The tendons connect muscle to bone and often near a joint. Tendinopathy is an injury to the tendon. It causes pain, inflammation, and makes movement difficult. Tendinopathy may be:
There are several tendons in the shoulder.
Tendinopathy is most often caused by overuse of a muscle and tendon. Over time, the regular strain on the tendon causes the structure of the tendon to change.
Shoulder tendons are overused most often with:
Shoulder tendinopathy may also be caused by injury to the tendon from:
Shoulder tendinopathy is more common in people 30 years and older. It is also common in people that regularly use the arm in an overhead position or throwing motion such as:
Symptoms will develop gradually over time. Pain may not always be present but slowly increases with use.
Common signs of shoulder tendinopathy include:
You will be asked about your symptoms and medical history. A physical exam will be done. Your doctor will check tender areas. Your shoulder range of motion, and muscle strength will also be checked. Most can be diagnosed based on your symptoms and physical exam.
Bursitis can cause similar pain symptoms. Your doctor may inject a medication that numbs pain. If the pain goes away, it may suggest bursitis not tendinopathy.
Tendinopathy may take weeks or months to fully heal. Treatments include:
Full rest is usually not needed. Tendons do need a break from activities that are causing pain. A gradual return to normal activity will decrease the chance of damaging the tendon again.
Medications may help to manage pain and inflammation. Options may include:
Persistent or severe pain may need steroid medication. The medication is injected directly to the area. These injections can not be done often because frequent use can damage the tendon.
Rehabilitation will help you regain strength and range of motion in your shoulder. It may also help to prevent future injuries. Rehabilitation may include:
To help reduce your chance of shoulder tendinopathy:
Arthroscopy Association of North America
Ortho Info—American Academy of Orthopaedic Surgeons
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
Biceps tendonitis. Move Forward—American Physical Therapy Association website. Available at: http://www.moveforwardpt.com/SymptomsConditionsDetail.aspx?cid=6737f4e9-e8ec-43fe-b0b9-01e86354dcea#.VfG2WUW6n-Y, Updated December 19, 2013. Accessed September 16, 2015.
Biceps tendonitis and biceps rupture. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114474/Biceps-tendonitis-and-biceps-rupture. Updated February 5, 2015. Accessed September 16, 2015.
Bursitis and tendonitis. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health_Info/Bursitis/default.asp. Updated June 2013. Accessed September 16, 2015.
Rotator cuff tendonitis. Move Forward—American Physical Therapy Association website. Available at: http://www.moveforwardpt.com/SymptomsConditionsDetail.aspx?cid=1bd18bbc-e7ea-436d-bc9e-ffee9c4dbd87#.VfG01UW6n-Y. Accessed September 16, 2015.
Swimmer's shoulder. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/services/orthopaedics-rheumatology/diseases-conditions/hic-shoulder-tendonitis. Updated March 27, 2015. Accessed September 16, 2015.
Shoulder impingement/rotator cuff tendinitis. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00032. Updated February 2011. Accessed September 16, 2015.
10/26/2010 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T114474/Biceps-tendonitis-and-biceps-rupture: Derry S, Moore R, et al H. Topical NSAIDs for acute musculoskeletal pain in adults. Cochrane Database Syst Rev. 2015 June 11;6:CD007402.
Last reviewed September 2016 by Michael Woods, MD, FAAP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.