Musculoskeletal disorders of the shoulder (tendonitis)

Ice application – A demonstration

This sheet deals more specifically with the rotator cuff tendinopathy, the musculoskeletal disorder that most commonly affects the joint of theshoulder.

This condition occurs when tendon of the shoulder has been strained too much. Tendons are the fibrous tissue that connects muscles to bones. When you repeat the same movements often or apply force inappropriately, small injuries occur in the tendons. These microtraumas cause pain and furthermore cause a decrease in the elasticity of the tendons. This is because the collagen fibers produced to repair tendons are not of as good quality as the original tendon.

Musculoskeletal disorders of the shoulder (tendonitis): understand everything in 2 min

Swimmers, baseball pitchers, carpenters and plasterers are most at risk because they often have to raise their arms with strong forward pressure. Preventive measures usually prevent it.

Tendonitis, tendinosis or tendinopathy?

In common parlance, the affection referred to here is often called tendonitis of the rotator cuff. However, the suffix “ite” indicates the presence of inflammation. Since it is now known that the majority of tendon injuries are not accompanied by inflammation, the correct word is instead tendinosis ou tendinopathy – the latter term covering all tendon injuries, therefore tendinosis and tendonitis. The term tendonitis should be reserved for the rare cases induced by acute trauma to the shoulder which cause inflammation of the tendon.

Causes

  • A overuse tendon by frequent repetition of incorrectly performed gestures;
  • A variation too fastintensity an effort imposed on a poorly prepared joint (for lack of strength or endurance). Very often, there is an imbalance between the muscles that “pull” theshoulder forward – which are generally strong – and the muscles at the rear – weaker. This imbalance puts the shoulder in an improper position and puts additional stress on the tendons, making them more fragile. The imbalance is often accentuated by poor posture.

We sometimes hear of calcifying tendinitis or calcification in the shoulder. Calcium deposits in tendons are part of natural aging. They are rarely the cause of pain, unless they are particularly large.

A little anatomy

The shoulder joint includes 4 muscles which make up what is called the rotator cuff: the subscapularis, the supraspinatus, the infraspinatus and the teres minor (see diagram). It is most often the supraspinatus tendon which is the cause of tendinopathy of the shoulder.

Le tendon is an extension of the muscle which attaches it to the bone. It is powerful, flexible and not very elastic. It consists largely of fibers of collagen and contains some blood vessels.

See also our article entitled Anatomy of the joints: basics.

Complication possible

Although not a serious condition in itself, one should heal quickly tendinopathy, otherwise you will develop adhesive capsulitis. It is the inflammation of the joint capsule, the fibrous and elastic envelope that surrounds the joint. Adhesive capsulitis occurs mostly when you avoid moving your arm too much. It results in a stiffness accentuated shoulder, which causes loss of range of motion in the arm. This problem is treated, but much more difficult than tendinosis. It also takes a lot longer to heal.

It is important not to wait until you have reached this stage to consult. The sooner the tendon injury is treated, the better the results.

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