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Just the other day, I had a patient come in to see for shoulder pain. Their pain had been around for a long time, but has recently gotten worse. It got to the point where they could no longer swim as many laps as they wanted too and even had pain when picking up their grandkids. On top of that, they had recently been told they had rotator cuff tendonitis and needed to rest. This patient was upset, not just because of their pain but also because they had no idea what to do. All they knew is that they wanted to get back in the pool and be able to lift their grandkids.
This scenario is incredibly common, especially for those who have had shoulder pain before. The word tendonitis can be pretty intimidating, especially when you are dealing with the shoulder. But if you understand what tendonitis is and what is really going on in your shoulder, then it does not seem as bad.
If you have shoulder tendonitis, it is most likely one of your rotator cuff muscles that is the “tissue with the issue.” If you google tendonitis, the definition that shows up is “inflammation or irritation of a tendon.” However, whenever someone has had their shoulder pain for more than a couple of weeks, most of the inflammation should be resolved. In fact, it has been found that most people diagnosed with rotator cuff tendonitis, have little to no inflammation. Instead of tendonitis, the correct term is tendinopathy for many people.
Tendinopathy is a general term that includes any painful condition in or around a tendon that has little to no inflammation. While tendonitis and tendinopathy are used interchangeably, tendinopathy is much more common.
This has been a hot topic in the scientific community over the last couple years. A proposed theory is that the tendon has an increase in blood vessels and sensory nerves in the tendon. An increase in blood vessels and sensory nerves, increases the sensitivity of the tendon, which makes things that were painless before, suddenly feel painful. The good news is that strengthening the tendons will actually decrease your tendon sensitivity, allowing you to get out of pain and get back to what you love.
Sometimes you may be diagnosed with rotator cuff tendonitis, but it may not actually be what is causing your pain. Sometimes your other tissues, like ligaments, bursa, or your joint capsule could be the source of your pain. Here are some of the common symptoms associated with rotator tendonitis
The first step is to calm the irritation in the tendons down. Some of the methods we use at Lifestrength PT to do this are manual therapy, passive range of motion, and gentle exercises targeting the rotator cuff and scapular muscles.
The second step is to begin strengthening the rotator cuff and any other muscles that are weak. At Lifestrength, we select specific and targeted exercises that address your specific impairments. This is absolutely critical, as everyone’s rotator cuff tendonitis is a little different. Giving everyone the same exercises would NOT be effective.
The third, and last, step is to integrate the specific strengthening exercises into more functional exercises. Examples of these functional exercises could be shoulder press, TRX rows, or push ups.
Does this make sense, but you are not sure where to begin? Give us a call!
