Shoulder tendonitis is not an uncommon injury for the throwing/overhead athlete. If you are a baseball, softball or tennis player you may have encountered this form of injury.

Just to give you a quick background on this condition, we must first step back and examine what is tendonitis. The mechanism of injury for this condition is chronic overuse. Chronic overuse without proper rest can lead to micro-tearing of the musculotendinous junction (the area where the muscle "meets" the tendon). This constant micro-injury causes inflammation which has these cardinal signs; redness, swelling, heat, tenderness and loss of function.

Some of the common sites for this injury to occur include the achilles, elbow, knee and of course the shoulder. There are actually two tendons in the shoulder that seem to be predisposed to tendonitis. These two tendons are the supraspinatus muscle, which is actually one of the rotator cuff muscles, and the long head of biceps brachii (the Biceps has actually two heads, a short and a long head). A person suffering from tendonitis of the shoulder may have pain increasing when doing overhead motions.

During overhead motions these tendons are constantly being taxed. If you can picture a major-league pitcher who throws over 100 pitches a game, you may be able to grasp the degree of injury these elite throwers can encounter.

For the recreational athlete, these injuries can become debilitating to the point where there is pain before, during and after activity. A piece of advice; never let this injury get to this point. When you suspect you may have tendonitis, it is always a good idea to seek professional help to assist you in preventing further injury. You can also do some preventative measures to decrease the chances of getting tendonitis. Other than seeking professional help, you can follow the advice listed below:

1. Warm-up properly, stretch before and after activity.
2. Use ice on the shoulder after a game for 15 minutes.
3. Make sure you strengthen the shoulder muscles prior to the season.
4. Don't overdo overhead activities; make sure you give these tissues time to heal.
5. Seek advice from a certified coach to help you with your mechanics. Improper mechanics may predispose you to injury.

Massage can also be beneficial to help stretch muscles, decrease pain, increase circulation locally and breakdown any scarring that may have occurred because of activity. Physiotherapy can help to identify muscle imbalances and prescribe exercises to correct them. Mobilization of joints may be required to normalize biomechanics.

Tendonitis need not prevent you from playing your sport. Follow the advice listed above, and it will help you perform optimally. If you have further questions, please contact the Team at Toronto SEMI.

References:

1. Magee, David J. Orthopedic Physical Examination 4th edition. Saunders. Toronto. 2002.
2. Kisner, Carolyn. Colby, Lynn Allen. Therapeutic Exercise, Foundations and Techniques, 3^rd edition. F.A. Davis Company. Philadelphia. 1990.
3. www.sportsinjuryclinic.net/.../shoulder/supraspinrupt.htm