On fire and frozen - tendonitis, anyone?

The shoulder is the most movable joint of the body. Anatomically, this joint is where a shallow socket which is the glenoid fossa of the scapula (wings), meets the ball, which is the head of the humerus or arm bone. Despite this unique arrangement, shoulder joints are kept aligned and intact because of a very competent and strong supporting capsule, criss crossed by tendons to make a surrounding, circumferential cuff called the rotator cuff.

There are 4 of these tendons, and one other tendon just outside the capsule that can cause trouble - tendon of the biceps muscles, with its 2 heads, the short and the long head. These tendons are lodged in a groove along the front of the arm bone, but as how biceps go, we can twist and over exert during lifting, and so we can "over-pull" the tendon. The resulting pain can be exquisite, and each motion of reaching out to the lower back to scratch an itch becomes impossible.

Bicipital tendonitis is quite a common occurrence, and with rest, the biceps tendon quiets down. But some "pulled" tendons don't. The pain smolders and like embers, can be fanned into a full blown conflagration, and rightly so -  continued work or gym-related lifting, pulling and other daily activities, just cannot be avoided. Increasing pain keeps you to move the shoulder less and less.  A week or 2 of decreased shoulder motion gets the rest of the rotator cuff tendons stiff. They later "freeze" to cause the "frozen shoulder".

Biceps tendon  on fire and shoulder cuff frozen - bad combination. It spells sleepless nights, gnawing shoulder pain, painful limitation of activities that in the past you could do without thinking. And for a working and active individual, this is catastrophe, indeed!

What else do we need to know about tendons?

Tendons are  found where there are muscles. They insert muscles to bone, thereby moving the skeleton as muscles move. But there is a catch - they are not well supplied with blood, and this makes healing slow.

Rest is best, with guided physical treatment, using deep and superficial heat or sometimes cold. Please avoid massage during the painful phase, it will only prolong the healing process. Exercises are introduced slowly and designed to allow slow but sure recovery of motion. Some cases count years, with residual limitation on stretching out of arms, but full recovery is possible.

Pain medicines? Not fully helpful. Treatment is applied over the area that hurts, and this can include anti-inflammatory liniments and steroid injection. The latter can effectively remove pain fast, but the recovery of motion takes the slow and long way.

And so, tendonitis anyone? I'd say, no thanks.

Photos from Google images of rotator cuff tendonitis.