The tendons work with the muscles to keep the shoulder joint fully supported and able to perform a wide range of movement. Tendonitis occurs when there is irritation, inflammation or damage to the tendons.

Calcific tendonitis

This condition refers to a build-up of calcium in the rotator cuff, the group of muscles, tendons and ligaments that support the shoulder. Calcium deposits in the tendon lead to a chemical irritation and build up of pressure that results in extreme pain in the shoulder. The function of the rotator cuff is affected meaning mobility is reduced.

The exact cause is not known and it can resolve by itself, but many patients seek treatment as the pain can be debilitating.

During your consultation with your London Shoulder Specialist consultant, they will assess your pain levels and lack of mobility. Diagnosis will be supported by X-rays and ultrasound scans that will show the extent of the calcium deposits.

Treatment can initially be non-surgical and encompasses anti-inflammatory medications, physiotherapy and steroid injections. Another option is ultrasound-guided barbotage where the calcium is extracted with a syringe. If these do not provide adequate relief, you may require surgical excision of the calcium deposits.

Tendonitis of the long head of the biceps

The tendon that connects the biceps muscle to the shoulder bones can be worn down by overuse and this is particularly common in athletes that perform repeated overhead movements. Typically, patients will feel pain and tenderness at the front of the shoulder that worsens when raising the arm above the head.

Your London Shoulder Specialists surgeon will perform tests to assess the range of movement of the shoulder and the strength and function of the biceps. They will then typically request investigative tests such as X-rays, ultrasounds or MRI scans to support their diagnosis.

Non-surgical treatments include resting the shoulder and refraining from making movements that put the shoulder and biceps under pressure. Anti-inflammatories and steroid injections may be prescribed and you should follow a physiotherapy programme to regain full mobility. However, if pain and lack of mobility continue then you may require an arthroscopic surgical procedure to repair or remove the tendon. In extreme cases, the tendon may be released entirely. Surgery usually results in a full return to normal activities and sports.

Rotator Cuff Tendonitis

Also known as shoulder impingement, this is a common cause of pain in the shoulder. It is caused by the tendons in the rotator cuff becoming damaged, but can also be the result of a spatial restriction that forces the end of the shoulder blade to rub against the tendon when certain actions are performed. There is also a small fluid-filled sac called the bursa in the shoulder which lubricates the rotator cuff and this can burst, causing irritation.

Patients are often younger athletes in sports such as tennis and swimming that involve repeated overhead actions. Initially, there may just be pain when performing these actions but, if untreated, the shoulder can start to hurt all the time and there can be loss of strength and restriction of movement.

During your consultation at the London Shoulder Specialists, other conditions will be ruled out and typically you will have an X-ray, MRI or ultrasound to assess the exact nature of the damage to the rotator cuff. If non-surgical management, including anti-inflammatories and physiotherapy, does not reduce the symptoms then surgery to increase the space in the shoulder joint may be advised.

For diagnosis, advice and treatment of shoulder tendonitis, please get in touch with the London Shoulder Specialists to arrange a consultation.