Shoulder tendonitis: signs, symptoms and treatment

Shoulder tendonitisTendinitis is the inflammation of the tendon and the sheath surrounding the tendon. The synovial sheath surrounding the tendon is the site for maximal inflammation. The cause of this disorder is generally unknown but is seen in middle aged to older people as there vascular condition of the tendon itself deteriorates over time. Repeated trauma to the area along with accentuated exercise may also precipitate the condition. Most common sites affected are the rotator cuff, the achilles tendon, patellar tendon as well as the knee, and the elbow.Shoulder tendinitis or rotator cuff tendinits , swimmers shoulder, tennis shoulder or shoulder impigment syndrome is it is also known. The rotator cuff (supraspinatus, infraspinatus, subscapularis teres minor) holds the humeral head in the glenoid fossa of the scapula. Tearing and inflammation of these tendons and muscles usually occur in sports requiring the arm to be moved regularly over ones head for eg in baseball, swimming, cricket, backstroke, butterfly stroke, weightlifting, certain racket sports , and atheletics such as javelin throw and pole vault. Reaching forward causes the humeral head of the anteriorly flexed shoulder to aut the acromion and coracoacrominal ligament, which in turn is rubbed by the tendon of the supraspinatus. Chronic irritation can cause subacromial bursitis, inflammation and erosion of the tendons. Acute excessive force can eventually tear the rotator cuff. If exercise continues bdespie the pain , the lesion eventually progresses to periostitisand then to avulsion of the tendons from there attachment on the humeral tuberosities.Symptoms and signs; initially pain occurs only in sports which require the arm to be held over the head and forcibly brought forward,. Later pain may occur while moving the arm forwards to shake someones and. Usually pain is also elicited while pushing things away, with little or no pain while pulling things or objects in . to palpate the rotator cuff, abduct the arm backward and away from the body in internal rotation with elbow held straight. The patient may complain of tenderness over the tendons,especially when the arm is raised above the shoulder but often not while the arm is held down by the side. Severe pain is caused by the adduction of te arm across the chest. Humeral abduction is weak, usually because of an underuse atrophy of the deltoid. An MRI cannot usually detect the partial tear of a rotator cuff but can demonstrate a complete tear.Treatment; the injured tendons should be rested and the uninjured shoulder muscles strengthened. The patient should avoid pushing movements and instead should perform pulling movements, provided there is no further pain. Surgery may be found to be necessary in certain cases which are particularly severe, if there is a complete tear of the rotator cuff, or if the tendons do not eventually heal within 6 months. Localized NSAID treatment for 7 to 10 days is usually sufficient but sometimes injections and symptomatic treatment maybe required every 2 or 3 weeks for 1 to 2 months.