It is the tendons that connect muscle to bone and often connect near a joint.  Tendinopathy refers to injury to the tendon.  It can lead to pain and swelling and movement can become very difficult.  Tendinopathy may be:

Tendonitis — inflammation of the tendon (not very common)

Tendinosis — tiny tears in the tendon with no significant inflammation (more common)

Shoulder consists of many tendons.  They are connected to muscles of rotator cuff and biceps muscle of the arm.  If you have tendinopathy, it means your tendons are inflamed, irritated or torn.

Over use of the muscle and tendon is the main reason for tendinopathy. Constant strain on the tendons causes the structure of the tendon to change. The condition can set in over a period of time.  It can be the result of involving in activities that require lifting your arm over your head, sleeping on your shoulder every night, repeated throwing or keeping your shoulder in one position for a while.

It should be noted that shoulder tendinopathy can also occur on account of injury to the tendon from:

    • Inflammatory disease in the shoulder, such as arthritis
    • Trauma to the shoulder such as a fall on outstretched arms
    • Normal wear and tear associated with age

Shoulder tendinopathy is generally seen in people who are 30 years and older.  It is also common among athletes who have to use their arm extensively in overhead position and throwing motion such as:

    • Tennis or other racquet sports
    • Swimming
    • Baseball
    • Bowlers (cricket)
    • Overhead assembly work, butchering or using an overhead pressing machine

Symptoms of shoulder tendinopathy:

Symptoms of the condition tend to get worse over time.  In the beginning, symptoms may be relieved with rest, but later the symptoms can present constantly.  Pain (dull ache) may not always be present but slowly increases as you strain the shoulder.  If the symptoms go past the elbow,it usually indicates another problem.

Common signs of the condition include:

    • pain and swelling in the front of your shoulder and side of your arm
    • pain triggered by raising or lowering your arm
    • a clicking sound when raising your arm
    • stiffness
    • pain that causes you to wake from sleep
    • a loss of mobility and strength in the affected arm
    • Pain when trying to reach for a back zipper or pocket
    • Shoulder stiffness with some loss of motion

Diagnosis of shoulder tendinopathy:

Doctor will ask about your symptoms and medical history followed by a physical exam.  Tender areas of your shoulder will be thoroughly examined.  You will be asked to move your shoulder in certain directions to test your range of motion.  Strength of your shoulder will also be checked by asking you to press against the doctor’s hands.  As pinched nerve and arthritis bring about almost the same symptoms, they may check your neck.  Bursitis often has the same symptoms.  Your doctor may inject a medication that numbs pain.  If the pain goes away, it may suggest bursitis, not tendinopathy.

To confirm the diagnosis your doctor may order some imaging tests.  An x-ray may be ordered in order to rule out a bone spur.  An ultrasound and an MRI may also be ordered to check if there is inflammation in your rotator cuff and signs of any tearing.


It may take several weeks or months to fully heal.  Treatments include:

Rest – Though it does not call for full rest, a break from activities that cause pain is warranted.  A phased return to normal activities will decrease the chance of damaging the tendon again.  Applying cold packs to your shoulder three to four times per day may also be helpful.

Medication – Medications may help to manage the condition, mainly nonsteroidal anti-inflammatory drugs (NSAIDs).  Topical pain medications can also be applied to the skin to relieve pain.  However, if the pain is severe, steroid medications may be needed.  These medications are injected directly to the area.  Frequent use of steroid medications can damage the tendons, so it is done with due caution.

Surgery – If conservative treatment modalities do not bring about the required change, your doctor may recommend surgery.  The type of surgery will depend on the specific injuries.Most people experience full recovery after having the surgery.


Proper rehabilitation measures help regain strength and range of motion in the shoulder.  It may also keep further injuries at bay.  Rehabilitation may include:

    • Physical therapy to strengthen muscles that control the shoulder
    • Exercises to maintain normal range of motion
    • Exercises for specific muscles that are used in sports or job activities
    • Gradual return to sports and work
    • Learning how to adjust activities to prevent re-injury

Tips to prevent shoulder tendinopathy:

    • Do regular resistance exercises to strengthen the muscles.
    • Use proper athletic training methods.
    • Do not increase exercise duration or intensity more than 10% per week.
    • Avoid overusing your arm in an overhead position.
    • Alter job duties to avoid overhead activity.
    • Do not ignore or try to work through shoulder pain.
    • Adopt good posture while sitting
    • Taking breaks from repetitive activities
    • Avoid carrying a bag on only one shoulder
    • Avoid sleeping on the same side every night

For questions related to Shoulder Tendinopathy and its treatment options, send a message to

Shoulder Tendinopathy

Q & A on Shoulder Tendinopathy

1. What is shoulder tendinopathy?

Shoulder tendinopathy is an injury caused to the shoulder tendons. This can result in pain and swelling and therefore difficulty in moving the shoulders. It can be in the form of inflammation of the tendons or tears in the tendon without inflammation. The tendons in the shoulder are attached to the rotator cuff muscles enabling movement. When this is affected, movement is restricted. This injury may be chronic or acute and is mainly because of overuse of the shoulder.

2.What are the causes of shoulder tendinopathy?

The main reason for tendinopathy is the repeated use of the shoulder. The rotator cuff is the place where tendon injury happens. This is because it is the place that facilitates circular motion in your arm. This condition can be primarily seen in sports like baseball and volleyball players. Tendinopathy can also be due to arthritis, trauma to the shoulder like a fall on outstretched arms, use of hands overhead repeatedly like people using overhead pressing machines, and normal wear and tear associated with age.

3.What are the symptoms of shoulder tendinopathy?

The following are some of the common signs of tendinopathy.

  • Pain in the front part of the shoulder
  • Pain reaching to the back of the shoulder
  • Pain at night when sleeping on the injured side.
  • Shoulder stiffness and weakness
  • Loss of range of motion
  • Clicking sound while raising the arm
  • Pain while lifting the shoulder above the head
  • Pain while using the arm

4.What are the types of tendinopathy in the shoulder?

There are two types of tendinopathy of the shoulder. They are:

Tendonitis: When there is an overuse and inflammation of the tendons, tendonitis occurs. The pain in this case is immediate and acute. This condition can be easily treated and the damage caused is also not permanent.

Tendinosis: This condition happens when there is degeneration of the tendons and tears begin to appear. This is due to chronic overuse or sudden force leading to an overload of tendons. This injury is more severe than tendonitis. The inflammation begins as tendonitis and slowly develops into tendinosis when untreated.

5.What are the treatment methods for shoulder tendinopathy?

One of the main ways is to stop the root cause leading to tendinopathy. The healing time will be more if the activities causing inflammation are continued. There are both surgical and non-surgical treatments for shoulder tendinopathy.

a. Non-surgical treatment

To begin with, doctors start with non-surgical methods to reduce pain and inflammation.

  • Rest is the first thing advised to reduce pain
  • Apply ice packs for 20 minutes at a time, many times a day to reduce swelling
  • Apply heat to reduce stiffness
  • NSAIDs or non-steroidal anti-inflammatory drugs to reduce pain and swelling
  • Steroidal injections like cortisone to reduce pain
  • Physical therapy that involves stretching exercises to restore range of motion

b.Surgical treatment

The doctor performs arthroscopic surgery if non-surgical methods fail to provide relief. Here, the surgeon inserts a camera called the arthroscope into the shoulder joint and performs the surgery.

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