Shoulder Tendinitis

1. Repetitive Strain: Tendinitis is also known as a repetitive strain injury meaning that activity in sport or your occupation can cause symptoms. Over time the repetitive activity or poor technique can cause micro tears, which in turn causes an inflammatory response. This chronic cycle of micro tearing coupled with the inflammatory process causes the pain associated with tendinitis. Certain occupations that include repetitive activity like plumbing, construction or even office jobs are at a higher risk of causing tendinitis. Most sports like golf, swimming, tennis, or running all have a repetitive component that can put stress on the tendons leading to pain and inflammation.
2. Biomechanical Deficit: If an individual has a poor technique or a biomechanical deficit, they are more likely to develop tendinitis. For example, a weightlifter who uses their forearms more than their biceps when doing a bicep curl will put pressure on the elbow tendons. A runner who has a fallen arch (flat foot) when running will put more pressure on the Achilles or patella tendon. These types of issues are correctable if that person gets the right information from their therapist.
3. Poor Posture: you might not think that sitting for eight hours a day working on a computer can cause tendinitis, but you are wrong! The poor postural alignment will put pressure on your neck, spine, and shoulders. Over time the tendons in the shoulder, known as the rotator cuff, will break down causing micro tears and inflammation. This type of tendinitis is common and generally leads to pain in the shoulder which may or may not radiate down the arm to the elbow. For this type of postural strain it is common to have neck symptoms as well as shoulder pain.

There are certain techniques you can use to decrease your chances of developing tendinitis.

• Listen to your body: avoid activities that place excessive stress on your tendons. If you exercise and feel pain then you need to evaluate your technique, or the weight you are lifting and make sure you are not stressing your tendons. An increase in pain means you should stop doing whatever it is you are doing that causes the pain.
• Mix it up: persistent pain means you should try something else. Generally, low impact loading exercise can be helpful to decrease the load on the tendons. For example, cycling versus running or swimming versus tennis.
• Identify and improve your technique flaws: as we have already discussed, poor technique can cause stress on the tendons leading to micro tears and inflammation. If you have a coach perhaps ask for some guidance on your technique or seek advice from a professional in the field.
• Stretching: a dynamic stretch and warm up before your event and a static prolonged stretch after your exercise will help keep the muscles and tendons healthy. If you are sitting at a desk all day stand up every 30-45mins and stretch.
• Ergonomics: If you work at a desk for a living perhaps ask your employer for an ergonomic evaluation at your workstation. This should help with improving your posture and keep the joints in alignment. Remember, a proper alignment will mean less stress on the tendons.
• Pre-habilitation: You can focus a stretching and strengthening program on the major muscle groups that will keep them strong and flexible, thereby decreasing the likelihood tendinitis will develop.

Our physiotherapists at Physiotherapy@Woodbridge haves all the knowledge and skills to diagnose and treat tendinitis. Approximately 90% of people diagnosed with this condition respond positively to conservative treatment. The treatments may differ depending on the anatomical area and type of the tendinitis.

• Low Intensity Laser Therapy (LILT): is thought to accelerate tissue repair, act as an anti-inflammatory agent, and decrease your pain levels. It is very effective at treating tendinitis, you can read more here
• Shockwave Therapy: this treatment for physiotherapy is non-invasive in which it stimulates the immune system through acoustic waves (sound waves). It and has been recognized as a very successful therapy  in the treatment of many different chronic painful conditions. Read more on shockwave here
• Dry Needling: Acupuncture needles are used to directly penetrate muscle trigger points. Dry needling is an incredibly effective way of releasing the trigger points, thereby restoring function and relieving pain and tension within the muscles. You can read more on dry needling here
• Manual Therapy: this physiotherapy modality will help by mobilizing the joints and tissues which will take the stress off the tendons.
• Exercise Therapy: individualized targeted stretching and strengthening will help to decrease pain, and restore normal joint movement.
• Medical Intervention: If you have tried conservative treatment and it has not worked there are medical interventions that  may be applicable, such as anti-inflammatory medication, steroid injections or surgical repair of the tendon