Shoulder tendonitis is an irritation or inflammation of a tendon within the shoulder joint, causing pain and limited movement. This common issue affects people who perform repetitive overhead motions, such as athletes or those in certain professions. Healing requires a structured process that transitions from immediate pain control to restoring strength and mobility.
Understanding the Condition and Its Causes
Tendonitis most commonly affects the rotator cuff or the long head of the biceps tendon. The rotator cuff is a group of four muscles and tendons that stabilize the shoulder joint. When these tendons become inflamed or thickened, they can be pinched against the top bone of the shoulder, which is sometimes referred to as impingement.
The causes of shoulder tendonitis are usually related to mechanical stress rather than sudden trauma. Repeated overhead movements, such as those performed in sports or construction, place excessive strain on the tendons. Poor posture alters the shoulder’s mechanics and can contribute to the tendons being compressed or overworked. Increasing the intensity or duration of an activity too quickly can also overload the tissue and lead to inflammation.
Immediate Self-Management and Acute Pain Relief
The acute phase of shoulder tendonitis, typically the first 48 to 72 hours, focuses on reducing inflammation and preventing further irritation. This initial period is best addressed by the RICE protocol: Rest, Ice, Compression, and Elevation. Rest means avoiding any activity that causes or worsens the pain, such as sports or overhead work.
Applying ice to the affected area helps to reduce both pain and swelling by constricting blood vessels. An ice pack should be applied for 15 to 20 minutes at a time, several times a day, always with a towel or cloth barrier to prevent frostbite. Compression, often achieved by wrapping the shoulder with an elastic bandage, helps to limit swelling. Elevation is achieved by propping the arm up with pillows, keeping the joint near or above the level of the heart to encourage fluid drainage.
Over-the-counter Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), such as ibuprofen, can temporarily reduce pain and inflammation. Follow dosage instructions strictly, understanding that these medications offer symptom relief but do not cure the underlying condition. Topical creams or gels may also provide localized pain relief for those who prefer non-pill options.
Structured Rehabilitation and Restoring Movement
Once acute pain subsides, the focus shifts from passive rest to active, controlled movement to heal the tendon and prevent recurrence. Prolonged rest causes stiffness and weakness, making a cautious transition to rehabilitation necessary. The goal is to restore the shoulder’s full range of motion and build strength in the stabilizing muscles.
Gentle range-of-motion exercises are introduced early to mobilize the joint without stressing the injured tendon. Pendulum swings are a starting point: the person leans forward, letting the affected arm hang loose, and uses body movement to gently swing the arm in various directions. These passive movements encourage blood flow. As pain allows, gentle stretches, such as the cross-body arm stretch, can be added to improve flexibility.
The next step incorporates gentle strengthening exercises, often using light resistance bands, small weights, or body weight. Exercises focusing on the periscapular muscles (surrounding the shoulder blade) and the rotator cuff promote long-term stability. Examples include scapular squeezes or isometric contractions against a wall. Consistency is important, but any activity causing sharp pain must be immediately stopped, as this signals that the tissue is being overstressed.
To prevent future occurrences, incorporate proper posture and ergonomic adjustments into daily life. Correct posture keeps the shoulder joint in a mechanically sound position, reducing the chance of tendon impingement. For those with prolonged sitting jobs, adjusting the chair and desk setup to keep shoulders relaxed and arms supported minimizes strain on the healed tendons.
When to Seek Professional Medical Intervention
While self-care and structured rehabilitation are effective for many cases, professional medical attention is required if the condition is severe or not improving. Consult a healthcare provider if pain worsens despite a week of diligent self-care, or if the pain consistently disrupts sleep. A doctor’s visit is also necessary if there is an inability to lift the arm or a sudden loss of function, which may signal a tendon tear.
A medical professional assesses the injury starting with a physical exam and testing the shoulder’s range of motion and strength. Imaging tests, such as ultrasound or Magnetic Resonance Imaging (MRI), may be used to confirm the extent of tendon damage or inflammation. Advanced treatment options are available for persistent inflammation that does not respond to physical therapy and oral medication.
One common medical intervention is a corticosteroid injection, often referred to as a cortisone shot, which delivers a powerful anti-inflammatory medication directly to the inflamed area. This injection is a targeted treatment to reduce swelling, providing a window of relief that allows the patient to participate more effectively in physical therapy. While effective for short-term symptom improvement, the injection does not cure the underlying problem, and it must be followed up with an appropriate rehabilitation program to restore strength and function.