Our shoulders are a complex joint and can cause lots of problems. This blog will detail a common issue known as tendinopathies and subsequent treatment for them.
A quick bit of anatomy-
The shoulder complex is made up of 3 bones
- The humerus (top bone in your arm)
- The scapular (shoulder blade)
- The clavicle (collar bone).
There are many muscles attaching to the bones of the shoulder. You may have heard of the 4 muscles that make up the rotator cuff. These are a set of muscles used to stabilise the joint.
Attaching your muscle to bone are tendons. So, tendinopathies (you may have heard them referred to as tendinitis) is an irritation of the tendon brought on by trauma but more often repetitive movements. Famous ones you may have heard of are tennis (tennis elbow), golf (golfers elbow), obviously these aren’t in the shoulder however, it’s useful to help to understand that tendinopathies can happen anywhere there is a tendon, not just in the shoulder.
Causes of tendinopathies in your shoulders
- Repetitive overhead reaching/throwing,
- Tennis or other racquet sports,
- Gym exercises.
Firstly we advise you to consult a professional so that they can diagnose exactly what is going on with your shoulder. This would enable them to give you the correct exercises for your tendinopathy. In the initial stages (1-3 days) you may be advised to rest your shoulder. After that the key is optimal load. Then your clinician will give you exercises that will put the correct load through the tendon to help correct the problem.
We at Back 2 Balance can help you to understand why this problem has occurred. It may be that there are joints elsewhere that aren’t moving as well as they can, causing more load to go through the tendons. You may have sub-optimal nerve and blood supply to the tendons as they travel from the spine to the shoulder and arm. Therefore, getting adjusted alongside your exercises can speed up the healing process even more! Have a look at this previous blog post on how we can help with sporting injuries if you think that causes your tendinopathy.
We may begin your rehab programme with some isometric exercises if your shoulder is very painful to help calm everything down. Before progressing onto some eccentric exercises to help calm everything down
(isometric= contracting the muscle whilst it is being lengthened) (eccentric loading= loading the muscle whilst it is being lengthened).
Consistency is KEY with tendinopathies as research says they can take up to 12 weeks of doing the exercises DAILY to fully resolve.
An example of an isometric loading exercise for the supraspinatus muscle. Stand sideways against a wall with your arm by your side. The tip of your shoulder and the back of your hand is touching the wall. You are then going to press your arm into the wall and hold for 10 seconds. Repeat 3 times. Basically, you are going to try to do the movement that proved painful in your shoulder, but the wall will be stopping you from actually doing it.
An example of eccentric abduction exercise for the supraspinatus muscle. Get hold of a very small weight- (you can use a water bottle or anything with a bit of weight if you don’t have access to a weight), and raise your arm to the side to 90 degrees- like a shoulder raise. Focus on the movement coming down returning to neutral as this is where the eccentric loading takes place. 8-10 reps 3 sets daily.
If the weights are WAY too easy – use a heavier one. However the goal here isn’t to build muscle so don’t feel that you have to use heavy weights. Another tip is to always listen to your body. Your Back 2 Balance clinician will advise you on the amounts of reps and sets of the exercise you will do. Note that feeling a bit of pain up even to a 4/10 is fine and you won’t be causing more damage. However, if you feel that it is aggravating your shoulder tendinopathy too much, then stop. Consult with your clinician or just drop the repetitions or weight down and then build from there.
Stretching can be a great way to keep your tendinopathy at bay. Head over to our YouTube channel to watch a video on how to stretch your rotator cuff.
If you have any questions, or are suffering with shoulder pain, please comment below or contact us on 01273 206868.