Shoulder Tendonitis or Tenosynovitis is a degenerative condition of any of the tendons surrounding the shoulder joint. This is usually the rotator cuff tendons but it can also occur in the biceps and triceps tendons. The shoulder pain usually comes on gradually and is due to repetitive movements and overuse. It is common in those with poor posture and those who use the joint a lot, like athletes who throw and manual workers.
Symptoms of shoulder tendinitis include pain when moving the shoulder. The pain usually comes on gradually. The exact movement which causes most pain will indicate which tendon or tendons are inflamed. For example, rotator cuff injuries will be painful when rotating the shoulder and biceps tendonitis when flexing or moving the shoulder upwards. Pain is often worse after a period of rest then improves with activity as it warms up.
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.
Shoulder tendonitis explained
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 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.
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.
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.