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Physical Therapy for Shoulder Tendonitis: How it Can Help, Exercises, and More

Your shoulder has been bothering you for some time. You tried to ignore it. You wished the pain away. You’ve even tried to flat out deny it. Unfortunately, there’s no denying shoulder tendonitis.  Now you find yourself asking the question, “Will physical therapy for shoulder tendonitis help?” The answer is a resounding yes. In this short guide, we break it down, starting with the possible causes of shoulder tendonitis, treatment options, and how to avoid re-injury. 

Table of Contents

What Is Shoulder Tendonitis?

Most commonly caused by overuse, shoulder tendonitis, can be felt at the tip of the shoulder and often radiates down the arm when it’s lifted or twisted. The upper arm bone called the humerus, rotator cuff tendons, and bursa all move back and forth in a narrow archway called the coracoacromial arch. When the arm is raised above the head it narrows the archway even further, compressing the bursa and tendons. When used repetitively, the area becomes prone to inflammation and injury.

What Causes Shoulder Tendonitis?

While shoulder tendonitis is most commonly sports-related (where the arm is continually raised above the head, such as in swimming, baseball, and tennis), it can also be caused by other repetitive activities. The four stages of shoulder tendonitis are:

  1. Overuse tendonitis: Caused by repetitive shoulder motions and leading to irritation, bruising, or even fraying of the tendon. 
  2. Calcific tendonitis: If inflammation is left untreated for long periods of time, then calcium deposits will build up within the rotator cuff tendons, leading to pain and a loss of motion and strength.
  3. Impingement tendonitis: As the space between the rotator cuff and coracoacromial arch narrows, the humerus pinches the rotator cuff. This usually occurs when the bursa is inflamed, the cuff is weak, or a bone spur is present.
  4. Rotator cuff tear: When impingement, injuries, or degeneration are left untreated, or in the event of sudden impact, a partial or complete tear of the tendons is possible.

Symptoms of Shoulder Tendonitis

The pain of shoulder tendonitis can creep up over time or start suddenly, depending on the cause. It starts in the shoulder region and often radiates down the upper arm, usually stopping at the elbow. While you may remain symptom-free when your shoulder is not in use, here are some signs that you may be experiencing shoulder tendonitis:

  • Pain when conducting overhead movement
  • Pain at night when rolling over or side sleeping
  • Weakness in the shoulder when lifting or reaching 
  • The pain spreads to surrounding areas like the upper arm or neck

When left untreated, these symptoms will continue and even worsen over time.

Physical Therapy for Shoulder Tendonitis: How Can it Help?

Getting treatment as soon as the symptoms of tendonitis occur is essential. When left untreated, the tendon can degenerate and worsen over time, causing the condition to become more serious.  Physical therapy for shoulder tendonitis can also successfully treat impingement syndrome and tendonosis. Your physical therapist will create a treatment plan specific to both your condition and goals. Whether you’re suffering from

  • Acute injury – like a torn shoulder tendon
  • Chronic injuries – like bursitis or tendonitis
  • Surgery recovery – regaining strength after tendonitis

PRO~PT can help. Physical therapy for shoulder bursitis or tendonitis is our specialty. We’re experts in the treatment and ongoing care of your shoulder ailments.

How Do You Do Physical Therapy for Shoulder Tendonitis?

A physical therapist will conduct an initial evaluation, asking questions about the symptoms and level of pain you are experiencing.  The therapist may also perform the following tests during your evaluation:

  • Range of motion tests
  • Posture evaluations
  • Strength tests
  • Muscle imbalances 

The therapist may also question you about your daily habits, hobbies, and job duties. A physical exam is usually all that’s required to diagnose shoulder tendonitis, but if physical therapy is not resolving the issue, then an MRI may be used to determine if there’s an underlying condition that was previously undetected.

What Does Shoulder Tendonitis Physical Therapy Protocol Look Like?

Physical therapy for shoulder tendonitis may involve the following steps:

  1. Pain management – Ice, moist heat, and massage are commonly applied for pain management, but therapeutic modalities such as TENS (electrical stimulation) or iontophoresis (an electrically charged patch that delivers medication) may also be prescribed.
  2. Patient education – Your PT may suggest changes to your posture, workstation, sleeping positions, and more. They will educate you on how to avoid painful activities and show you movements and exercises that should be avoided.
  3. Manual therapy – Soft-tissue massage, shoulder stretches, and gentle joint movement may be applied to help get your shoulder moving properly again.
  4. Range-of-motion exercises – The therapist will teach you stretches and exercises to improve the mobility and range-of-motion of your shoulder so that you can return to normal activities.
  5. Strengthening exercises – Depending on your condition, your PT will prescribe certain strengthening exercises using weights, bands, and other equipment to challenge the weakened muscles. You will continue the exercises at home.
  6. Functional training – When your condition begins to improve, your therapist will introduce functional exercises that will get you back to your previous level of functioning.

4 Common Physical Therapy Exercises for Shoulder Tendonitis

Your individual treatment plan will include exercises that will challenge and strengthen your shoulder muscles and eventually return your shoulder to its prior mobility and functionality.  It’s important that you only engage in the exercises and activities prescribed to you by your physical therapist.

#1: Doorway Stretch

The doorway stretch is effective for opening up your chest and maintaining shoulder and chest muscles flexibility. 

  1. Stand in an open doorway.
  2. Raise your arms up to each side and bend the elbow at a 90-degree angle, with palms pressed on the door frame.
  3. Carefully step forward with one foot until you feel stretching in your chest and shoulders. This may cause discomfort, but you should stop if you feel pain.
  4. Hold the position for 30 seconds before stepping back. Relax for a few seconds before repeating with the other foot. 
  5. Repeat three times.

#2: Side-Lying External Rotation

Side-lying external rotations can be done with a weight, or your PT might suggest starting with a very light weight or no weight if your injury is severe.

  1. Lie sideways on the opposite side of your injured shoulder.
  2. Bend your elbow at 90 degrees and rest it on your side body. Your forearm should be resting across your abdominal area.
  3. With the dumbbell in hand, palm facing the floor, slowly raise the weight while keeping your elbow pressed to your side. 
  4. Hold the dumbbell in the upward position for a few seconds before slowly lowering it back to the ground.
  5. It’s important to stop the rotation if you feel any pain in your arm.
  6. Repeat the exercise for three sets with 10 repetitions each set. You can increase your reps to 20 when 10 begins to feel easy.

#3: Reverse Fly

Doing reverse flies will help strengthen your rhomboid muscles in the shoulder and upper back area, thus improving balance and protecting you from future injury.

  1. With your feet shoulder-width apart and your knees slightly bent, stand with a straight back and a slight bend at the waist.
  2. Using weights or a band, as directed by your PT, extend your arms behind you as you raise them toward the ceiling. Palms should be facing down, and your elbows should be slightly bent, not locked.
  3. Squeeze between your shoulder blades as you lift the weights toward the ceiling but make sure not to allow your arms to go above shoulder height.
  4. Repeat the exercise three times with 10 repetitions per set.

#4: High to Low Row

The high-to-low row can be done using a resistance band and will help increase your range of motion and strength in your shoulder muscles.

  1. Attach your resistance bank to a sturdy base that is at or slightly above your shoulder height. It must be secure, or it could come loose during the exercise.
  2. Bend down on one knee and raise the opposite arm above while your other arm rests on your raised knee.
  3. Hold the band securely with your raised arm and pull your elbow toward your body while keeping your back straight. Squeeze your shoulder blades as you pull down while keeping your body still and firmly planted.
  4. Repeat the exercise three times with 10 repetitions per set.

How Long Is Physical Therapy for Shoulder Tendonitis?

Every case is different and your physical therapist will devise a treatment plan that is specific to the severity of your condition and your goals. For a mild case or shoulder tendonitis, you can expect therapy to last for approximately six to eight weeks, whereas a more severe case could take up to 12 weeks to treat. Seeking help as soon as you experience symptoms will play a big role in how long physical therapy is required and how quickly you recover from your injury.

Can Physical Therapy for Shoulder Tendonitis Prevent Re-Injury?

Working with a physical therapist for shoulder tendonitis will not only get you back to your regular activities sooner, but it will help strengthen the muscles in your shoulder and help prevent reinjury.  The education you receive from your physical therapist will also make it easier to recognize the return of symptoms sooner and the knowledge of which activities may be contributing to the issue so that they can be avoided. Your therapist will likely recommend an at-home maintenance program for you to follow that will greatly reduce the risk of reinjury by keeping the area strong and properly stretched.

The Licensed Physical Therapists at PRO~PT Are Here for Your Shoulder Tendonitis Physical Therapy Needs

The licensed physical therapists at PRO~PT specialize in the evaluation and types of physical therapy treatments for shoulder tendonitis.  We’ll customize a treatment plan that is specific to both your condition and your goals, and get you back to doing the things you love to do. Our treatments go beyond the examination table. Our PTs specialize in improving your mobility and strengthening your shoulder muscles so that you won’t have to worry about reinjury. Call us today to schedule a physical therapy for shoulder tendonitis evaluation in Fresno.

Categories: Shoulder Problems• May 18, 2021