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Shoulder Tendon Pain Overview

by Jaydee Vykoukal, PT, DPT November 21, 2020 0 Comments

woman shoulder pain

Shoulder tendonitis goes beyond everyday shoulder pain. Shoulder tendon pain can cause significant pain, swelling, and stiffness. Athletes are particularly susceptible, but they’re not the only ones at risk. The shoulder is the most mobile joint in the human body, and healthy shoulders are key to performing everyday tasks. If shoulder tendonitis is threatening to make you less mobile or active, rest assured that there are a number of treatments. Read on to learn about this condition, what causes shoulder tendonitis and how to treat it.

What is Shoulder Tendonitis?

Simply put, shoulder tendonitis is an inflammation or irritation of the shoulder muscle tendons in the shoulder joint. You may also hear this condition referred to as rotator cuff tendonitis or tendinitis.

The most commonly affected tendon is one of the four rotator cuff tendons, with the supraspinatus tendon the most common of all. However, you can also experience problems in the triceps or biceps tendon.

Though a shoulder tendon pain or injury can be caused by one-off events, such as an impact, it is generally considered a repetitive or overuse injury, also known as a wear-and-tear injury.

Sufferers of chronic shoulder tendonitis experience the symptoms of tendonitis for a sustained period of time. Symptoms do not subside until the condition is properly treated.

What is the Rotator Cuff?

The rotator cuff refers to the group of muscles and tendons in your shoulder joint that support the ball of your arm in the shoulder socket. They provide strength and stability to allow the arm and shoulder blade to move, while also keeping it secure.

Torn Rotator Cuff?

The shoulder socket is amazingly mobile, allowing you to raise and rotate your arm in a way that is not possible in other joints. Tendonitis of the shoulder commonly occurs when a tendon in the rotator cuff becomes inflamed.

The rotator cuff is an umbrella term that includes the following muscles:

  • Infraspinatus

    This muscle provides glenohumeral stability and allows you to externally rotate your shoulder.

  • Supraspinatus

    Keeps the upper arm bone (humerus) secure in the socket. Plus, it supports the larger deltoid muscle when elevating the arm to prevent unnecessary pinching of all the rotator cuff tendons.

  • Subscapularis

    The largest cuff muscle, which is responsible for internally rotating and adducting the shoulder.

  • Teres minor

    A small muscle that supports the infraspinatus and has similar function.

Types of Shoulder Tendonitis

There are several types of shoulder or rotator cuff tendinitis. This can cause some confusion, particularly where catch-all, umbrella terms are used or where different terms are used interchangeably. Here, we provide some jargon-busting explanations to help you understand the key types of shoulder tendonitis.

  • Swimmer’s Shoulder

    This umbrella term encompasses numerous shoulder ailments. As swimmers frequently experience various types of shoulder pain, it is common to hear these conditions grouped together as swimmer’s shoulder, or swimmer’s shoulder tendonitis.

    Overuse, poor technique, and fatigue can cause problems for swimmers, and tendonitis of the shoulder is a common issue. If you are a swimmer, it is important to assess your stroke technique (and keep the rotator cuff stabilized and balanced) to ensure you are not causing issues or exacerbating existing problems. If you do experience shoulder problems or pain, consult a physical therapist to assess your injury and assist in your recovery.

  • Calcific Tendonitis

    Calcific tendonitis of the shoulder involves the buildup of calcium deposits in the tendon. These deposits are small, usually one to two centimeters, and the exact cause is unknown but is correlated to overuse as well. This disorder is most common in people over the age of 30.

    This buildup of calcium creates pressure in the tendon, affects tissue health, and can narrow space for the shoulder to move- leading to pain. In some cases, the pain can be intense. In other cases, these small deposits may form unnoticed.

    This buildup of calcium deposits can occur in any of the body’s tendons, but it is most common in the shoulder.

  • Chronic Tendonitis Shoulder

    If you repeatedly suffer from tendonitis in the shoulder, your condition could be described as chronic. This means that it is persistent and long-lasting for 6 weeks or more. Even short bouts of shoulder pain can be frustrating, so chronic shoulder tendonitis is particularly troublesome.

  • Acute Tendonitis Shoulder

    Tendonitis of the shoulder often develops over time, and for this reason, it is slightly less common to experience acute shoulder tendonitis, which involves a sudden onset of pain and swelling. However, if your tendonitis was brought on by a sudden impact or fall, you could experience acute and sudden pain.

    Additionally, you can aggravate an existing shoulder injury- consider acute on chronic- too. If your symptoms develop suddenly and worsen rapidly, consult your doctor as soon as possible.

What Causes Tendonitis in the Shoulder?

Tendonitis of the shoulder often occurs over time as the result of repeated microtrauma. Overuse and abnormal wear and tear of the joint can eventually lead to the development of shoulder tendonitis.

Below are the most common causes of shoulder tendonitis.

  • A direct impact or fall
  • Participating regularly in sports that require high levels of arm use, such as basketball, baseball, or swimming
  • Poor technique during sports or exercise
  • Heavy lifting
  • Operating overhead machinery
  • Repeated microtrauma

For some people, what causes shoulder tendonitis is unknown or difficult to deduce. In cases where the condition develops slowly, people may be less motivated to see a doctor. This can lengthen the shoulder tendonitis recovery time, leading to chronic shoulder tendonitis.

Let’s discuss in-depth a few of the most common causes of shoulder tendonitis.

  • Athletics

    Athletes are particularly vulnerable to this condition. Those who play sports that involve a lot of overhead movements are at an increased risk, due to repeated overuse of the tendons in the rotator cuff. This can be further exacerbated with mechanics that are not good.

  • Age

    As we age, our risk of falling increases and tissue extensibility decreases, which places us at greater risk of experiencing shoulder tendonitis. Falling on an outstretched arm, poor healing capabilities, and more can lead to shoulder injury. The resulting impact can injure the shoulder joint and lead to a rotator cuff tear or tendonitis.

  • Shoulder Bursitis

    Shoulder bursitis can either occur in conjunction with shoulder tendonitis or can cause shoulder tendonitis.

    Bursa protect the shoulder tendons from friction. Subacromial bursa sit in the spaces between the tendons and bones. When these become inflamed, they can cause slowly developing pain, which is felt on the outside of the shoulder and down the arm.

  • Shoulder Impingement Syndrome

    Shoulder impingement syndrome is a common cause of shoulder pain and can potentially lead to tendonitis. The rotator cuff tendons become trapped and begin to rub and catch on nearby tissue. Sufferers typically experience pain and weaknesses in the shoulder.

Symptoms of Shoulder Tendonitis

The shoulder tendonitis symptoms vary depending on the root cause of the tendonitis, where it is located (which tendon it affects), and whether it came on suddenly or over time. Aside from pain, shoulder tendonitis can cause a number of additional problems. If you experience any of the symptoms below, see your doctor for a formal diagnosis.

  • Pain in the tendon
  • Pain around the shoulder and the upper arm
  • Pain when lifting or moving the arm
  • Difficulty sleeping or lying on the side of the affected arm
  • A clicking noise in the shoulder
  • Swelling around the shoulder
  • Stiffness around the shoulder
  • Weakness in the arm and shoulder
  • Loss in range of motion

Diagnosing Shoulder Tendonitis

Your doctor or physical therapist will begin by asking questions about your symptoms. He or she will also perform a physical examination of the shoulder to assess your pain and mobility.

An ultrasound scan may also be used if necessary. This is one of the most common methods of diagnosing shoulder tendonitis and can also check for other conditions, tears, or injuries around the joint.

An X-ray is less commonly used, but your doctor may order an X-ray if there is a possibility of a bone injury, such as a bone spur encroachment or fracture with a fall.

Treating Shoulder Tendonitis

If you are experiencing shoulder pain, particularly tendonitis, physical therapy is a great option to address pain and dysfunction. Additionally, you can treat your shoulder at home with pain relieving modalities and shoulder balancing exercises. If severe, you may need to consider options like medication, injections, and surgery. Talk to your doctor or physical therapy for the best recommendations.

Shoulder Tendonitis Treatments

Average Recovery Time

Many make a full recovery, or at least learn to better manage their symptoms, within weeks or months—six weeks is average. Follow your doctor’s advice and seek out physical therapy for a customized shoulder tendonitis rehab program to ensure a speedier recovery.

Consult a doctor if you are suffering from shoulder tendonitis symptoms, as seeking help and advice can significantly reduce your risk of chronic shoulder tendonitis.

Shoulder Tendonitis Products

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Jaydee Vykoukal, PT, DPT
Jaydee Vykoukal, PT, DPT

JayDee Vykoukal is a Doctor of Physical Therapy, owner of the healthy habit platform Health Means Wealth, and freelance medical writer. She loves traveling and spending time with her family in nature. Her passion is helping others continue to participate in the activities they love through education and proper exercise.



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