Shoulder tendonitis is inflammation or irritation of a tendon that causes pain and tenderness in the shoulder, which may occur with repeated shoulder impingement (rotator cuff) injury. Tendonitis can occur in any tendon in the body, but tends to be most common in shoulders, elbows, wrists, and heels. Tendonitis is also sometimes called tendinitis. The rotator cuff tendon becomes swollen and inflamed over time. Shoulder tendonitis is classified as either:
Acute Shoulder Tendonitis: Brought on suddenly by excessive overhead activities.
- Chronic Shoulder Tendonitis: Typically caused by a degenerative disease, such as arthritis, or long-term repetitive wear and tear.
How Do I Know if I Have Shoulder Tendonitis?
You may have tendonitis if you have pain in a limb or joint and feel the pain most when you move that part of your body. The area might also be tender, and you may have swelling. Your sports medicine doctor can usually diagnose tendonitis with a physical exam, but may prescribe other tests (such as X-ray or MRI) to make sure you don’t have another injury.
What Causes Tendonitis?
Tendonitis is most often caused by overuse or repetitive motion. An athlete who performs the same skill over and over again can strain certain tendons. Tennis players and baseball players, for example, are at risk of tendonitis in the elbow; and swimmers may develop it in their shoulders.
Risk Factors for Tendonitis
Developing tendonitis is often more common as patients age, and for people who work in certain jobs or participate in particular sports. Tendons naturally become less flexible as we get older, thus they are more susceptible to injury.
Tendonitis is quite common in those who participate in sports which involve a repetitive motion or in those who develop an incorrect technique in their sport. Sports which have a higher risk of tendonitis include:
Certain jobs are more likely to result in tendonitis when they involve:
- Excessive vibration (such as some construction or maintenance jobs)
- Repetitive movement (such as painting)
- Frequent unusual or awkward positions (roofing or plumbing)
- Over-exertion (moving heavy objects or equipment)
- Frequent reaching overhead (stocking or lifting)
Common everyday activities can result in tendonitis, as well. Any household chore that involves overusing or repetitively using a tendon can be a contributing factor, such as:
- Cleaning house (excessively vacuuming or scrubbing, cleaning windows)
Risk for tendonitis is also increased any time incorrect posture is involved.
Additional risk factors for tendonitis include:
- Conditions which stress the soft tissue structures (such as arthritis)
- Not stretching or conditioning before strenuous activity
- Infection (especially from a dog or cat bite)
Symptoms of Shoulder Tendonitis
- Pain when arm is at shoulder height or behind back or head.
- Shoulder clicking
- Pain when lying on shoulder.
- Upper arm pain (as far as the elbow)
Shoulder tendonitis is generally diagnosed by an ultrasound, but an x-ray can reveal if a bone spur is causing your tendonitis.
How Is Tendonitis Treated?
Though tendonitis can be a hassle, causing pain and keeping you away from activities, treatment is often simple. It starts with an effort to reduce inflammation, and thereby pain. Your sports medicine doctor will first recommend resting and taking over-the-counter anti-inflammatory medications and/or anti-inflammatory creams. As well, he or she may have you use the RICE orthopedic injury treatment if the injury is new or severe.
If you need more aggressive treatment, your doctor may inject your tendon with cortisone to reduce inflammation or use ultrasound to promote healing. Physical therapy may also be used as part of your treatment and rehabilitation, with the goal of stretching and strengthening the injured tendon. In more severe cases, tendonitis can be repaired with surgery.
How to Avoid Tendonitis
Because most tendonitis is caused by repetitive motion, you should try to avoid excessively doing an activity, if possible. However, when work is involved, avoidance is not always an option. Taking occasional breaks and stretching often can be helpful, as well as varying the direction of movement or body position when you are able.
If the activity is not something you regularly do, take it slow and build up to the desired level of activity. Overdoing things on the weekend when your body is not accustomed to that stress is often a common cause of tendonitis. If pain occurs during an activity, stop and rest. If pain continues when you restart the activity, you should stop for the day. Pain is one method that your body uses to communicate to your brain, so it is wise to listen.
The best way to prevent tendonitis is to follow these tips:
- Always warm up before strenuous activity. Tendons should be lightly exercised for 5 minutes before placed under any stress.
- Stretch before and after activities. Stretching should consist of at least 20 seconds of holding in one position without bouncing the area. Bouncing can actually damage the tendon from excess strain.
- Strengthen and condition tendons regularly. Resistance training with light weights 3 times per week will improve tendon strength, making them less likely to become injured.
- Use proper posture and form. Use ergonomic equipment (chair and desk at proper heights) for work. Be sure to use proper form and correctly sized equipment (such as rackets and bats) in sporting activities. Proper support in shoes is also key.
- Take breaks. When you feel stiff or tired, stop the activity. Take a walk or do something else to give your body a rest. Even a short break will relieve pressure and let your tendons heal.
Shoulder bursitis, which often accompanies tendonitis, occurs when the bursae become swollen and inflamed due to excessive use. Treatment of the underlying shoulder impingement should alleviate shoulder tendonitis and bursitis. Severe tendonitis can eventually cause a partial or complete tear in the rotator cuff which could require shoulder arthroscopy or shoulder surgery.
Our goal at the Orthopedic and Sports Medicine Institute (OSMI) is to provide our patients quality, cutting-edge orthopedic treatments, both surgical and non-surgical. If you have questions about shoulder tendonitis, shoulder joint pain, or physical therapy, please submit an online appointment request or contact our office at 817-529-1900.