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Shoulder Tendinopathy

(Shoulder Tendonitis; Shoulder Tendinosis; Bicipital Tendinopathy; Bicipital Tendonitis; Bicipital Tendinosis; Supraspinatus Tendinopathy; Supraspinatus Tendonitis; Supraspinatus Tendinosis; Pitcher's Shoulder; Swimmer's Shoulder; Tennis Shoulder)

Definition

Shoulder tendinopathy is an injury to a tendon in the shoulder. Tendons connect muscle to bone, often near a joint. Tendinopathy makes it hard to move the shoulder due to:

  • Tendinosis—tiny tears in the tendon with little or no inflammation
  • Tendonitis—inflammation of the tendon
Shoulder Tendons
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Causes

The most common cause is overuse of a muscle and tendon. This can happen with repetitive motions such as reaching overhead or throwing.

It may be caused by:

  • Inflammatory disease in the shoulder, such as arthritis
  • Trauma to the shoulder, such as a fall on an outstretched arm

Risk Factors

This problem is more common in people 30 years of age and older. People who do these activities are also at higher risk:

  • Tennis or other racquet sports
  • Swimming
  • Baseball
  • Overhead assembly work, butchering, or using an overhead pressing machine

Symptoms

Symptoms start slowly over time. Pain is often worse when using the shoulder.

Common problems are:

  • Dull pain in the shoulder and upper arm
  • Pain at night, mainly when sleeping
  • Pain when reaching behind
  • Pain with overhead use
  • Shoulder weakness
  • Shoulder stiffness and problems moving

Diagnosis

You will be asked about your symptoms and health history. A physical exam will be done. It will focus on the shoulders. This is often enough to make the diagnosis.

Images may be taken. This can be done with:

Treatment

It may take weeks or months to heal. The goals of treatment are to ease pain and swelling. This may include:

  • Medicine to ease pain and swelling
  • A sling to prevent the shoulder from moving as it heals
  • Exercises to help with strength, flexibility, and range of motion

Surgery

Some people may need surgery to repair the tendon. The type that is done depends on the injury.

Prevention

This problem cannot always be prevented. Starting a new sport slowly may help lower the risk of injury.

RESOURCES:

Arthroscopy Association of North America
http://www.aana.org

Ortho Info—American Academy of Orthopaedic Surgeons
http://orthoinfo.org

CANADIAN RESOURCES:

Canadian Orthopaedic Association
http://www.coa-aco.org

Canadian Orthopaedic Foundation
http://www.canorth.org

REFERENCES:

Biceps tendonitis and biceps rupture. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/biceps-tendonitis-and-biceps-rupture. Updated February 5, 2105. Accessed December 9, 2019.

Derry S, Wiffen PJ, et al. Topical analgesics for acute and chronic pain in adults—an overview of Cochrane Reviews. 2017 May 12;5:CD008609.

Snyder GM, Mair SD, et al. Tendinopathy of the long head of the biceps. Med Sport Sci. 2012;57:76-89.

Swimmer's shoulder. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/services/orthopaedics-rheumatology/diseases-conditions/hic-shoulder-tendonitis. Accessed December 9, 2019.

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 December 9, 2019.

Last reviewed September 2019 by EBSCO Medical Review Board Laura Lei-Rivera, PT, DPT, GCS  Last Updated: 12/9/2019