A rather common disorder of the shoulder joints, shoulder tendonitis or tendinopathy is often seen in athletic individuals due to the sheer amount of repetitive stress placed on the connective tissues and muscles of the rotator cuff and nearby structures.
Fortunately, despite the nature of shoulder tendonitis, rehabilitating it is actually quite simple in most cases - so long as you follow the correct methodologies, cessation of symptoms is all but guaranteed.
To fix shoulder tendonitis, it is important to follow the advice of your physician, perform appropriate rehabilitative exercises that target a full range of motion, and ensure that you give the joint sufficient periods of rest.
Shoulder tendonitis is a chronic overuse injury primarily centered around the connective tissues of the shoulder girdle.
In most cases of non-degenerative shoulder tendonitis, it is due to an individual repeatedly performing overhead or externally rotating movements during their line of work or chosen sport.
The most frequently reported symptoms of shoulder tendonitis are swelling and inflammation (that may not be visible), pain during rotation of the shoulders and a reduced range of motion due to stiffness or pain.
Keep in mind that these symptoms are not solely confined to that of shoulder tendonitis, and self-diagnosing based on experienced symptoms alone can lead to ineffective or potentially dangerous attempts at rehabilitation.
If you believe that you have sustained a case of shoulder tendonitis or a similar condition, seek out the advice of a medical professional that can confirm whether it is in fact shoulder tendonitis or not.
Physical rehabilitation of chronic physiological injuries is done for two reasons; ensuring that the injured area retains its full functional capacity, and speed the patient’s recovery by improving localized blood flow and similar biological processes.
These benefits can be achieved through a structured utilization of both stretching movements and exercises that feature small amounts of applied resistance so as to trigger a greater response within the tissues of the injured area.
For shoulder tendonitis, this will often mean that the patient must perform stretches that utilize the usual biomechanics of the shoulder joint - especially full rotation, overhead extension of the arm and stretches that affect the nearby structures of the shoulder.
Keep in mind that these stretches and exercises are not meant to train the shoulder joint but to instead ensure that full mobility and strength is retained despite the impact of the tendonitis, allowing the patient to return to their regular activities without any loss in physical capability.
Frequently encountered in pre-exercise mobility routines, the crossover shoulder stretch or cross-chest shoulder stretch is meant to act as a static stretch for the lateral adduction biomechanic of the arm and shoulder.
Resistance may be modulated towards the level of pain the patient is experiencing by simply applying pressure with the opposing hand upon the elbow of the arm that is being stretched.
To perform the cross-chest shoulder stretch, the patient will extend the arm of the injured side loosely across the sternum, gripping the elbow of said arm with the opposite hand.
Then, pulling gently with the opposite hand, the patient will draw the elbow across their torso until a stretching sensation is felt along the rear and medial side of the deltoid muscles.
This position must be held for a short length of time before the arm is released, thereby completing the stretch.
The external rotation stretch is the most basic variation of the shoulder external rotation stretch, wherein the patient will perform the movement while standing and without the use of an anchor or any other sort of assistance.
This ensures that as little resistance as possible is placed on the shoulder structure, and that the patient does not accidentally overextend their shoulder in a manner that may interrupt rehabilitation.
To perform the external shoulder rotation stretch, the patient will bend the elbow of the injured side at a 90° angle so as to face the fingertips forward.
Then, taking care to avoid over rotation of the shoulder, the patient will rotate the forearm (and by extension the shoulder) outwards, as if attempting to place the forearm at a horizontal parallel with the torso.
Once reaching the end of the shoulder’s effective range of motion, the patient will hold this point for a count before ending the stretch.
Just as the external rotation stretch is meant to target the biomechanic of shoulder rotation at an outward angle, so too does the internal rotation stretch for the opposite direction.
Much like its external counterpart, the shoulder internal rotation stretch is performed in a standing position without the use of additional equipment or resistance - though it is possible to perform variations that make use of doorways, resistance bands or other rehabilitation tools.
To perform the shoulder internal rotation stretch, the patient will move the hand of the injured arm behind their back, palm facing outwards and head facing forward.
Then, using the opposite hand, the patient will push the injured side’s hand upwards along their back. If performed properly, a stretch should be felt along the anterior and medial side of the deltoid muscle group.
After holding this position for a count, the patient will release their injured arm, ending the stretch.
The chair shoulder flexion stretch is a variation of the standard shoulder flexion exercise that makes use of an anchor (namely, a chair) in order to reinforce the shoulder flexion biomechanic.
It may be performed unilaterally or bilaterally, and is generally considered to be very low impact, hence its frequent inclusion into frozen shoulder rehabilitation plans.
To perform the chair shoulder flexion stretch, the patient will stand approximately an arms-length away from a chair or similarly sturdy object of low elevation.
Placing both palms on the chair’s back, the patient will then bend at the waist, bringing the arms into a parallel plane with the torso - or, at least, as far as the shoulder’s effective range of motion is capable of reaching.
Holding this position for several counts, the patient then returns to a standing position, having completed the stretch.
The sleeper stretch is considered to be an essential part of any effective shoulder rehabilitation plan, as it stretches the entirety of the shoulder structure in an easily controlled and low-impact manner.
Furthermore, it is particularly useful for individuals with concurrent injuries, as it is performed in a lying position and is classified as an isolation stretch.
For the greatest comfort, it is advised that patients perform this stretch with a pillow supporting the neck and shoulders.
To begin performing the sleeper stretch, the patient will lie on their side with the injured shoulder facing the floor.
Extending the arm forward, they will then bend the elbow until the hand is facing directly upwards.
Then, grasping the wrist or forearm with the opposite arm, the patient will bend the arm towards the floor as the elbow remains bent. Once reaching the maximum effective range of motion of the injured shoulder, they will hold this position for several seconds before allowing the arm to be released, thereby completing the stretch.
Before performing any sort of resistance exercise, be sure to consult your physician.
Placing stress and tension on the tissues of the shoulder while they are in a critical state of recovery can potentially set back your rehabilitation, or even permanently alter the physical capabilities of your shoulder in certain cases.
The pendulum exercise is a rehabilitative exercise that makes use of very low levels of resistance to aid in reinforcement of the shoulder joint in its entirety.
It is most often encountered in surgical prehabilitation plans, but is nonetheless still effective as a tool to aid in the recovery of shoulder tendonitis during the early and intermediate stages of a physical rehabilitation program.
To perform the pendulum exercise, the patient will lean over a stable object of approximately waist height and support their torso with their uninjured arm.
Then, allowing the injured arm to hang beneath them, the patient will gently create momentum with their shoulder, causing the arm to move in a pendular motion that slowly grows in radius until sufficient movement has been achieved.
This particular shoulder tendonitis exercise is meant to be performed during the later stages of physical rehabilitation, wherein the shoulder has regained the majority of its stability and is capable of sustaining tension over a short length of time.
As is clued in by the name, the resistance band chest expansion will require a resistance band or similar source of resistance.
To perform the resistance band chest expansion exercise, the patient will attach the band to a stable object behind them, grasping the opposite end in both hands as they position their arms behind their torso.
Once the patient has achieved this position, they will then simply retract the scapula as they push their chest outwards, exercising the rotational capacity of the shoulder joints.
Repeat this exercise as many times as necessary.
A classic exercise frequently employed by bodybuilders to strengthen the deltoid muscles, shoulder flyes can also double as a rehabilitative exercise during the latter stages of physical rehabilitation of shoulder tendonitis.
In order to add resistance to the shoulder fly exercise, the patient may utilize weighted dumbbells, kettlebells, resistance bands or perform the exercise entirely without equipment.
Gripping the weighted implement in the hand of their injured shoulder, the patient will slowly raise their arm (fully extended) to the side, taking care not to raise the hands too high as this may place further stress upon the shoulder joint.
Once reaching near the parallel level of the hand with the shoulder, the patient will slowly lower the weighted implement towards their side, completing the repetition.
The exercise is meant to be performed with the elbows in a state of extension, as bending of the elbows can place excessive resistance on the rotator cuff and negate the rehabilitative effects of the exercise.
A rehabilitative exercise that makes use of the tension derived from a resistance band to aid in recovery from shoulder tendonitis, the resistance band shoulder extension does exactly as it is named - rehabilitating the shoulder extension biomechanic.
This particular exercise is meant to be performed during the latter stages of physical rehabilitation, as performing it before the tissues of the shoulder joint have sufficiently recovered will result in the injury worsening.
To perform a repetition of the resistance band shoulder extension, the patient will wrap the center of the resistance band around a sufficiently anchored item overhead. Ensure that the band is secured so as to prevent it from slipping off the anchor and injuring the patient.
Once the resistance band is prepared, the patient will then grip the ends of in both hands as they step a sufficient distance away.
Maintaining an upright posture, they will then draw both ends of the resistance band behind them, squeezing the deltoid muscles as they do so. If performed correctly, some tension should be felt within the shoulder girdle itself.
Once the maximum range of motion has been reached, the patient will slowly allow the tension of the band to pull their hands back to their original position, thereby completing the repetition.
The biomechanical flexion counterpart of the resistance band shoulder extension, this particular rehabilitative exercise is often performed during the later stages of rehabilitation, or even during certain lower-impact bodybuilding workouts.
Due to the more delicate angle of resistance employed by the shoulder flexion exercise, it is better for the patient to utilize a resistance band of lesser weight than they would for the shoulder extension exercise.
To begin performing a repetition of the resistance band shoulder flexion, the patient will wrap the center of the band beneath their foot, gripping the ends within the fist of their injured side.
Standing straight and ensuring that the band is firmly trapped beneath the foot, the patient will then slowly pull the ends of the band upward, fully extending their arm forwards and ensuring that the shoulder remains at a neutral angle throughout the motion.
Once the hand has reached a parallel plane with the shoulder, the patient will allow the resistance of the band to slowly pull their hand back to its original position beneath their waist. This completes a repetition of the resistance band shoulder flexion exercise.
Unfortunately, due to the nonspecific nature of shoulder tendonitis symptoms, it is often mistaken for a number of other conditions that require vastly different forms of treatment to remedy.
Conditions like early-onset arthritis, shoulder bursitis, sprains, localized internal contusions or any other number of localized tissue conditions may be mistaken for shoulder tendonitis, or vice versa.
The surest method of checking whether your pain is due to shoulder tendonitis is to consult a physician, who will employ physical examination techniques to identify the issue. If insufficient, the physician may also order an MRI scan.
The length of time in which shoulder tendonitis can be considered healed will depend on the severity of the condition.
Minor cases of shoulder tendonitis can recover in as little as one and a half months time, so long as proper recovery methods are employed.
More severe cases of shoulder tendonitis may take a far longer period of up to four months, or even require surgery to fully repair.
The most efficient and sure-fire way of healing shoulder tendonitis is to employ clinically-established recovery methods while simultaneously following the advice of a medical professional.
Making use of over the counter anti-inflammatory medication, giving the body sufficient periods of inactive recovery and the application of ice and heat are just a few methods of speeding the recovery from shoulder tendonitis.
Furthermore, ensure that you are consuming sufficient macronutrients, micronutrients and calories to fuel your body’s recovery.
Despite the frequency with which shoulder tendonitis develops, it is nonetheless a rather complex physiological issue that is easily worsened due to the function of the shoulder joint itself.
Ensure that the joint is given as much rest as possible before attempting any sort of exercise with the shoulder, as permanently reduced range of motion or tendon weakness can occur if recovery is interrupted.
Nonetheless, if done correctly, adherence to proper physical rehabilitation exercises will ensure that your shoulder returns to its full function in a relatively short length of time.
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