Diagram of an inflamed shoulder tendon      Examination showing area of tenderness with tendonitis

Shoulder Tendonitis

Shoulder tendonitis is an inflammatory condition in which the tendons around the shoulder joint become irritated and inflamed. There are two main categories, each with a separate management: rotator cuff tendonitis and biceps tendonitis. The rotator cuff is a group of 4 tendons which surround the ball of the shoulder joint and assist with movements. Repetitive activity can cause irritation of one or more of these tendons causing pain the shoulder and upper arm. .  Most patients describe a sharp pain in the upper/outer arm when lifting their arm overhead or trying to put on a jacket.  Strength and motion are preserved, but painful.  Initial treatment includes activity modification, anti-inflammatory medication and corticosteroid injection.  If the condition persists I add physical therapy.  In refractory cases, I proceed with an MRI to make sure the tendons are not torn and occasionally surgery is required to remove the inflamed bursa and clean out the tendon inflammation. This is done as an outpatient procedure with minimally invasive arthroscopic techniques.

Biceps tendonitis is a condition in which the area surrounding the upper portion of the biceps tendon becomes irritated.  Many cases develop suddenly after increasing activity; others develop slowly over time as a result of degenerative changes around the shoulder.  Most patients describe a sharp pain in the upper/front part of the arm when lifting their arm out straight in front of them or with bending the elbow against resistance.  Motion is preserved, but painful.  Initial treatment includes activity modification, anti-inflammatory medication and corticosteroid injection.  If the condition persists I add physical therapy.  In refractory cases, I proceed with an MRI and occasionally surgery is required to repair the tendon using a procedure called biceps tenodesis. This is done as an outpatient procedure with minimally invasive arthroscopic techniques.