- Adam R Whatley Osteopath
Tendonitis of the shoulder often occurs within the rotator cuff tendons, which are a group of 4 important muscles that connect the arm bone to the shoulder ball at the ball and socket. The rotator cuff allows for dynamic mobility at the shoulder, allowing for high amounts of mobility, whilst at the same time allowing for stability of the joint. The tendons run under part of the shoulder blade, at the top of the shoulder, and this where they are very vulnerable to being pinched and inflamed. Over time repeated pinching or overuse can lead tendonitis, which is thickening of the tendon causing further pain and more pinching (often referred to as sub-acromial shoulder impingement or bursitis). If left untreated, shoulder tendonitis can go on to cause rotator cuff tears.
Traumatic injury, like a fall for example.
Overuse or repetitive activity.
Age related degenerative changes due to poor blood supply to an area of the cuff.
Impingement (either from bursitis or bone spurs).
Pain when raising arm over head or behind your back
Pain when lifting and lowering your arm or with specific movements.
Weakness when lifting or rotating your arm.
Aching sensation into the arm
Painkillers and anti-inflammatory medications only provide short term relief.
Osteopathic Treatment and physical rehabilitation aims to keep your shoulder mobile and strong, with further aims to reduce pain and weakness.
If conservative treatment fails then you may be offered a Cortisone steroid injection into the area to help reduce inflammation and control the pain. However, it should be noted that these in most cases only offer short term relief and I’m not a solution long-term. Furthermore, It is advisable to avoid repeated steroid injections in the presence of a tendon tear, as this has been shown to further damage the tendon.
Platelet rich plasma (PRP) Treatment - a natural non-surgical treatment aiming to restore function and reduce pain.
Surgery is required may be required if the tear follows a bad tearing injury. Or, when pain and weakness has not responded to conservative management and rehabilitation. It is important to note that surgery requires a long period of rehabilitation following.
- REGENERATIVE MEDICINE. PLATELET RICH PLASMA (PRP) TREATMENT:
Platelet-rich plasma (PRP) is a very popular ortho-biologic treatment use in regenerative medicine. Ortho-biologics are substances that occur naturally in the human body. When extracted, concentrated and injected back into the body, these substances activate the body’s own healing mechanisms. PRP treatment is performed by taking a small sample of the patient’s blood, extracting the platelets are then further contacting them before they are used to speed up healing and recovery.
PRP injections are very commonly used to facilitate the body’s self-healing mechanisms, and the clinical outcomes are very good. Furthermore, it is completely natural and associated with minimal downtime.
PRP has been shown in scientific research to be highly effective for treating shoulder pain and tendonitis, without the risks and expense of surgery.
Most patients here at Dynamic Osteopaths & Regenerative Medicine report minimal discomfort associated with the injection. Also, go on to report significant improvement that occurs in the subsequent weeks. A recent study compared PRP treatment to corticosteroid injections for a rotator cuff tear. Results showed that, at 3 months following treatment, the PRP patients had a significant reduction in pain and improvement in mobility than patients treated with corticosteroid injections. Furthermore, less that 5% of the PRP patients in this study progressed to surgery for their rotator cuff after one year, compared to almost half of the corticosteroid group.
The Efficacy of Platelet-Rich Plasma on Tendon and Ligament Healing
Ultrasound guided platelet rich plasma injection for partial rotator cuff treatment is an effective procedure that leads to significant decrease in pain, improvement in shoulder functions, much cost-effective and less problematic compared to a surgical treatment
PLEASE FOLLOW THIS LINK HERE FOR FURTHER SPECIFIC INFORMATION ON PRP TREATMENT
Exercises for shoulder tendonitis
It is important that the stabilising muscles are working to their best ability during rehabilitation of the shoulder. The shoulder joint relies heavily on dynamic synergistic control while moving and if this is out, there shoulder biomechanics will be affected and the rotator cuff is susceptible to damage So, it is important to do some corrective stabilisation and strengthening exercises under the guidance of your osteopath, such as:
Rear scapular (shoulder blade) control
Rotator cuff strengthening
Further specific exercises (below) can be adopted when tolerated
Therapy ball can be used to strengthen the core muscles
Rear shoulder strengthening (when tolerated)
PLEASE FOLLOW LINK HERE FOR SPECIFIC SHOULDER REHABILITATION FOLLOWING SHOULDER TENDONITIS