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

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Shoulder Tendinopathy
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