Tendonitis In The Shoulder | Cause, diagnosis, symptoms, exercises and treatment

Do you have tendonitis in the shoulder? Here you can learn more about shoulder tendinitis, as well as associated symptoms, causes and various treatments for tendonitis in the shoulder. A tendonitis is known in the technical language as a tendinitis and indicates that there is an injury reaction and inflammation in one or more tendons in the shoulder.

The most common tendon in the shoulder affected by such tendinitis is the supraspinatus tendon - which sits on the shoulder blade and then goes through a tunnel in the shoulder, before it attaches to the outside of the shoulder. This tendon can be damaged and inflamed by incorrect loading, lack of function in the neck and thoracic spine, as well as overload. We remind you that you will find links to exercises, as well as a video with exercises, at the bottom of this article.

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In this article, we consider the most common cause of tendonitis in the shoulder - namely tendinitis in the rotator cuff muscles; and especially supraspinatus. If you have persistent pain and malfunction, we advise you to contact a clinician for assessment and possible treatment of the problem.

You risk that the condition worsens if you do not address the problem with a combination of home exercises, self-measures (for example trigger point balls that can help increase local circulation for tight muscles and possible treatment - link opens in new window) and professional treatment if the pain is persistent.

In this article we will, among other things, go through:

• Causes
• diagnoses
• Symptoms
• Diagnosis
• Clinical signs
• Exercises (with video)
• Treatment
• Forecast and duration

In this article you will learn more about what can be the reason why you have tendonitis in the shoulder, as well as various symptoms and treatments for such pain.

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Cause and diagnosis: Why do I have tendonitis in my shoulder?

Here we will go through a number of possible causes and diagnoses that can lead to tendonitis in the shoulder.

Causes of Tendonitis in the Shoulder

Tendonitis in the shoulder is caused by repetitive strain on the shoulder - most often due to overuse in sports or sports, but can also occur if you have a job that involves a lot of work above shoulder height or which consists of lifting in unfavorable working positions. It is important to understand that such tendon injuries and tendonitis occur past the load exceeds the capacity. In light of this, there are some occupational groups that are particularly vulnerable to shoulder problems:

• Craftsmen - including carpenter, carpenter, electrician and plumber.
• Nurses and auxiliary nurses.
• Factory Employees.

The condition also affects certain athletes more than others - some of the sports that are particularly vulnerable include:

• Tennis players
• golfers
• swimmers
• Javelin throwers (just look at Andreas Thorkildsen who had to quit due to shoulder pain)
• Handball Players

With prolonged failure loads, micro-tears (small damage) occur in the tendon which gradually grows larger and larger as the overload continues. When the body tries to repair this, inflammation and fluid accumulation occurs in and around the tendon itself. This also leads to the formation of damage tissue in the area - a form of soft tissue that is both weaker and more pain-sensitive than the normal muscle and tendon tissue. Over time, the tears in the tendon will lead to it gradually becoming weaker and weaker - which in turn increases the risk of a tendon rupture occurring in the affected tendon (partial or complete tearing).

Common causes and contributing factors to this tendonitis include:

• Malformations in the thoracic spine and neck: Excess head position and forward-extended shoulders - as well as an increased curve in the thoracic spine - will lead to more pressure and strain on the shoulders when we load them, both during sports and at work. Therefore, it is important to have good mobility in our joints in the neck and thoracic spine, as well as to train what we call the "posture muscles" between the shoulder blades and in the middle part of the back. A modern chiropractor can help you loosen up stiff joints, as well as work tight muscles and instruct in home exercises.

• Not enough "micro-breaks": Tendons and muscles are dynamic structures - this means that they are absolutely constantly working to repair themselves and clean up the overloads you expose them to. A bit like a naive mother who always cleans up after the teenager in the house - without asking him to sharpen up. Yes, such incorrect loads can go well for a very long time - but when the pain begins to set in, then the muscle and tendon fibers have had enough and decided to say no. A good solution to reduce congestion is to take micro breaks at work and thus ensure enough time for healing. Small breaks ensure that the fibers are not completely overloaded and that they get some rest between loads.

• Lack of capacity in the rotator cuff cuff (stability muscles of the shoulders): Our muscles relieve joints, tendons and ligaments. If we do not have enough strength and responsiveness in nearby stability muscles, then injuries will occur - that is how simple it actually is and that is what most cases of tendon injuries boil down to. The four main stability muscles in the shoulders are called the rotator cuff cuff or rotator cuff in English - and consist of supraspinatus, infraspinatus, teres minor and subscapularis.

• Tight neck muscles and muscular imbalance: Muscular imbalance in the upper body is also known as upper croup syndrome. This means too tight pectoralis muscles (chest muscles - which pull the shoulders forward), too high activity in the upper trapezius (pulls the shoulders upwards) - and these two cause problems inside the shoulder blades (often burning and aching pain) in the serratus anterior and rhomboideus . As a consequence, the muscles in the neck are also involuntarily dragged down into the traction - and thus we get pain in the neck and shoulder at the same time.

Also read: - 5 Exercises for Muscle Tension in the Neck and Shoulders

Symptoms of Tendonitis In The Shoulder

There are several symptoms and clinical signs that may indicate that you have a tendonitis in your shoulder. Some of the most characteristic symptoms involve pain and pressure soreness on the outside or front of the shoulder. Other symptoms include:

• Possible associated swelling in the front of the shoulder and on the outside of the upper part of the arm.
• Pain that gets worse when you raise and lower your arm.
• A clicking sound when you lift your arm - especially above shoulder height.
• Pain that wakes you up from sleep - especially if you sleep on the shoulder involved.
• Hurts when you stretch your arm behind your back.
• Significantly reduced functionality in the form of less movement and strength.

Tendonitis tends to get worse if you do nothing about it. As the tendon fibers become weaker and more irritated, the symptoms will increase and worsen. At the beginning of the problem, you may only experience pain when doing sports or similar loads - but as the condition worsens, and you do nothing about it, so will everyday things like lifting a milk carton or sleeping on the shoulder involved. hurt.

Pressure wave treatment is a non-invasive treatment method that breaks down tendon tissue and initiates a natural healing response that both heals and strengthens the tendon fibers. The treatment is performed by publicly authorized health personnel with expertise in muscles and joints - in Norway it involves the three professions; chiropractor, physiotherapist and manual therapist.

Also read: - Have You Tried Pressure Wave Therapy?

Diagnosis of Tendonitis in the Shoulder

When you visit a clinician - such as a modern chiropractor or physiotherapist - he or she will first carry out a history examination (anamnesis) and then perform a functional examination. This may involve questions about:

• Your activity level
• What kind of symptoms are bothering you
• When the symptoms are most present
• What relieves the pain

The functional examination involves a physical examination of the shoulder, where the clinician, among other things, checks active and passive movement in the shoulder - and measures how far you get before it possibly hurts. A modern, publicly licensed clinician can also, with orthopedic tests, give you information on what is the most likely cause of a tendonitis or tendon injury.

If there is suspicion of tendon injury or that the functional examination points to a more serious involvement of bone injury, fracture or the like, then imaging can be requested. Both doctor and chiropractor have the right to be referred to such imaging examinations - such as X-rays, MRI, CT and diagnostic ultrasound.

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Complications of Prolonged Tendonitis in the Shoulder

If you do not consult a clinician for measures and treatment - and you have felt that the condition only worsens over time - then you risk that the tendonitis and the extent of the damage will be far more extensive than it should have been. This can mean that the problem becomes so great that conservative treatment does not help as quickly and the pain becomes chronic.

This means that you can expect a long and hard treatment regimen in combination with a rigorous exercise program if you have let it go too far. It's an honest case - the sooner you tackle the problem, the better.

It is important to remember that you do not have to be an athlete to gradually break down the tendons in the shoulder - it is something we can all achieve with repetitive strains and lack of consideration. The question you have to ask yourself is - what is your shoulder health worth to you? You would probably let someone look at your car if the steering wheel could only be turned halfway to the right?

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Treatment of Tendonitis in the Shoulder

Treatment will vary somewhat depending on the extent of tendon injury and tendon inflammation. All treatment should have as its main purpose that it stimulates healing and promotes improved functionality.

Conservative treatment

• Physiotherapy: The purpose of physical therapy and exercise is to reduce pain and unnecessary inflammation, as well as strengthen the shoulder and neck muscles.

• Modern Chiropractic: A modern chiropractor works with muscles, tendons and joints. Considering that the shoulder, neck and thoracic spine often go hand in hand - as mentioned earlier in the article - it is often seen that joint treatment plays a central role in restoring normal function in the shoulders. This occupational group also has the right to refer to imaging if there is a need for this.

• Shockwave therapy: Studies have shown significant effect of pressure wave therapy in the treatment of tendonitis in the shoulder (1). The treatment should be performed by an authorized healthcare professional - such as a physiotherapist or modern chiropractor.

• Dry needling (needle treatment): Intramuscular needle treatment aims to reduce pain and initiate an increased healing response in the treated area.

Invasive treatment

• Cortisone Injection: A cortical injection can relieve the pain, but as documented by the acclaimed Mayo Clinic, this is also a form of treatment that results in weaker tendon fibers and a higher risk of the tendon smoking later. So other treatment should be tested for the longest time before considering this measure.

• Operation: Arthroscopy is the most common surgical method for this type of shoulder pain. As mentioned, this type of procedure should be avoided if it is not absolutely necessary due to the risk of late injuries and lifelong scar tissue formation. Many people experience more frequent relapses after surgery and that the pain, when they return, is often significantly worse than it was before.

Also read: - Therefore you should Avoid Cortisone Injection

The prognosis for tendonitis in the shoulder

As we have said earlier in the article - tendonitis has a tired tendency to get worse and worse if one does not address the problem. With early measures, you have a very good chance of being completely well again - but if you ignore it, then it will require significantly more effort and treatment.

However, it is generally said that the mildest variants can take about 3 weeks (with proper treatment and measures) to get well. More severe cases can take as long as 6 to 8 months. Some of the more serious cases never get well and end up chronic. As mentioned earlier, this is a diagnosis that can put an end to even the most promising sports career. Therefore, we strongly recommend that you consult a clinician if you experience such symptoms.

Exercises for Tendonitis in the Shoulder (Video)

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Summarizeringing

It is important to take all shoulder pain seriously - due to the fact that persistent pain can lead to dysfunction and worsening symptoms as time goes on. In case of tendon damage and tendon inflammation, you are simply at risk that the tendon fibers will be in ever worse condition and that they will gradually become weaker and more painful.

In the link below you will find some exercises that you can try - but we therefore recommend that you get an adapted exercise program adapted to you and your symptoms via a modern clinician.

Also read: - 8 Exercises for Shoulder Pain

Click on the picture above to see the exercises.

Do you have questions about the article or do you need any more tips? Ask us directly through our facebook page or via the comment box below.

Recommended self-help and self-help measures

Reusable Gel Combination Gasket (Heat & Cold Gasket)

Heat can increase blood circulation to tight and sore muscles - but in other situations, with more acute pain, cooling is recommended, as it reduces the transmission of pain signals. Due to the fact that these can also be used as a cold pack to calm down swelling, we recommend these.

Read more here (opens in new window): Reusable Gel Combination Gasket (Heat & Cold Gasket)

Set of 5x trigger point balls

Trigger point balls are used by laying the ball so that it hits well into the aching muscle or tendon. This, like physical treatment, will lead to increased blood circulation and healing in tight and sore muscle fibers. A very good measure for those who like to tackle problems on their own.

Read more here (opens in new window): Set of 5x trigger point balls

Visit if necessary Your Health Store to see more good products for self-treatment and training

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