Shoulder joint tendinitis can be defined as a health condition in which the tendons of the rotator cuff get inflamed due to injury. These types of injuries that cause inflammation in the shoulder tendons are called rotator cuff tendinopathy.
What is Shoulder Joint Tendinitis?
The composite structure of the shoulder is primarily made of three bones which are the upper arm bone or humerus, the shoulder blade or scapula and the collar bone or the clavicle. The shoulder joint is brought together and supported by a structure called the rotator cuff. It is made up of muscles and tendons that form a covering over the shoulder joint and is attach to the shoulder blade. To allow the free movement of the rotator cuff over the shoulder bone and the joint, there exists a lubricating sac called the bursa. Whenever there is an inflammation or injury in the tendons or the bursa then it results into shoulder pain and stiffness.
In case of tendinitis, the bicipital tendon which is present in the rotator cuff gets inflamed and irritated resulting in aggravated shoulder pain. The shoulder joint tendinitis is also called rotator cuff tendinitis or bicipital tendinitis. The inflammation occurs at the long head of the tendons present in the biceps region. Initially, the tendon has reddish appearance and swelling but with progression, the tendon sheath becomes thick and becomes large accompanied by severe inflammation and dark reddish color. Under rare circumstances, it may also lead to tendon tear or arm deformation.
Symptoms of Shoulder Joint Tendinitis
The symptoms that identify the shoulder joint tendinitis are:
- Severe pain in the front of the shoulder.
- Increased shoulder pain on lifting objects or related activities.
- Clicking or snapping sound when the arm is raised to the height of the shoulder or the hand is moved behind the back or the head.
- Occurrence of pain when lying on the affected shoulder.
- On deterioration of the condition, the shoulder may pain even while taking rest.
- Radiating pain towards the neck or front side of the lower arm.
Prognosis of Shoulder Joint Tendinitis
The prognosis for shoulder joint tendonitis is good and it can be treated successfully and reversed. This condition is a progressive one. It often coexists with shoulder bursitis which may further lead to calcification of tendons and rotator cuff tears, if the condition is left unattended or the treatment is poor. Such conditions then require surgery along with biomechanical correction.
Causes of Shoulder Joint Tendinitis
This condition is a resultant of frequent injury to the rotator cuff tendons instead of a single injury trauma. This can occur due to:
- Rotator-cuff Impingement as a Cause of Shoulder Joint Tendinitis: It occurs when the rotator cuff tendon rubs against the acromion bone resulting in tendon inflammation and swelling, thereby causing shoulder tendinitis.
- Shoulder Bursitis as a reason for Shoulder Joint Tendinitis: The bursa present between the rotator cuff and the bone gets inflamed and prevent the smooth motion of rotator cuff over the bone, resulting in shoulder pain and shoulder joint tendinitis.
Risk Factors of Shoulder Joint Tendinitis
The general risk factors that pose a threat of shoulder joint tendinitis are:
- Age advancement leading to lower flexibility of tendons and making them prone to injuries.
- Occupations that involve repetitive motion, vibration, forceful exertion and frequent overhead lifting of objects leading to over use of the shoulder.
- Presence of previous shoulder problems or injuries like arthritis, labral tears and shoulder dislocation.
- Involvement in sports with repetitive shoulder motions like swimming, basketball, bowling, baseball, golf, and tennis.
- Improper and inappropriate exercising techniques.
Complications of Shoulder Joint Tendinitis
Complications surface in the cases when proper treatment is not taken to address the condition. The most common complications that come up are:
- Tendon Rupture: Neglected tendinitis may result in the rupturing of the tendons which then can only be treated by surgical repair.
- Tendinosis: Tendinosis develops when tendon irritation persists for a long time, resulting in degeneration of tendons and abnormal growth of blood vessels in the associated region.
Diagnosis of Shoulder Joint Tendinitis
The diagnosis of shoulder joint tendinitis generally involves a comprehensive physical examination that assesses the sensation, motion, strength and flexibility of the shoulder. In some cases, X-ray and MRI may be required to check for other medical conditions that may result in the symptoms similar to shoulder joint tendinitis.
Treatment of Shoulder Joint Tendinitis
To treat the shoulder joint tendinitis, the doctors follow certain essential principles that ensure at restoring the normal functioning of shoulder and prevent reoccurrence of shoulder joint tendinitis. These principles are:
- Treatment and protection from injury at the earliest by administration of pain relieving and anti-inflammatory medications along with cold compression and rest.
- Reacquire the complete and full range of motion of the shoulder joint after the period of rest is over.
- Restore the proper functioning and control of scapula.
- Restore the proper coordination among the neck and shoulder region.
- Restore the strength and appropriate function of the rotator cuff.
- Achieve appropriate the strength, speed, power and agility of the shoulder joint.
- Return to normal routine.
The above approach is achieved through below treatments:
- Pain Relieving Medications to treat Shoulder Joint Tendinitis: These can be taken in the form of oral medications like Ibuprofen and Aspirin, or as topical ointments. These greatly help in reducing the pain and discomfort.
- Platelet-rich Plasma Treatment for Shoulder Joint Tendinitis: This treatment involves injecting of blood platelets into the shoulder tendons to help in its healing. To obtain the blood platelets, the blood is extracted from the patient’s body, and is spin to separate the platelets from other particles of the blood. Once done, the blood is sent back to the patient’s body.
- Using Corticosteroids for Treating Shoulder Joint Tendinitis: These are cortisone injections that help in easing of pain and reduction of inflammation.
- Physiotherapy as a Treatment Method for Shoulder Joint Tendinitis: The chiropractic sessions use a specific exercises regime that strengthens and stretches the shoulder joint to treat the inflammation.
- Surgical Measure to Treat Shoulder Joint Tendinitis: Surgical measures are opted in the scenarios when the tendon gets torn off from the shoulder bone. In such cases, minimal invasive surgical technique is performed to remove the tendon scar tissue without distressing the healthy tendon tissue. This procedure is called FAST or Focused Aspiration of Scar Tissue and it is done with the help of ultrasound technique.
Exercises for Shoulder Joint Tendinitis
The chiropractic sessions taken to improve the condition involve performing of specific stretching and strengthening exercises to strengthen the shoulder and improve its flexibility.
- Stretching Exercises for Shoulder Joint Tendinitis: These exercises help in improving the flexibility of the shoulder and its range of motion. It involves stretching of shoulder until the feeling of stretch is comfortable. It can be done for fifteen to twenty seconds each time.
- Strengthening Exercises for Shoulder Joint Tendinitis: These exercises focus on the rotator cuff and scapula, to achieve a better muscle contraction through the entire range of motion by performing slow and gradual resistance exercises. Individuals can take up weight training to achieve appropriate shoulder strength and muscle balance.
Prevention of Shoulder Joint Tendinitis
There are several measures which can be taken up in order to prevent shoulder joint tendinitis. These include:
- Regular exercising along with gradual increase in the intensity of the work out.
- Perform exercises that focus on strengthening the shoulder muscles.
- Refrain from performing activities that strain the shoulder and cause pain.
- Practice good posture.
- Escape sitting still for long duration.
In case, the patient had shoulder joint tendonitis previously then professional advice and help should be sought before taking up any new exercises or physical activities. Avoid handling heavy tools for long durations. In case, it is unavoidable, then use both hands to handle the tool.
Shoulder joint tendinitis emerges when the bicipetal tendons get injured and inflamed. This results in severe shoulder pain and stiffness that hamper the routine activities of an individual. The condition if treated timely and appropriately can be successfully cured and reversed, but if left unattended then it can lead to serious complication like shoulder deformation and tears in the tendon. Thus, the condition should be checked and treated as soon as possible. In order to escape the occurrence of the condition, individuals can indulge in regular exercising and practice good posture as well as refrain from handling heavy tools or objects.