Shoulder Tendonitis

What is shoulder tendonitis?

Shoulder tendonitis (tendonitis) is inflammation that affects an area within your shoulder joint. Your shoulder joint is kept stable by a group of muscles called the rotator cuff, as well as the biceps tendon. These muscles and tendons keep your upper arm bone (humerus) within your shoulder socket (glenoid).

Tendonitis in your shoulder occurs when inflammation traps or pinches the muscles and tendons against the top bone in your shoulder (acromion). When your rotator cuff tendons become inflamed and irritated, it’s called rotator cuff tendonitis. When your biceps tendon becomes inflamed and irritated, it’s called biceps tendonitis.

What does tendonitis feel like in your shoulder?

Shoulder tendonitis symptoms range from mild stiffness to severe pain. You may feel pain at the tip of your shoulder or radiating down your arm. You may feel the pain when you lift your arm overhead or twist it. Other symptoms may include:

• Dull ache or soreness.
• Tenderness.
• Pain at night.
• Difficulty keeping your arm held in certain positions.
• Mild swelling.
• Loss of mobility.
• A “clicking” sound when you move your shoulder.

What causes shoulder tendonitis?

Shoulder tendonitis often occurs as a result of sports injuries, where an athlete must move their arm over their head repeatedly. Sports where this frequently occurs include:

• Baseball.
• Swimming.
• Tennis and other racket sports.
• Golf.
• Weightlifting.
• Volleyball.

Improper technique in any sport is one of the primary causes of overload on tissues, including tendons, which can contribute to tendonitis.

But you don’t have to be a professional athlete to develop this condition. People with jobs that require overhead work (such as assembly work or an overhead pressing machine) or heavy lifting are at risk of tendonitis, but any person can develop tendonitis from repetitive use of these tendons. A direct blow to your shoulder area or falling on an outstretched arm can also cause shoulder tendonitis.

What are the risk factors for this condition?

As we age, our tendons naturally become less flexible, so your risk of shoulder tendonitis goes up. Other risk factors include:

• Participation in any sports that require repetitive motions, like baseball, swimming or tennis.
• Working in occupations that involve repetitive movements or require reaching overhead, like painters, movers or roofers.
• Performing household chores like cleaning, raking or shoveling.
• Having a health condition that puts stress on your tendons, like arthritis.
• Not stretching before being physically active.

What are the complications of this condition?

If left untreated, shoulder tendonitis can lead to complications, including:

• Loss of motion or strength.
• Pain that makes it difficult for you to sleep.
• Difficulty performing everyday tasks like fastening buttons or placing objects in high places.

How is shoulder tendonitis diagnosed?

A healthcare provider will ask about your medical history and perform a physical exam. Depending on their findings, they may also order tests, including:

• X-rays.
• Ultrasounds.
• Magnetic resonance imaging (MRI) scan.

Stages of shoulder tendonitis

Your healthcare provider may use the following stages to classify your condition:

• Overuse tendonitis: Repetitive motions can overstress your rotator cuff, which can cause bruising, irritation and fraying of your tendons. This can lead to pain and weakness.
• Calcific tendonitis: Over time, inflammation can sometimes cause a buildup of calcium deposits within your rotator cuff tendons. This can lead to loss of shoulder motion and strength.
• Rotator cuff tear: Severe shoulder tendonitis from degeneration or fraying can cause a partial or complete tear of your rotator cuff. This can lead to severe pain, weakness and loss of motion.

How is shoulder tendonitis treated?

Shoulder tendonitis treatment depends on several factors, including your age, symptoms and severity of your condition. Your healthcare provider may recommend a combination of rest, wraps and ice packs for recent or severe injuries. Other nonsurgical treatment options include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs): You can use aspirin, naproxen or ibuprofen to reduce pain and swelling.
• Physical therapy: Your provider may recommend that you see a physical therapist. A physical therapist can help you with a range of motion exercises and strengthening.
• Corticosteroid injection: You could receive a cortisone injection if you have constant and severe shoulder pain.
• Platelet-rich plasma (PRP) therapy: A provider injects concentrated samples of your own platelets to help with recovery and healing.

Your provider may recommend surgery if either your rotator cuff or biceps tendon has partially or completely torn and your symptoms don’t improve with other treatments. Surgery repairs the damaged tendon or tendons and removes inflamed bursae that may also be irritating your shoulder.

Can this be prevented?

Because most cases of shoulder tendonitis are caused by overuse, the best treatment is prevention. It’s important to avoid or modify the activities that cause the problem. You must correct underlying conditions, like improper posture or poor technique in sports or work.

Apply these basic rules when performing activities:

• Take it slow at first and gradually build up your activity level.
• Use limited force and limited repetitions.
• Stop if unusual pain occurs.

How long does it take for shoulder tendonitis to heal?

The time it takes shoulder tendonitis to heal depends on the severity of your injury. Mild cases may start to heal with nonsurgical treatment methods within two to four weeks. But it can take several months in more severe situations. Your healthcare provider can give you a clearer picture of your prognosis.

When can I go back to my normal activities?

You should rest your shoulder until you no longer have any pain or other symptoms. When you do go back to work, sports or other activities, take it easy. Make sure to warm up your shoulder with flexibility exercises. Try to avoid lifting your arm over your head, and don’t participate in the activity for too long. Make sure to get plenty of rest. Take your time, and gradually increase your level of activity.

When should I see my healthcare provider?

Most cases of shoulder tendonitis go away on their own over time. It may take weeks to months to recover, depending on the severity. See your healthcare provider if you:

• Experience pain that interferes with your normal day-to-day activities.
• Have soreness that doesn’t improve despite self-care measures.
• Have a recurrence.
• Have a fever and your shoulder appears red or inflamed. (These signs and symptoms may indicate you have an infection.)
• Have other medical conditions that may increase your risk of an infection.
• Take medications that increase your risk of infection, like corticosteroids or immunosuppressants.

What questions should I ask my healthcare provider?

If you have shoulder tendonitis, you may want to ask your provider:

• How long will the pain last?
• What treatment methods do you recommend?
• Do you think I need surgery?
• When can I return to my previous activities (sports/work)?
• What can I do to prevent shoulder tendonitis in the future?