Blog 9- Tackling Shoulder Tendonitis: A Comprehensive Guide to Relief and Prevention

Shoulder tendonitis can be a real pain in the .... shoulder! If you've ever experienced the sharp discomfort that comes with this condition, you're not alone. Shoulder tendonitis, also known as rotator cuff tendonitis, is a common issue that can significantly impact your ability to perform everyday activities. In this blog, we'll dive into the nitty-gritty of shoulder tendonitis, including its causes, the anatomy involved, effective physiotherapy exercises, pain management techniques, and preventative strategies to keep your shoulders in top shape. 

Understanding Shoulder Tendonitis 

Etiology: How Does It Happen? 

Shoulder tendonitis occurs when the tendons in your shoulder become inflamed. This inflammation is often the result of repetitive overhead activities, sudden injuries, or degenerative changes in the tendons due to aging. Athletes, especially those who participate in sports like swimming, pickleball, or baseball, are particularly susceptible. Additionally, individuals who engage in repetitive lifting or those who have poor posture may also find themselves dealing with this painful condition. 

Anatomy of the Affected Tissues 

Right Shoulder Muscles (Side View)

The shoulder is a marvel of engineering, designed to provide a wide range of motion while maintaining stability. Central to this functionality is the rotator cuff, a group of four muscles and their tendons that ensure the smooth operation of the shoulder joint. These muscles include: 

1. Supraspinatus: This muscle is primarily responsible for lifting the arm away from the body (abduction). Due to its anatomical position underneath the acromion—a bony projection on the scapula—it is prone to impingement and irritation. Furthermore, the supraspinatus has poor vascularization, meaning it receives a limited blood supply, which can impede healing and make it more susceptible to tendonitis. 

2. Infraspinatus: This muscle assists with external rotation of the shoulder, allowing you to rotate your arm away from the body. It is situated on the back of the shoulder blade. 

3. Teres Minor: Also involved in external rotation, the teres minor is a small muscle located below the infraspinatus, contributing to the stability and movement of the shoulder. 

4. Subscapularis: This muscle enables internal rotation, allowing you to rotate your arm towards the body. It is located on the front of the shoulder blade, covering a large portion of the anterior surface of the scapula. 

Among these muscles, the supraspinatus is the most likely to be affected by tendonitis due to its anatomical position and poor vascularization. The constant friction against the acromion can lead to inflammation and damage over time, making it a common site of pain and dysfunction in the shoulder. 

Physio-Specific Exercises for Shoulder Tendonitis 

Stretching Exercises 

1. Hand Behind Back Stretch: Stand with your feet shoulder-width apart. Place the affected arm behind your back, and gently pull it towards the opposite side using your other hand. Hold the stretch for 20-30 seconds, then release. Repeat 2-3 times. 

2. Doorway Stretch: Stand in a doorway with your elbow bent at a 90-degree angle and pressed against your side, with your palm resting on the doorframe. Gently turn your body away from the doorframe until you feel a stretch in the front of your shoulder. Hold for 20-30 seconds, then release. Repeat 2-3 times. 

3. Pendulum Stretch: Bend at the waist and let your affected arm hang down. Swing it gently in small circles or back and forth for 1-2 minutes. 

By incorporating these stretches into your routine, you can help alleviate the discomfort associated with shoulder tendonitis and improve your shoulder's flexibility and range of motion. 

Strengthening Exercises 

Resisted Shoulder External Rotation

1. External Rotation with Resistance Band: Secure a resistance band at waist height. Hold the band with your elbow bent at 90 degrees and rotate your forearm outward, keeping your elbow close to your body. 

2. Internal Rotation with Resistance Band: Using the same setup as above, rotate your forearm inward against the resistance band. 

3. Shoulder Blade Squeezes: Sit or stand with your arms at your sides. Squeeze your shoulder blades together and hold for 5-10 seconds, then release. Repeat 10-15 times. 

Pain Management Techniques 

Managing pain from shoulder tendonitis involves a combination of rest, ice, and gentle movements to reduce inflammation and prevent stiffness. Here are some effective strategies: 

1. Rest and Modify Activities: Avoid activities that aggravate your shoulder pain. Give your shoulder time to heal. 

2. Ice Therapy: Apply an ice pack to the affected area for 15-20 minutes several times a day to reduce inflammation. 

3. Anti-inflammatory Medications: Over-the-counter NSAIDs, such as ibuprofen, can help manage pain and reduce swelling. 

Preventative Strategies 

Preventing shoulder tendonitis involves maintaining shoulder health through proper posture, regular exercise, and mindful movements. Here are some tips: 

1. Ergonomic Adjustments: Ensure your workstation is set up to promote good posture and reduce strain on your shoulders. 

2. Strengthening and Flexibility: Regularly perform exercises to keep your shoulder muscles strong and flexible. 

3. Warm-Up Before Activities: Always warm up before engaging in activities that involve repetitive shoulder movements. 

 Conclusion 

Shoulder tendonitis can be a challenging condition, but with the right knowledge and approach, you can manage and even prevent it. By understanding the causes, incorporating effective stretching and strengthening exercises, managing pain, and adopting preventative strategies, you can keep your shoulders healthy and pain-free. Remember, your physiotherapist is always here to help you tailor a plan that fits your specific needs and lifestyle. Stay active, stay healthy, and keep those shoulders happy! 

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For more tips and personalized advice, don't hesitate to reach out. I'm dedicated to helping you get back to doing what you love, pain-free. 

Marco Chiasson, Physiotherapist

Physika