Shoulder Tendonitis

Rotator cuff strain

Shoulder tendonitis is an overuse injury that causes inflammation of one of the tendons in the shoulder joint, usually a rotator cuff tendon. Shoulder tendinopathy is probably a more accurate term as it describes the degeneration of a tendon, rather than acute inflammation.



Symptoms of shoulder tendinitis usually develop over time and consist of shoulder pain, particularly when moving it. Pain is often worse after a period of rest but improves with activity as it warms up.

The exact movement causing the most pain indicates which tendons or tendons are inflamed. For example, rotator cuff injuries will be painful when rotating the shoulder. Biceps tendonitis is painful when flexing the shoulder (moving upwards in front).


A professional therapist or trainer will resist various shoulder movements to identify the injury in more detail. Trying to move the shoulder against resistance will increase pain.

When pressing in or feeling the painful tendon it may seem thickened compared with the other side and there may also be a creaking feeling known as crepitus in the tendon as it moves.

What is shoulder tendonitis?

Tendonitis of the shoulder tendons is a repetitive strain, overuse injury. It is often due to poor posture and muscle imbalance in the shoulder. As a result, stress increases on a particular muscle or tendon.

It is 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. There are many terms used to describe tendonitis. These include tendinopathy, tendinitis, and tenosynovitis.

Tendonitis or tendinopathy?

Tendinopathy is probably a more accurate term than tendonitis. This is because most chronic, long-term cases are not acute inflammation (itis means inflammation). The injury is in fact related more to the degeneration of the tendon from wear and tear. Tendinopathy more accurately describes this.


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.

Shoulder tendonitis treatment

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 to 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 muscle imbalance and postural issues.

Design a rehabilitation programme to improve the posture of the shoulder and strength of the affected muscles.

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