. Your physical therapist will provide a treatment plan for your condition and goals.
Physiotherapy for shoulder tendonitis may include the following steps:
- Pain management: Ice, moist heat, and massage are commonly used to control pain, but treatments such as TENS (electrical stimulation) or ion therapy (electrical stimulation used to deliver medication through your skin into deeper tissues) are also possible. It is to be prescribed.
- Patient education: The physical therapist may suggest changes in posture, work, sleeping position, and more. A physical therapist will teach you to avoid painful activities and inform you of movements and exercises to prevent them.
- Manual therapy: soft tissue massage, shoulder stretching, and gentle joint movement may help regain shoulder motion.
- Range of motion exercises: The therapist will teach you stretches and practices to improve your shoulder and motion content so you can resume your normal activities.
- Strengthening exercises: Depending on your condition, the physical therapist will prescribe specific strengthening exercises using weights, bands, and other equipment to challenge weak muscles. And you can continue the activities at home.
- Functional training: Once your condition begins to improve, the therapist will introduce practical exercises that will bring you back to your previous level of performance.
How Long Does Shoulder Tendonitis Physiotherapy Take?
Each case is different and the physiotherapist designs the treatment plan according to the severity of the condition and your goals. For a mild case of shoulder tendonitis, you can expect treatment to last approximately six to eight weeks, while a more severe case may take up to 12 weeks.
Seeking help as soon as you notice symptoms will play an important role in the length of time you need for physical therapy and how quickly you recover from your injury.
Can Physiotherapy for Shoulder Tendonitis Prevent Injury?
Exercising with a physical therapist to treat shoulder tendonitis will not only get you back to your normal activities sooner, but it will also help strengthen the shoulder muscles and prevent re-injury.
Physiotherapist training makes it easy to detect the return of symptoms early and to be aware of activities that may contribute to the problem so that they can be avoided. The therapist will likely recommend a home program that greatly reduces the risk of re-injury by keeping the area strong and stretching properly.