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

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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 aged 30 years 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:

• MRI scan
• X-rays
• Ultrasound

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

Prevention

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