Shoulder Tendonitis

Overview

Tendinitis is inflammation or irritation of a tendon — the thick fibrous cords that attach muscle to bone. The condition causes pain and tenderness just outside a joint.

While tendinitis can occur in any of your tendons, it's most common around your shoulders, elbows, wrists, knees and heels.

Some common names for various tendinitis problems are:

1.Tennis elbow

2.Golfer's elbow

3.Pitcher's shoulder

4.Swimmer's shoulder

5.Jumper's knee

Most cases of tendinitis can be successfully treated with rest, physical therapy and medications to reduce pain. If tendinitis is severe and leads to the rupture of a tendon, you may need surgery.

Symptoms

Signs and symptoms of tendinitis tend to occur at the point where a tendon attaches to a bone and typically include:

1.Pain often described as a dull ache, especially when moving the affected limb or joint

2.Tenderness

3.Mild swelling

Causes

Although tendinitis can be caused by a sudden injury, the condition is much more likely to stem from the repetition of a particular movement over time. Most people develop tendinitis because their jobs or hobbies involve repetitive motions, which put stress on the tendons.

Using proper technique is especially important when performing repetitive sports movements or job-related activities. Improper technique can overload the tendon — which can occur, for instance, with tennis elbow — and lead to tendinitis.

Risk factors

Risk factors for developing tendinitis include age, working in particular jobs or participating in certain sports.

Age

As people get older, their tendons become less flexible — which makes them easier to injure.

Occupation

Tendinitis is more common in people whose jobs involve:

1.Repetitive motions

2.Awkward positions

3.Frequent overhead reaching

4.Vibration

5.Forceful exertion

Sports

You may be more likely to develop tendinitis if you participate in certain sports that involve repetitive motions, especially if your technique isn't optimal. This can occur with:

1.Baseball

2.Basketball

3.Bowling

4.Golf

5.Running

6.Swimming

7.Tennis

Complications

Without proper treatment, tendinitis can increase your risk of experiencing tendon rupture — a much more serious condition that may require surgery.

If tendon irritation persists for several weeks or months, a condition known as tendinosis may develop. This condition involves degenerative changes in the tendon, along with abnormal new blood vessel growth.

Prevention

To reduce your chance of developing tendinitis, follow these suggestions:

1.Ease up. Avoid activities that place excessive stress on your tendons, especially for prolonged periods. If you notice pain during a particular exercise, stop and rest.

2.Mix it up. If one exercise or activity causes you a particular, persistent pain, try something else. Cross-training can help you mix up an impact-loading exercise, such as running, with lower impact exercise, such as biking or swimming.

3.Improve your technique. If your technique in an activity or exercise is flawed, you could be setting yourself up for problems with your tendons. Consider taking lessons or getting professional instructions when starting a new sport or using exercise equipment.

4.Stretch. Take time after exercise to stretch in order to maximize the range of motion of your joints. This can help to minimize repetitive trauma on tight tissues. The best time to stretch is after exercise, when your muscles are warmed up.

5.Use proper workplace ergonomics. If possible, get an ergonomic assessment of your workspace and adjust your chair, keyboard and desktop as recommended for your height, arm length and usual tasks. This will help protect all your joints and tendons from excessive stress.

6.Prepare your muscles to play. Strengthening muscles used in your activity or sport can help them better withstand stress and load.

Treatment

The goals of tendinitis treatment are to relieve your pain and reduce inflammation. Often, taking care of tendinitis on your own — including rest, ice and over-the-counter pain relievers — may be all the treatment that you need.

Medications

For tendinitis, your doctor may recommend these medications:

1.Pain relievers. Taking aspirin, naproxen sodium (Aleve) or ibuprofen (Advil, Motrin IB, others) may relieve discomfort associated with tendinitis. Topical creams with anti-inflammatory medication — popular in Europe and becoming increasingly available in the United States — also may be effective in relieving pain without the potential side effects of taking anti-inflammatory medications by mouth.

2.Corticosteroids. Sometimes your doctor may inject a corticosteroid medication around a tendon to relieve tendinitis. Injections of cortisone reduce inflammation and can help ease pain. Corticosteroids are not recommended for tendinitis lasting over three months (chronic tendinitis), as repeated injections may weaken a tendon and increase your risk of rupturing the tendon.

3.Platelet-rich plasma (PRP). PRP treatment involves taking a sample of your own blood and spinning the blood to separate out the platelets and other healing factors. The solution is then injected into the area of chronic tendon irritation. Though research is still underway to determine optimal uses, concentrations and techniques, PRP injection in the region of chronic tendon irritation has shown promise in the treatment of many chronic tendon conditions.

Physical therapy

You might benefit from a program of specific exercise designed to stretch and strengthen the affected muscle-tendon unit. For instance, eccentric strengthening — which emphasizes contraction of a muscle while it's lengthening — has been shown to be a very effective treatment for many chronic tendon conditions, and is now considered first line treatment.

Surgical and other procedures

In situations where physical therapy hasn't resolved symptoms, your doctor might suggest:

1.Dry needling. This procedure involves making small holes in the tendon with a fine needle to stimulate factors involved in tendon healing.

2.Ultrasonic treatment. This minimally invasive procedure uses a small incision to insert a special device that removes tendon scar tissue with ultrasonic sound waves.

3.Surgery. Depending on the severity of your tendon injury, surgical repair may be needed, especially if the tendon has torn away from the bone.

Diagnosis

Usually, your doctor can diagnose tendinitis during the physical exam alone. Your doctor may order X-rays or other imaging tests if it's necessary to rule out other conditions that may be causing your signs and symptoms.

Exercises

While keeping the operated arm firmly against your side and the elbow at a right (90 degree) angle, rotate your body away from the door to produce outward rotation at the shoulder. Hold ten seconds. Do ten repetitions, two times a day.

What is the fastest way to get rid of tendonitis?

To treat tendinitis at home, R.I.C.E. is the acronym to remember — rest, ice, compression and elevation.

This treatment can help speed your recovery and help prevent further problems.

1.Rest. Avoid activities that increase the pain or swelling. ...

2.Ice. ...

3.Compression. ...

4.Elevation.

Does shoulder tendonitis go away?

Most cases of shoulder tendinitis go away on their own over time. It may take weeks to months to recover, depending on the severity. See your doctor if you experience pain that interferes with your normal day-to-day activities or have soreness that doesn't improve despite self-care measures.

Shoulder tendonitis recovery time

The minimum time for recovery from rotator cuff tendonitis or a small tear is generally two to four weeks, and stubborn cases can take several months. Early on, the aim is to reduce swelling and inflammation of the tendons and relieve compression in the subacromial space.