What is shoulder tendonitis?
Shoulder tendonitis is an inflammation (irritation and swelling) of the tendons of the shoulder. The shoulder joint is a ball and socket type joint where the top part of the arm bone (humerus) forms a joint with the shoulder blade (scapula). The rotator cuff holds the head of the humerus into the scapula. The muscles of the rotator cuff connect the humerus, or upper
bone of the arm, to the shoulder. At the end of each muscle is a tendon that attaches the muscle to the bone. The four muscles of the rotator cuff are able to move bones by pulling on these tendons. These muscles and tendons allow movement and rotation of the arm and shoulder. Since these tendons are in frequent motion they are susceptible to injury, pain, and inflammation.
Inflammation of the tendons of the shoulder muscles can occur in sports requiring the arm to be moved over the head repeatedly as in tennis, baseball (particularly pitching), swimming, and lifting weights over the head. Chronic inflammation or injury can cause the tendons of the rotator cuff to tear. The most common cause of rotator cuff problems is shoulder impingement, in which there is a narrowing of the gap between a portion of the shoulder blade known as the acromion and the top of the upper arm bone. This causes increased friction and gradually damages the rotator cuff. Rotator cuff tears can also happen suddenly; for example, when a person tries to lift a heavy object above the head. Repeatedly performing a strenuous task such as throwing a baseball can also damage the rotator cuff. In such cases, the excess strain on the rotator cuff causes one or more tendons to tear. The risk factors are being over age 40 and participation in sports or exercise that involves repetitive arm motion over the head (such as baseball).
The most common symptom of rotator cuff disease is shoulder pain. The pain is often noticed gradually and may be first noticed even a day after the actual event which may have caused the injury. Sometimes, a sudden pain occurs during a sport activity. The pain is usually located to the front and side of the shoulder and is increased when the shoulder is moved away from the body. The pain is usually noted to be more intense at nighttime and sometimes increases when lying on the affected shoulder. If the rotator cuff is torn completely, though, the pain can be constant. A person with a completely torn rotator cuff may not be able to lift the arm from the side of his or her body.
People with rotator cuff injuries often experience pain at night because sleeping in certain positions puts pressure on the shoulder. In some people, the injured shoulder makes popping or clicking sounds when moved. For others, the shoulder seems to stick momentarily. The diagnosis is made when specific movements, especially raising the arm above the shoulder, cause pain and soreness. Magnetic resonance imaging (MRI) is the best diagnostic tool for this condition. A physical examination will reveal tenderness over the shoulder. Pain may occur when the shoulder is raised overhead. There is usually weakness of the shoulder when it is placed in certain positions. X-rays may show a bone spur, while MRI may demonstrate inflammation in the rotator cuff. If a tear in the rotator cuff is present, this can usually be identified on MRI.
The injured shoulder should be rested from the activities that caused the problem and from activities that cause pain. Ice packs applied to the shoulder and non-steroidal anti-inflammatory drugs will help reduce inflammation and pain. Physical therapy to strengthen the muscles of the rotator cuff should be started. If the pain persists or if therapy is not possible because of severe pain, a steroid injection may reduce pain and inflammation enough to allow effective therapy. If the rotator cuff has sustained a complete tear, or if the symptoms persist despite conservative therapy, surgery may be necessary. Arthroscopic surgery can remove bone spurs and inflamed tissue around the shoulder. Small tears can be treated with arthroscopic surgery. Newer techniques allow even large tears to be repaired arthroscopically, although some large tears require open surgery to repair the torn tendon.
More information on tendinitis
What is tendinitis? - Tendinitis is inflammation, irritation, and swelling of a tendon, which is the fibrous structure that joins muscle to bone.
What causes tendinitis? - Tendinitis can occur as a result of injury, overuse, or with aging as the tendon loses elasticity. It can also be seen in systemic diseases.
What're the symptoms of tendinitis? - Tendinitis causes pain over the affected tendon. Tendonitis produces pain in the tissues surrounding a joint.
How is tendinitis diagnosed? - Careful pressure testing and movement of the parts is all that is necessary to identify the tendinitis. There are specific tests for specific tendons.
What is the treatment for tendinitis? - The goal of treatment for tendinitis is to relieve pain and reduce inflammation. Rest or immobilization of the affected tendons is helpful for recovery.
What is achilles tendinitis? - Achilles tendinitis is inflammation, irritation, and swelling of the Achilles tendon (the tendon that connects the muscles of the calf to the heel).
What is patellar tendonitis? - Patellar tendonitis (jumper's knee) is a condition characterized by inflammation of the patellar tendon, which connects the kneecap to shin bone.
What is tennis elbow? - Tennis elbow is an inflammation, soreness, or pain on the outside (lateral) side of the upper arm near the elbow.
What is shoulder tendonitis? - Shoulder tendonitis is an inflammation (irritation and swelling) of the tendons of the shoulder.