Humans are able to do many things in daily life when they have a healthy body and mind. Both upper and lower limbs enable humans to move around and to move objects with ease. It is important to take care of your health so that you can achieve so much more in life. This also includes taking care of the limbs which often are neglected. In this article, we will be learning about shoulder tendonitis that can cause a person to have discomfort when using their upper limb and the best treatment for it.
Shoulder tendonitis is defined as the inflammation of the rotator cuff or biceps tendon. The rotator cuff contains muscle and tendons. This connects the upper arm bone to the shoulder blade. There are 4 tendons make up for rotator cuff which is infraspinatus tendon (located behind the supraspinatus tendon), subscapularis tendon (located at the front of the shoulder), supraspinatus tendon (located on the top of the shoulder) and teres minor tendon (located at the back of the shoulder). The most common injured tendon is the supraspinatus tendon. Rotator cuff tendon remains strong in enabling humans to lift and rotate the arm. Tendonitis in general may occur in any tendon of the body but most common in shoulder, elbows, wrist and heels.
Shoulder tendonitis is often caused by overuse or injury from the repetitive movement or a traumatic blow to the shoulder. This condition is common in athletes and after suffering shoulder injury. Common sports associated with tendonitis are tennis players, baseball players and swimmers. Even so, anyone can develop shoulder tendonitis from repetitive use of the tendons.
Risk factors for tendonitis include the ageing process as a person grows older and people who work for certain jobs or particular sports. Those participating in sports with repetitive movements or using incorrect technique in sport have high risk for developing shoulder tendonitis. As a person ages, their tendons become naturally less flexible making it prone to injury. Common everyday activities that involve overusing or repetitive use of the tendon such as gardening and cleaning house can contribute to tendinitis. Risk for tendonitis in general increases when incorrect posture is involved.
Common symptoms of shoulder tendonitis include clicking or popping of the shoulder, swelling or tenderness of the shoulder, inability to hold arm in certain positions, shoulder pain especially when lying on shoulder, sore shoulder, stiff shoulder, shoulder weakness and losing ability to move the arm. Pain at night and difficulty performing activities that place the arm behind the back such as buttoning or zipping clothing can be symptoms of shoulder tendonitis. Since symptoms of shoulder tendonitis may seem like other conditions, it is best to get checked by doctors when there are any of the symptoms.
To diagnose shoulder tendonitis, symptoms, medical history of patient and physical examination is the initial information needed by doctors. Physical examinations check for the shoulder area and measure the arm function. Doctor may recommend further tests to evaluate the shoulder. This includes imaging tests such as x-ray or MRI. X-rays of shoulder tendonitis often show normal or small bone spurs. MRI creates better image soft tissue such as the rotator cuff tendons and can show signs of inflammation or tearing in some cases.
The best treatment of shoulder tendonitis aims to reduce pain and restore function. In most cases, the best treatment would be physical therapy to restore the normal function of the shoulder such as strengthening exercises and specific stretching. Patients are often given non-steroidal anti-inflammatory drugs (NSAIDs) to alleviate symptoms of inflammation such as pain and swelling. Doctors will always suggest patients to take more rest and make activity modification such as avoiding overhead activities. Patients can try applying ice or a heat pack on the shoulder joint. In certain cases, patients may benefit from corticosteroid injection to the shoulder joint.
When any of the above methods does not help to relieve shoulder tendonitis or the condition is very severe such as a teared tendon, surgery may be beneficial. Surgery can help strengthen muscles and tendons. The goal of surgery is to provide more space for the rotator cuff. Commonly, arthroscopic technique is used as it is less invasive. After surgery, the patient’s arms are placed in a sling for a short period of time to promote early healing. When a patient starts to feel comfortable, the sling is removed and enables exercise for the arm. Rehabilitation programs are provided based on the patient’s needs and findings at surgery. Exercise includes restoring the range of motion of the shoulder and its strength. It will take 2 to 4 months to be completely relieved from pain but may take up to a year.
The best way to prevent shoulder tendonitis is to take preventative measures. This includes doing warm up before strenuous activity, doing stretching before and after activities, doing exercise that strengthen and condition tendons regularly such as resistance training with light weight, use proper posture and equipment, and last but not least, to take breaks when feeling muscle stiff or tired.