Is Shoulder Tendonitis
causing your shoulder joint pain?

Shoulder tendonitis can significantly limit your ability to use your arm. If you have been diagnosed with or suspect shoulder tendonitis to be the cause of your shoulder joint pain, learn what you can do to get out of pain and back to the activity you enjoy.




What is Shoulder Tendonitis?

The shoulder is the most mobile joint of the body. The shoulder is a ball and socket joint comprised of the head of the humerus (ball) and the glenoid of the scapula (socket). Because of small size of the glenoid, the bony contact between these bones is rather limited. It is similar to a golf ball as it sits on a golf tee.

Because the bony articulation provides little stability, the soft tissue of the joint, namely the ligaments and tendons, provide the bulk of the stability of the shoulder joint. The rotator cuff tendons provide dynamic stability for the shoulder joint. The rotator cuff is comprised of four tendons: the supraspinatus, infraspinatus, teres major, and subscapularis. Increased wear on these tendons can cause tendonitis, or inflammation of the tendons.


rotator cuff tendonitis

In addition to the rotator cuff tendons, other structures of the shoulder joint can also become inflamed. The bicep tendon is located in the front of the shoulder and helps to provide anterior stability to the shoulder joint. Typically when the rotator cuff tendons become overworked, the biceps tendon is put under more stress to help stabilize the shoulder. It is not uncommon for the bicep tendon to become inflamed as a secondary issue of rotator cuff tendonitis.

Bursa sacs function to help cushion and provide lubrication for joints. In the shoulder, the subacromial bursa sits just above the supraspinatus tendon and just below the arch of the acromion. If the rotator cuff cannot stabilize the shoulder appropriately, stress on this bursa can cause it to become inflamed, causing bursitis.


Typical Symptoms

Tendonitis and bursitis can be caused from two separate shoulder issues: a shoulder that is hypomobile (stiff) or a shoulder that is weak or hypermobile (unstable).

In a hypomobile/stiff shoulder, the shoulder undergoes abnormal stress because of a lack of normal range of motion of the shoulder joint. An extreme version of this lack of mobility is called frozen shoulder. Symptoms of a shoulder that is too stiff include pain and difficulty lifting the arm overhead, out to the side, or behind the back. Stress on the tendons and bursa can occur because the shoulder is not moving correctly causing them to either get pinched (called impingement) or become inflamed.

A shoulder that is weak or hypermobile can also have symptoms of pain, but can also feel as if the shoulder might come ‘out of joint’. The tendons of the shoulder become overworked trying to maintain normal positioning of shoulder in the socket. This additional stress on the tendons can lead to tendonitis and at times bursitis.


Typical Conservative Treatment Protocol

As with all painful joint conditions, treatment goals include first, reducing inflammation, second, restoring normal range of motion, and finally, restoring strength and function.

Reducing inflammation can be achieved through a number of means. First, the use of ice therapy is a must. Icing the shoulder 10 to 15 minutes a few times a day is a safe means of reducing inflammation.

The use of oral anti-inflammatory medications are frequently recommended to reduce inflammation. There are also some anti-inflammatory creams that are effective in treating inflammation of superficial structures such as the tendons of the shoulder (consult your doctor regarding medications). In significant cases of inflammation, a cortisone injection may be another treatment option that your doctor may utilize.


Physical Therapy Exercise

For tendonitis resulting from a stiff shoulder, the next goal after reducing inflammation is to restore normal joint range of motion. Unfortunately in order to improve the mobility of a stiff shoulder, these stretches will be uncomfortable.

For tendonitis or bursitis caused by excessive shoulder mobility or weakness in the rotator cuff, or for the stiff shoulder that now has improved range of motion, strengthening is the next goal. It is very important that in an effort to increase strength that the exercises be pain free. Exercising a muscle or tendon that is painful will only add to the inflammation.

The following is a link to shoulder stretching and strengthening exercises typical for treating shoulder tendonitis and bursitis: Shoulder Tendonitis Exercises.


Summary

• Tendonitis of the shoulder most often effects the rotator cuff tendons but can involve the biceps tendon.

• Shoulder tendonitis can be the result of a shoulder that is stiff or a shoulder that is weak and unstable.

• Typical treatment includes anti-inflammatory medication, ice therapy , rest from painful activities, cortisone injections, and physical therapy.

• To reduce pain and improve shoulder function, implement the following program: Shoulder Tendonitis Exercises.

Shoulder tendonitis does not have to mean months of pain and limited mobility. Follow the recommendations and you will be on your way to recovering from your shoulder condition.

Return to Top

Return to Shoulder Pain Relief