Shoulder tendinopathy
Definition:
It refers to a condition involving damage, degeneration, or irritation of the tendons in the shoulder joint. This condition can affect any of the tendons in the shoulder, including those of the rotator cuff muscles, which are commonly involved.
There are various types of shoulder tendinopathy, including:
Rotator cuff tendinopathy: This is the most common type of shoulder tendinopathy and typically involves damage or degeneration of the tendons of the rotator cuff muscles, which help stabilize the shoulder joint and facilitate movement.
Bicipital tendinopathy: This involves damage or irritation of the biceps tendon, which attaches the biceps muscle to the shoulder and helps stabilize the joint during certain movements.
Subacromial tendinopathy: This refers to damage or inflammation of the tendons that pass through the subacromial space, a narrow passage between the acromion (a bony prominence on the shoulder blade) and the rotator cuff tendons. Subacromial tendinopathy is often associated with impingement syndrome, where the tendons become pinched or compressed during shoulder movements.
Principal causes:
Overuse: Repetitive overhead activities, such as throwing, lifting, or reaching, can place stress on the tendons in the shoulder and lead to irritation or damage over time.
Age-related changes: Degenerative changes in the tendons, such as tendon degeneration or calcification, are more common as individuals age and can increase the risk of developing tendinopathy.
Poor biomechanics: Abnormalities in shoulder mechanics or posture can contribute to excessive stress on the tendons and increase the risk of injury.
Trauma: Acute injuries, such as falls or direct blows to the shoulder, can cause damage to the tendons and predispose individuals to tendinopathy.
Symptoms:
Pain: Persistent pain in the shoulder, particularly with overhead movements or activities that place stress on the affected tendons.
Stiffness: Stiffness or limited range of motion in the shoulder joint, especially in the morning or after periods of inactivity.
Weakness: Weakness or difficulty with activities that involve the shoulder, such as lifting or reaching.
Diagnosis of shoulder tendinopathy typically involves a physical examination, evaluation of symptoms, and imaging studies such as X-rays, ultrasound, or magnetic resonance imaging (MRI) to confirm the diagnosis and assess the extent of tendon damage.
Treatment as a EvivaPHYSIO:
Rest and activity modification: Avoiding activities that exacerbate symptoms and modifying daily activities to reduce stress on the affected tendons.
Physical therapy: Specific exercises and stretching techniques to strengthen the muscles surrounding the shoulder joint, improve shoulder mechanics, and promote tendon healing.
Modalities: Heat, cold, ultrasound, or electrical stimulation may be used to relieve pain and inflammation and promote tissue healing.
Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroid injections may be prescribed to reduce pain and inflammation (if necessary).
Biomechanical corrections: Addressing underlying biomechanical issues or postural abnormalities that contribute to shoulder tendinopathy.
In some cases, particularly if conservative treatments fail to provide relief, surgical intervention such as arthroscopic tendon debridement or repair may be considered to address underlying tendon damage.
Overall, the prognosis for shoulder tendinopathy is generally favorable with appropriate treatment, although recovery may be slow and gradual. It is important for individuals with shoulder tendinopathy to work closely with their healthcare provider and physical therapist to develop a comprehensive treatment plan tailored to their specific needs and goals. Early intervention and consistent management can help minimize pain and stiffness, restore shoulder function, and promote optimal recovery.