Shoulder Tendonitis is characterized by inflammation in the shoulder joint, specifically in the tendon (the attachment between muscle and bone). Shoulder tendonitis frequently occurs along with shoulder bursitis. Usually it is the muscles of the rotator cuff (Teres Minor, Infraspinatus, Supraspinatus and Subscapularis), but can also occur in the biceps tendon. Tendonitis generally occurs as a result of impingement in the shoulder joint. Gradual changes in posture cause incorrect alignment of the shoulder joint which leads to wear and tear on the tendons and bursa by pinching (or impinging) them between the boney structures. This wear and tear causes inflammation (swelling) and pain and can lead to loss of motion and weakness.
- Acute Tendonitis: occurs with overuse of the shoulder (such as ball throwing or overhead activities) or a traumatic injury.
- Chronic Tendonitis: occurs over time by degenerative disease or general wear and tear.
- Repetitive motions, especially those overhead (such as throwing, swimming, painting and carpentry)
- Traumatic injury such as a fall
- Dislocation of the shoulder
- Arthritis (bone spurs place excess pressure on the bursa)
- Shoulder Instability
- Pain in shoulder that is present both with activity and with rest
- Pain with overhead activities
- Decrease in the range of motion (ROM) in the shoulder
- Pain while sleeping at night
- Loss of strength in the shoulder
- Pain over the outside of the shoulder and upper arm
- Noticeable swelling in the front of the shoulder
- Review of medical history
- Physical Examination
- Possibly and MRI if symptoms do not improve
- Allowing the shoulder to rest by not performing the activities that are contributing to the problem (such as overhead lifting or reaching) will allow the tendons time to heal
- Ice can help decrease pain and swelling (use 15 minutes at a time to the painful / swollen area).
- Physical Therapy
- Subacromial Decompression: in severe cases it may be necessary to remove the tip of acromion process to allow more room for the tendons in the shoulder joint.
How Can Physical Therapy Help
Physical Therapy is often very helpful for shoulder tendonitis. Commonly, a patient will visit their Primary Care Physician complaining of shoulder pain and will be referred to a PT. They can confirm the diagnosis of shoulder tendonitis by completing a detailed history of the problem, along with a thorough evaluation of the shoulder joint (motion, strength, pain, sensation, joint mobility). Once the evaluation is complete and treatment is initiated, it will usually consist of the following:
- Behavior Modification:
- Instructions will be given on how to change activities to limit more trauma to the area.
- Postural Modification:
- Poor posture is often associated with tendonitis. Improper posture causes mal-alignment of the shoulder joint and contributes to impingement. Instructions will be given on how to correct posture.
- Therapeutic Exercise:
- In order to correct posture and regain strength and motion in the shoulder joint, it is necessary to perform specific exercises that will target these areas.
- A physical therapist will use many modalities (or pieces of equipment) in the clinic to help relieve inflammation and pain. You can expect to receive and or all of the following:
- Manual Techniques:
American Academy of Orthopedic Surgeons
Mass General Hospital Sports Medicine
Shoulder tendonitis and bursitis often occur together.
Many people ignore shoulder pain until they notice significant changes in function. If you are having shoulder pain, visit your doctor to see what treatment options are available.