Shoulder Tendonitis
Shoulder Tendonitis or Tenosynovitis is a degenerative condition of any of the tendons surrounding the shoulder joint. This predominantly ocurs in the rotator cuff tendons, although may also occur in the Biceps Brachii and Deltoid muscles.
Symptoms of Shoulder Tendonitis
- Pain on moving the shoulder - for rotator cuff injuries this may be overhead movements or shoulder rotation movements. For the Biceps Brachii this may be shoulder flexion and for the Deltoid, abduction.
- Pain increases on the same movement when it is resisted by a therapist.
- Tenderness when touching the affected tendon.
- The tendon may feel thickened compared to the same tendon on the other shoulder.
- There may be a creaking feeling (known as crepitus) in the tendon.
- Pain is worst after rest and improves with activity.
Causes
Tendonitis of the shoulder tendons is a repetitive, or overuse injury. This is usually due to poor posture and muscle imbalances around the shoulder which put more pressure on one muscle or tendon than it is used to.
It also also common in those who use the shoulder joint excessively, such as throwers (i.e. baseball or field events like javelin) or manual workers such as carpenters and electricians who may work with their arms overhead.
Clarification of Terms
There are many terms used to describe tendonitis. These include tendinopathy, tendinitis and tenosynovitis.
The most accurate term which is used by medical professionals is tendinopathy. The reason for this is that 'itis' suggests inflammation which has been shown in most cases, via biopsies and other investigations, not to be present. However, the term tendonitis is still the most commonly used and understood name even though inflammatory conditions are less common than degenerative ones.
The other consideration is the condition of tenosynovitis which is actually a problem with the outer sheath that lines the tendon rather than the tendon fibres themselves. However, without investigation such as an ultrasound scan it is virtually impossible to distinguish between tenosynovitis and tendonitis. The treatment is also the same and so in most cases there is no need to distinguish between the two conditions, which may well occur together.
Treatment of Shoulder Tendonitis
What can the athlete do?
- Rest from aggravating activities and movements.
- Apply ice or other cold therapy treatments for 15 minutes every 3-4 hours to ease pain and swelling.
- Visit a sports injury professional.
What can a specialist do?
- Assess the condition to confirm the diagnosis.
- Refer for investigations such as MRI or ultrasound scans if required.
- Use electrotherapy treatments such as ultrasound or laser.
- Use sports massage techniques to relax the associated muscles.
- Help to determine the cause of the injury and address any musle imbalance and postural issues.
- Design a rehabilitation programme to improve posture of the shoulder and strength of the affected muscles.
