How To Get Rid of Tendonitis in the Shoulder

Vessel Crew on May 31, 2023

How To Get Rid of Tendonitis in the Shoulder

What is Shoulder Tendonitis?

Shoulder tendonitis, also known as rotator cuff tendonitis, is an overuse injury causing inflammation and irritation of the shoulder tendons and muscles. Impingement syndrome often causes it, where the top bone of your shoulder (the acromion) and part of your shoulder blade (scapula) pinch (impinge) the rotator cuff tendons, resulting in a limited range of motion.

Repetitive overhead movements during activities such as swimming, volleyball, baseball, or tennis increase your chances of developing shoulder tendonitis. Thus, it is also referred to as swimmer’s shoulder, pitcher’s shoulder, and tennis shoulder. Likewise, if you are a painter, carpenter, or have a job that requires a lot of overhead movement, you are more likely to develop this painful condition.

Shoulder tendonitis symptoms include pain when you raise or lower your arm, pain and swelling in the front of your shoulder or side of your arm, and a clicking sound when raising your arm. Other common symptoms include loss of mobility and pain when trying to reach behind your back or sleeping at night. Shoulder tendonitis symptoms may get worse over time if not treated. Additionally, if tendonitis is not treated, it can result in a degeneration of the tendon that becomes tendinosis. You can learn more about what happens if tendonitis goes untreated in our article here. It is essential to know how to heal your shoulder tendonitis early so it does not turn into a more severe injury.

Shoulder Tendonitis Treatments

Shoulder tendonitis is very common, and there are well-established guidelines for getting rid of tendonitis in the shoulder. Treatments range from self-care remedies to physical therapy and injections. If these conservative treatments do not provide relief, surgery and High-energy Shockwave therapy are additional options.

1. Self-Care

If you have shoulder tendonitis, it is critical to start self-care immediately. These treatments help prevent further damage and allow your body to initiate healing. First and foremost, rest the affected shoulder.

Overuse of the arm and shoulder caused the tendonitis in the first place, so taking a break from the repetitive movement that caused the injury will give it time to heal. To reduce inflammation, apply ice three to four times daily for the first 48 to 72-hours and take a nonsteroidal anti-inflammatory drug (NSAID) like Advil or Aleve or a natural anti-inflammatory like curcumin.

Other important things you can do throughout your day are using good posture and avoiding carrying heavy objects with the affected arm and shoulder. Avoiding heavy items includes moving a book bag or purse from your affected shoulder to the other so that the shoulder gets maximum rest. If you must carry something heavy, hold it close to your body and not to your side. Lightly stretching the shoulder throughout the day is also helpful in reducing stiffness but not to the point that it causes pain. At night, try not to sleep on the painful side.

2. Physical therapy

Physical therapy is an excellent next treatment option. In addition to the self-care remedies listed above, physical therapy will include stretching and passive range of motion exercises to restore mobility and reduce pain. Once the pain is under control, the therapist will often add arm and shoulder strengthening movements.

3. Steroid injection

Your doctor may recommend a steroid injection after these other treatments have failed or initially if the pain is severe. Usually known as a cortisone shot, steroid injections provide short-term pain relief but are not a long-term solution.

Cortisone is a powerful anti-inflammatory that significantly reduces or eliminates pain. The doctor may utilize it to decrease the pain, so you can work with a therapist on stretching and strengthening your injury. It is important to note that cortisone shots do not cause or speed healing. In fact, frequent use of steroids can cause tissue damage or tendon rupture, so their use is limited.

4. Surgery

Usually, conservative treatments are sufficient at fixing shoulder tendonitis. But, if you do not heal after several months, you may have a severe case that requires surgery. The surgery is an outpatient procedure where the surgeon debrides the damaged tendon(s). You go under general anesthesia for the surgery, and the surgeon makes an incision, and they scrape away (debride) the scar tissue on the tendon. Then, your arm is in an immobilizer for several weeks.

5. Alternative to Surgery

If you would like to avoid the risks and downtime of surgery, High-energy Extracorporeal Shockwave Therapy (HeSWT) is an effective treatment for your shoulder tendonitis. HeSWT is an FDA approved, non-invasive alternative to surgery for numerous chronic overuse injuries, including shoulder tendonitis. It uses powerful, focused acoustic waves to break apart the scar tissue, trigger the development of new blood vessels, and stimulate your body’s healing response. Only a single session of OrthoWave® is needed, and there is no downtime after your treatment, unlike surgery.

Conclusion

Healing shoulder tendonitis is relatively easy if caught early and properly treated. Unfortunately, it is difficult for most of us to stop doing what caused the injury, and the condition can worsen. The treatment options for how to get rid of tendonitis in the shoulder range from self-care to physical therapy and steroid injections. Conservative treatments work in most cases, but occasionally shoulder tendonitis may require surgery or High-energy Shockwave Therapy, a non-invasive alternative to surgery. The good news is that self-care and medical treatments often work, but if they do not, you have a non-invasive option to surgery that will get you back to doing what you love pain-free.

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Tendonitis vs Tendinosis

I will not bore you with a bunch of medical terms, but It is probably best to start with the meaning of “itis” and “osis.” “Itis” indicates an inflammatory process while “osis” indicates a degenerative process. Tendonitis is an inflamed tendon, while tendinosis is a degenerated tendon. I do not have to tell you which one is worse.

When you overload a tendon with repetitive motions or too much tension, tears form, and you feel pain. Tears range from micro-tears that you may barely notice to complete ruptures that you will definitely notice. Let us focus on the micro-tears. With micro-tears, you will likely have some pain, but it is often one of those “sore in the morning” types of injuries. Your body initiates an inflammatory response when the micro-tear occurs.

Tendinosis Treatment

The good news is that tendinosis usually responds to non-surgical treatments such as physical therapy, bracing, and rest. Recovery can take four to six months, but severe cases sometimes require surgery to debride the tendon or High-energy Extracorporeal Shockwave Therapy.

A tendon debridement is when an orthopedic surgeon exposes the tendon and literally scrapes away the scar tissue. I often get asked what it looks like. Well, it kind of looks like snot. After the short surgery, your joint is typically immobilized for six to eight weeks to allow your tendon to heal properly. The total recovery time is four to six months. The results are generally good, but some patients are unable to return to sports activities.

Non-invasive Alternative to Surgery

High-energy Extracorporeal Shockwave Therapy is a non-invasive alternative to debridement surgery and the treatment we specialize. The treatment uses powerful acoustic shockwaves that are focused on the damaged portion of the tendon. The shockwave’s energy breaks apart scar tissue, causes new blood vessels to form, and stimulates the body’s healing processes to repair the damaged tendon.

You can return to routine activities right after your treatment but will have to avoid high-impact activities for about 30 days as the tendon heals. I am a surgeon, and most people think surgeons want to operate on everyone; but even we like having a non-invasive option that is extremely safe and highly effective.

Conclusion

So now you know tendonitis is an inflamed tendon and tendinosis is a degenerated tendon, and what happens when tendonitis goes untreated. I hope you also learned the importance of rest and proper treatment after even a minor injury. Early intervention helps keep your acute tendon injury from turning into a tendonitis and your tendonitis into tendinosis.

Tendinosis requires months to recover and sometimes surgery or High-energy Extracorporeal Shockwave Therapy. Both conditions are preventable. It is best to see your healthcare provider sooner rather than later to save yourself from months or years of pain and frustration if they do occur. Playing through the pain may not seem like a big deal now, but years from now, it may land you in an office like mine.