Physiotherapy for Shoulder Tendinitis: Stretching and Resistance Exercises

What Is Shoulder Tendinitis?

The shoulder contains a group of muscles known as the rotator cuff and biceps tendon that helps to keep the shoulder joint stable. When the tendons of these muscles become irritated and inflamed it leads to a condition called shoulder tendonitis or rotator cuff tendinitis. Shoulder tendinitis most commonly occurs as a result of repetitive movements, overuse, and sports injuries. Shoulder tendinitis is also described as the thickening of the rotator cuff tendons. It affects the everyday activities of a person which requires lifting an object overhead or twisting etc. The symptoms of shoulder tendinitis can range from mild to severe pain and stiffness.

What Are the Contributing Factors to Shoulder Tendinitis?

• Weak Muscles - If the rotator cuff muscles are weak, the action of deltoid muscles exerts more force on the tendons of the shoulder leading to inflammation.

• Overuse - Repeated overhead movement is the common cause of shoulder degeneration.

• Strenuous Training - Heavy workouts, weightlifting, and hard throws may cause the tendons to inflame.

• Improper Technique - Inappropriate throwing or swimming can cause stress on muscles and tendons.

• Loosen Shoulder Joint - Previous shoulder injury may cause permanent damage to the shoulder resulting in tendinitis.

What Are the Symptoms of Shoulder Tendinitis?

The symptoms include:

• Pain on moving or raising the arms.

• Stiffness in the shoulder.

• Tenderness.

• Swelling.

• Clicking sound in the shoulder.

• Reduced mobility and strength of the shoulder.

• Reduced range of motion.

• Continuous pain.

How Is Shoulder Tendonitis Treated Through Physical Therapy?

Physiotherapy for shoulder problems is usually accompanied by nonsurgical and surgical treatments of shoulder issues. Physical therapists usually recommend stretching and strengthening exercises to improve the strength and flexibility of the rotator cuff muscles and their parts. The exercises for shoulder tendinitis include:

Stretching Exercises:

1. Crossover Shoulder Stretch

This stretch exercise helps the arms and shoulder for lateral adduction movements. The instructions are:

• The person should stand straight on the floor with a flat foot by extending the injured arm in front. Then the person should hold the elbow of the injured arm with the opposite hand.

• Then the person should gently pull the injured arm with the other hand until they feel a stretch along the medial side of the deltoid muscles.

• This position should be held for a few seconds and repeated three times.

2. Chair Shoulder Flexion Stretch

This stretch also improves the flexibility and range of motion of the rotator cuff muscles. The instructions are:

• The person should stand in front of the chair by resting their hands on the strong firm chair.

• By placing the palms of the hands on the chair's back the person should bend at the waist by bringing their arms parallel to the torso until they feel a stretch.

• The position should be held for a few seconds and repeated 5 times.

3. Sleeper Stretch

This stretch helps in improving the range of motion of the shoulder muscles. The instructions are:

• The person should lie on the side of the floor with the injured arm facing the floor. The person can use a pillow to support their neck and shoulders.

• Then the person should extend their arm forward and bend the elbow until their hand faces directly upwards.

• Then the person should grasp the wrist of the injured hand with the opposite hand and bend the arm towards the floor. Once the injured arm is bent nicely to feel the stretch the position should be held for a few seconds.

4. Shoulder External Rotation Stretch

This stretch improves the movements of the arms overhead. The instructions are:

• The person should stand straight on the floor with flat feet and the person should bend the elbow of the injured arm at 90 degrees so that the fingertips of the injured arm face forward.

• Then the person should slowly rotate the forearm outwards until they feel the stretch.

• The position should be held for a few seconds and the exercise should be repeated.

5. Shoulder Internal Rotation Stretch

This stretch is also to improve the range of motion of the shoulders. The instructions are:

• The person should stand straight with flat feet and move the injured arm behind their back so that the palm faces outwards.

• Then the person should push the injured hand upward along their back with the opposite hand until they feel the stretch on the anterior and medial side of the deltoid muscles.

• The position should be held for a few seconds and the exercise should be repeated.

Resistance Exercises:

1. Pendulum Exercise

This exercise is recommended for all shoulder problems. The instructions are :

• The person should lean over the table of a height approximately to the person's waist. Then the person should support their torso with the unaffected arm.

• Then the injured arm should swing in the air behind the person's body. The person should gently move their injured arms front and back.

• This exercise should be repeated several times.

2. Chest Expansion Exercise With Resistance Band

This exercise helps to improve the stability of the shoulder muscles. The instructions are:

• The person should attach the resistance band to a stable object at the back and hold the ends of the band with both hands by positioning their arms behind the torso.

• Then the person should retract the resistance band to expand their chest.

• This exercise should be repeated several times.

3. Should Fly Exercise

This exercise helps to strengthen the deltoid muscles. The instructions are:

• The person can hold weighted dumbbells resistance bands or kettlebells or this can be done without any equipment.

• The person should lift the weight object with the injured arm and unaffected arm and raise their hands to reach the parallel level. The hands should not be raised too high as it may cause further stress to the shoulders.

• Then the hands with a weighted object can be brought down and the exercise should be repeated several times.

4. Shoulder Extension With Resistance Band

This exercise helps to improve the range of motion. The instructions are:

• The person should wrap the center of the resistance band around a heavy object.

• Then the person should hold the ends of the band with both hands and be in a sufficient distance from the object.

• By maintaining the upright position the person should draw both ends of the band behind the body to squeeze the deltoid muscles. This squeezing provides some tension in the shoulder girdle then the hands should return to their position.

• This exercise should be repeated several times.

5. Shoulder Flexion With Resistance Band

This exercise also helps in improving the range of motion of the shoulder muscles. The instructions are:

• The person should warp the center of the resistance band beneath the foot and hold the ends of the band with both hands.

• By standing straight the person should pull the ends of the bend upward by fully extending their arms forward. The shoulders should be at a neutral angle.

• The person should pull the ends until they reach parallel to the shoulders. Then the hands should reach their original position.

• The exercise should be repeated several times.

Conclusion

Shoulder injuries or rotator cuff injuries are common in sportspersons as they involve throwing, lifting, and other activities. It is a very common condition as people may have the majority of daily activities with their arms. Reaching out to the physical therapist may be beneficial.