Rotator Cuff Tendinopathy For Shoulder Pain

Tendon is a fibrous band that attaches muscle to bone. It has an ability to withstand tension and work in collaboration with muscles to exert pulling forces. Whereas, Tendinopathy is a general term used to describe tendon related injuries that includes repetitive use, degeneration and micro tears in a tendon. The most common affected sites include shoulders, elbows, wrists, knees and heels. 

CAUSES

Any activity that results in overloading and increase in tension may lead to damage in a tendon.

Causes may include:

• Repetitive movement-One of the most common cause
• Sport related injuries such as basket ball, golf, baseball, skiing and sprinting etc.
• Poor body mechanics such as pronated feet, slouched posture
• Awkward position/postures causing muscular imbalance
• Aging causes tendon to become less flexible and make them vulnerable to injury
• Sudden forceful activity
• Poor conditioning before and after exercise
• Insufficient and inappropriate exercise training-too much too soon
• Structural deformity such as leg length discrepancy
• Environmental conditions/factors such as vibrations
• Disease related stresses for example; Rheumatoid/Psoriatic arthritis, gout etc.

SYMPTOMS

Symptoms of tendinopathy may last up to few weeks or months depend on severity of injury.

Some common symptoms of Tendinopathy are:

• Inflammation in and around muscle and tendon
• Pain at site of inflammation that may last up to few weeks.
• Pain with activity
• Lack of motion
• Muscle spasm
• Trouble sleeping 

DIAGNOSIS of TENDINOPATHY

Any tendinopathy can be identified through physical exam done by a physiotherapist. However your doctor may prescribe you ultrasound/MRI to rule out other problems like tears, dislocations or bursitis but these imaging techniques are unnecessary at initial stages.

TREATMENT OPTIONS FOR ROTATOR CUFF TENDINOPATHY

There are different phases of treatment for tendinopathy In the acute phase when injury is new, apply ice/cold packs as needed and avoid any painful activity and rest the area. If the pain persists for a week and got worse or no change than seek doctor’s advice. In the beginning doctor may prescribe anti-inflammatory and pain medicines with further recommendation of ice and rest. But if the pain does not improve than corticosteroid injections may be given that will provide quick relief from symptoms but in long term may cause further damage to the tissues. If this is also not sufficient then you may be referred to a physiotherapy treatment. Surgery is also an option but only done for the severe conditions that does not respond to any treatment. However, the sooner you start physiotherapy treatment, the faster it recovers. By identifying and modifying aggravating and causative factors, OUR qualified physiotherapist working at Curezone Physiotherapy Mississauga near Heartland Town Center can effectively treat the condition with not only focusing on symptomatic relief but also tries to improve quality of life.

PRIMARY GOALS BY OUR REGISTERED PHYSIOTHERAPIST @ MISSISSAUGA LOCATION

• To relief pain/swelling
• Maintain strength and improve mobility
• Patient education regarding adaptations in life style activities in order to reduce risk of further complications such as capsulitis or a tendon tear that may arise secondary to lack of proper body mechanics or unnecessary overloading of tendon.
• Safe return to daily routine activities and job activities

WHAT IS DONE DURING PHYSIOTHERAPY EXAMINATION?

Physical examination starts right after the patient enters the examination room. A physiotherapist inspects signs of inflammation (redness, swelling, heat), posture, walking pattern, soft tissue appearance-atrophy which is mostly present in chronic conditions, Range of motion and strength testing. Examination may also include neurological assessment to exclude any nerve pathology. Furthermore, some special tests are also performed to load the tendon in order to reproduce the pain. 

WHAT PHYSIOTHERAPY TREATMENT METHODS WILL BE APPLIED? 

Physiotherapy treatment may consist of combination of any of the following methods;

• Heat therapy/Cold therapy
• Electrical stimulation
• Therapeutic Ultrasound for thermal and non thermal effects as needed
• Laser therapy
• Joint mobilizations/ soft tissue releases
• Deep tendon friction massage to release adhesions
• ROM exercises/ Flexibility and strengthening exercises/ Progressive resisted exercises/ Progressive functional exercise program
• Taping to hold tissue in place and prevent from re-injury
• Unloading brace for joint and tendon support to relief undue stresses
• Education regarding proper postural techniques, activity modification, self management techniques, retraining of body mechanics, ergonomic changes and preventative measures.
• Preventive measures may include proper warm up sessions during any exercise program, suitable environmental changes, proper footwear or use of protective equipment when required, pacing out strenuous activities to avoid overstressing your muscles and tendons etc.

RECOVERY TIME

Recovery may take from weeks to months depending on severity of injury and task of your daily living and your job nature. But with an expert advice and proper care from your physiotherapist it would be much easier for you to handle your daily tasks with less effort and proper techniques to reduce unnecessary stresses on your tendon. One should not forget that symptoms may recur with both operative and non operative treatment. However, self management techniques learned from a qualified physiotherapist may help you to control your symptoms effectively and delay the surgical procedures. If you or any of your loved ones is suffering from shoulder pain due to any of these symptoms Call us or email us to book an appointment at 905 997 4333. If you are not sure whether you need Physiotherapy or some other services you can call and have a 10 mins over the phone consultation with our physiotherapist.