Calcific tendinitis in the shoulder
It occurs when one or more of the shoulder tendons are irritated and calcium deposits have formed in the tendons.
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Other synonyms
- Calcific tendinopathy
- Shoulder calcification
- Calcified tendon
- Calcium deposit in the shoulder
What is the difference between tendinitis and tendinopathy?
The two are almost identical. Science has recently discovered that there is not always inflammation present in tendon pain.
"So when there is tendon pain without inflammation, it is called tendinopathy. When there is tendon pain with inflammation of the tendon, then it is called tendinitis."
In both cases, whether it is tendinitis or tendinopathy, the management is similar. Therefore, we will include tendinopathies and tendinitis as being the same injury.
What is calcific tendinitis?
It occurs when one or more of the shoulder tendons are irritated and calcium deposits have formed in the tendons.
What is a tendon?
A tendon is the structure that attaches the muscle to the bone. When a muscle contracts, the force is transmitted to the tendon, and the tendon stiffens to move the bones.
What is calcification?
Calcification of a tendon is a deposit of fluid containing calcium. This deposit is located on the tendon.
Many people mistakenly believe that a calcification or calcium deposit is the equivalent of having a rock or a piece of bone in the tendon. It is true that on an X-ray it looks like a bone since both are made of calcium. The difference is that in calcific tendinitis, the calcification is actually a fluid containing calcium. So it's not hard like a bone. In fact, it's not hard at all.
What are the causes of calcific tendinitis?
The presence of calcium on one or more tendons is generally due to a tendon wear process and occurs over a period of time. Therefore, this injury can develop as a result of:
- Repetitive shoulder movements with the arms in the air
- Overload on the shoulder muscles (after a new sport or moving, for example)
What are the risk factors for developing calcific tendinitis?
Certain factors can increase the chances of developing calcific tendinitis, such as:
- Being between 40 and 60 years old
- Women are more affected than men
- Being diabetic
- Having a job that requires lifting heavy loads
- Being an athlete who plays sports with their arms raised above their shoulders (volleyball, tennis, badminton, baseball, handball, etc.)
What are the symptoms of calcific tendinitis?
The most common symptoms are:
- Specific pain in the shoulder that has appeared gradually (the pain is often in the front or on the side and can radiate down the side of the arm)
- The pain is often worse in the morning upon waking
- Shoulder weakness and pain when lifting loads
- Shoulder pain and stiffness when raising your arms overhead
How is calcific tendinitis diagnosed?
Diagnosis is possible based on a history of symptoms and a clinical examination. An X-ray can show whether there are calcium deposits on the shoulder tendons.
When should I see a physiotherapist for calcific tendinitis?
You should consult a physiotherapist if you have symptoms as described above or if your doctor has already ruled out any other cause that may be responsible for your pain.
You do not need to see a doctor before consulting a physiotherapist. If your condition requires you to see a doctor, your physiotherapist will be able to tell you.
What physiotherapy treatments are available for calcific tendinitis?
Your physiotherapist will perform an assessment to determine why your tendon hurts. To do this, they will evaluate the following elements:
- Your joint mobility
- The gliding of your nerves
- The quality of your movements
- Your strength and stability
Based on the assessment results, your physiotherapist will:
- Mobilize your shoulder to reduce pain and improve your range of motion.
- Give you specific exercises to increase shoulder mobility, reduce pain, and improve control of your movements and muscle strength.
- Teach you how to properly manage your daily activities and hobbies to optimize healing
- Give you advice for your posture and movements.
What can I do at home for calcific tendinitis?
Temporarily stop doing movements that cause too much pain, and then gradually start doing them again.
Here are some other tips to help you:
- If you have pain at night or morning stiffness, make sure your neck is well supported while sleeping with a pillow that fills the hollow of your neck.
- Avoid sleeping with your arm behind your head or under the pillow. Keep your arm along your body or supported with a pillow.
- Avoid sleeping on the painful shoulder.
- If you can't find a comfortable position for the night, use one or two pillows to support your arm.
If you don't see any improvement after 10 days, you should consult a physiotherapist.
Did you know?
- In a good proportion of cases, the calcium deposits will disappear on their own as the body absorbs these deposits.
Sources
De Carli A, Pulcinelli F, Delle Rose G, Pitino D, Ferretti A. Calcific tendinitis of the shoulder. Joints. 2014 Jul;2(3):130.
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