Tendonitis / Tendonopathy

What is Tendonitis / Tendonopathy?

Tendonitis refers to inflammation of the tendons in the shoulder. Tendonitis in the shoulder is usually due to "overuse activities" like throwing, tennis, and overhead activities (painting, wallpaper, etc.).

Impingement on the tendons can amplify this effect by pinching the tendons. In these cases, sometimes only an hour of activity can cause severe tendonitis in the shoulder. (See the section on Impingement Syndrome.)

The most common tendons that will get tendonitis in the shoulder could be any of the 4 rotator cuff tendons and the biceps tendon. (See Bicep Tendon Injuries.)

Longstanding tendonitis will chronically decrease blood flow to the tendon (which doesn't have good blood flow to begin with). The tendon will begin to fray and become very brittle making it very easy to tear. This is called Tendonopathy.

What's Going Wrong In Tendonitis?

1. Adhesion. Adhesions will pull a muscle tight, keeping it's tendons under constant tension. The tendon becomes overworked and inflames. If the adhesions are not removed, the tendonitis always seems to come back. Many people will stop activity for weeks or even months to allow the tendonitis to heal. As soon as they go back to the activity, the pain returns. The reason the pain returns is that the adhesions were never taken care of. This ends up causing chronic tendonitis and possibly a tendonopathy. Remember, repetitive / overuse syndromes create adhesions and are the most common cause of tendonitis.
2. Strength and Flexibility Imbalances. A weak rotator cuff will be more prone to tendonitis due to obvious reasons. It cannot handle even small demands when used. The muscles and tendons become overworked and inflame. Imbalances in the Scapula Muscles will also increase the load on the rotator cuff. Remember, the Scapula Muscles provide enormous stability to the shoulder. If they are out of sync, the rotator cuff takes the load of work.
3. Structural Damage or Alteration. Direct damage to a tendon will, again, create adhesion within that tendon when it attempts to heal. Once the adhesions form, the tendon is more likely to become chronic and inflamed resulting in tendonitis.

How Can ART Help Tendonitis?

Remember, the number one cause for tendonitis is some type of overuse activity (like tennis, pitching, weights, etc.). The first treatment is to take care of the inflammation. In this case, ice over the affected area is best.

After a couple days, when the tendon and muscle attempts to heal, it will almost certainly lay down adhesion formation to mend the area. ART can help 'undo' the adhesion that is creating the ongoing pain, allowing the tendon to heal properly.

Once the adhesions are cleared, a proper strengthening program is essential for full recovery. However, if rehab is started before the adhesions have been cleared, the tendonitis can get worse.

Success Stories Of Those With Tendonitis