A tendon is a strong, fibrous tissue that is responsible for transferring force generated by the muscle to the bone producing movement at the joint. Inflammation of the muscle-tendon is called “tendinitis” and may result in pain paired with restriction of movement.
Tendinitis of the shoulder typically occurs in the subacromial space and is common due to the anatomy of the shoulder, coupled with stressful activity assigned to the joint. The subacromial space is an area on the top of the shoulder formed by the coracoacromial arch. This arch is formed by the acromioclavicular joint, coracoacromial ligament, and acromion (outer edge of the shoulder blade).
The chief tendons of the shoulder, the rotator cuff, and the long head of the biceps, pass under this arch. Reduction of this space exposes the tendons to a high risk for friction, rubbing, and irritation, setting the stage for a case of tendinitis. Tendon problems usually emerge in individuals 40 to 60 years old but are increasingly seen in young athletes as a byproduct of repetitive overuse.
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Damage to the rotator cuff is the most common cause of shoulder pain. The rotator cuff tendons are commonly irritated with repetitive overhead activities and routine lifting that may result in pain and weakness in the shoulder.
Tendinitis is most often diagnosed as an overuse repetitive strain injury (RSI), but most RSI cases exhibit genetically predisposing factors as well. Individuals that have a poor blood supply to the area are most susceptible to inflammation and the development of tendinitis (for example, the supraspinatus). Other high-risk activities or conditions that may lead to the development of shoulder tendonitis include:
At the first sign of tendinitis, one should avoid preforming positions and activities that increase and exasperate the pain stemming from the inflammation.
Conservative treatment plans exercised under a doctors care include rest, alternating application of heat and ice to the area, physical therapy and non-steroidal medications to reduce inflammation. A pain management program may be implemented to help limit discomfort allowing the patient to preform rehabilitation exercises.
If symptoms persist, steroidal medication or injections may be prescribed by your health care professional to be used in tandem with therapy. Surgical intervention may be discussed to treat highly severe cases to address and correct mechanical causes of the tendon irritation.
If surgery is thought to be unnecessary, treatment plans will focus on the restoration of shoulder motion. As the pain dissipates, strengthening exercises should be initiated to prevent muscle weakness and atrophy. Common treatment methods of a Rotator Cuff Tendinitis includes:
Small measures can be taken by at-risk individuals to help prevent tendinitis. It is far easier to prevent the condition than it is to treat it, as some damage may be irreversible or costly to fix. Below are some tips to reduce the risk of tendinitis:
Dr. Freeman is a kind, compassionate, knowledgeable doctor and a true professional. It’s evident that he truly cares about the well-being of his patients. The staff at Redefine also exemplifies professionalism. In particular, Andrea, who is extremely helpful, works to ensure each patient receives top notch care. Keep up the great work Redefine Healthcare!
Dr. Eric D. Freeman is a top-rated, best-in-class pain management doctor. He is a nationally recognized pain relief specialist and is among the top pain care doctors in New Jersey and the country. He is an award-winning expert and contributor to prominent media outlets.
Dr. Eric D. Freeman has been recognized for his thoughtful, thorough, modern approach to treating chronic pain. He has been named a “top pain management doctor in New Jersey” and one of “America’s Top Physicians” for advanced sports injury treatments.
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