Shoulder Tendinitis Or Is It Tendinosis?
By Lisa Thomson, DC
Categories: Pain Management, Shoulder, Shoulder Tendinitis, Shoulder Tendinosis
Shoulder Tendinitis (Or Is It Tendinosis?) – What Is It?
When most people think of tendinitis they often think of an injury that is a result of overuse -this is actually not the case. Shoulder tendinitis is an injury to the shoulder that occurs most commonly when attempting to lift something too quickly, lifting something that is too heavy or falling on an outstretched arm. The sudden stress on the tendon causes microtears which lead to inflammation of that tendon. Damage to a tendon as the result of overuse is called tendinosis. Shoulder tendinosis involves degeneration of the collagen in the tendon due to chronic overuse. For the best possible treatment outcomes it is important to know the difference between the two conditions.1,2,3
What Are The Symptoms?
With both shoulder tendinitis and shoulder tendinosis common symptoms include:
- Pain
- Stiffness/reduced range of motion
- Weakness
- Clicking with movement
Shoulder tendinitis will most likely be felt after an injury to the shoulder i.e. lifting a heavy suitcase. Shoulder tendinosis is usually more gradual in onset i.e. a work related overuse injury due to a repetitive motion.
How Serious Is It?
Shoulder tendinitis for some is a mild injury, for others it can lead to a chronic and very painful condition. The extent of damage to the tissue, timeliness of seeking treatment, proper diagnosis, proper treatment and overall health are all factors that influence how severe of a problem shoulder tendinopathy is.
What Are The Treatment Options?
One of the main reasons it is important to differentiate between tendinitis and tendinosis is because they should be treated differently. Going to see a qualified chiropractor, physical therapist, physiotherapist, etc. for an assessment can help tremendously in pain reduction and recovery time. A few of the treatment options for shoulder tendinopathy include, but aren’t limited to:
- Mechanical loading (exercises)
- NSAIDS
- Rest
- Injections (Corticosteroids)
- Injections (PRP)
- Massage
- IASTM (Instrument Assisted Soft Tissue Mobilization)
- Biomechanical assessment/intervention
How Long Will It Take To Heal?
Factors that influence how long a shoulder tendinopathy will take to heal include things such as age, extent of the injury, overall health, appropriateness of treatment, etc. A proper assessment of the shoulder is very important for the recovery process. Shoulder tendinitis when treated early and properly can be resolved in several days to 6 weeks. Shoulder tendinosis can be much more complicated to treat as there are many different factors involved. When treated early shoulder tendinosis can often be treated in 6-10 weeks, without appropriate intervention and treatment pain may last up to 9 months.2 Although it may seem unrelated, your overall health condition often plays a large role in the healing process. It is important to get adequate sleep, maintain a healthy diet and exercise routine.
What Should I Expect?
When receiving care for a shoulder tendinopathy the doctor or therapist will ask you questions and give you a shoulder exam to determine the best possible treatment. The doctor may perform a movement assessment to identify any possible movement patterns. Once a thorough exam is performed the doctor will be able to determine the best possible treatment strategy. It is important to follow any care instructions given by your doctor as strengthening and stretching exercises are often crucial to the healing process.
References:
- Bass E. Tendinopathy: why the difference between tendinitis and tendinosis matters. Int J Ther Massage Bodywork. 2012;5(1):14–17.
- Karim M. Khan, Jill L. Cook, Jack E. Taunton & Fiona Bonar (2000) Overuse Tendinosis, Not Tendinitis, Part 1. The Physician and Sportsmedicine, 28:5, 38-48, DOI: 10.3810/psm.2000.05.890
- Jill L. Cook, Karim M. Khan, Nicola Maffulli & Craig Purdam (2000) Overuse Tendinosis, Not Tendinitis, Part 2. The Physician and Sportsmedicine, 28:6, 31-46, DOI: 10.1080/00913847.2000.11439512
- Galloway, Marc T et al. “The role of mechanical loading in tendon development, maintenance, injury, and repair.” The Journal of bone and joint surgery. American volume vol. 95,17 (2013): 1620-8. doi:10.2106/JBJS.L.01004
