The tendons connect muscle to bone and often connect near a joint. Tendinopathy is an injury to the tendon. It can cause pain and swelling and makes it difficult to move. Tendinopathy may be:
There are several tendons in the shoulder. They are attached to muscles of the rotator cuff and the biceps muscle of the arm.
Tendinopathy is generally caused by overuse of a muscle and tendon. Over time, the 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:
Factors that increase your chance of developing shoulder tendinopathy include:
Symptoms develop gradually over time. Pain usually slowly increases with use.
Tendinopathy may cause:
The doctor will ask 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.
Your doctor may need to get detailed images of your shoulder. This may be done if the injury is severe or to rule out other problems. Images can be taken with:
Bursitis can cause similar pain symptoms. Your doctor may inject an anesthetic medication. If the pain goes away it may suggest bursitis not tendinopathy.
Tendinopathy and the associated pain may take months to resolve. It can be frustrating but it is important to follow through with recommended treatment. Treatments include:
Avoid activities that cause shoulder pain.
Use ice or an ice pak to help control pain and swelling, It may help during the first 24-48 hours after injury or after exercise. Protect your skin by placing a towel between the ice and your skin
After a few days, heat may help decrease stiffness. Check with a doctor or therapist before using heat the first time. Protect your skin by placing a towel between the heat source and your skin.
The doctor may recommend medication to help reduce swelling and pain. Medication options include:
Persistent or severe pain may need further treatment. Your doctor may inject a steroid into the area. It can temporarily relieve pain. However, frequent injections can damage the tendon.
Rehabilitation will help you regain strength and range of motion in your shoulder. It will also help you prevent future injuries. Rehabilitation may include:
To protect the shoulder from injury:
American Academy of Orthopaedic Surgeons
The American Orthopaedic Society for Sports Medicine
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
Bicpes tendinopathy. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated September 6, 2012. Accessed December 28, 2012.
Bursitis and tendonitis. National Institue of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health_Info/Bursitis/default.asp. Accessed December 28, 2012.
Shoulder tendonitis. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/disorders/Tendonitis/hic_Shoulder_Tendonitis.aspx. Accessed December 28, 2012.
Rotator Cuff Tendonitis. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00032. Accessed December 28, 2012.
10/26/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Massey T, Derry S, Moore R, McQuay H. Topical NSAIDs for acute pain in adults. Cochrane Database Syst Rev. 2010;(6):CD007402.
Last reviewed November 2012 by Michael Woods, MD
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.