How to treat shoulder pain – rotator cuff tendinitis

Did they just say you need a surgery? Don’t believe them!

If you already know how to train and eat, probably this section is the most important part of this website for you. Literally, there is barely anything useful on the internet, and that is kinda scary if I can be honest. We have the internet full of medical and fitness websites, forums and all the useless bullshit, while people just suffer and suffer, and sometimes end up undergoing some surgery, while the treatment actually does exist, and it is easily accessible and everybody can do it by themselves. For real! So don’t worry, science has always the answer!

The most common injury is tendonitis, or some call it tendinitis. Translated into a human language it means inflamed tendons. It happens when you overexert them, and they can’t regenerate. In contrast to the muscles, tendons heal much slower, and while you can recover from a super heavy workout in days, in tendon years the same would take weeks.

What is rotator cuff tendinitis?

Rotator cuff tendinitis is one of the most common types of tendinitis. And it’s not a coincidence, as our lifestyle puts a huge pressure on shoulders, especially for those whose profession requires them as well. It starts as a blunt pain in your shoulders, at the beginning only during workouts. This is a signal that you have to intervene, otherwise it is going to be worse…much worse! As you reach this milestone, you will feel the pain during work, and later even in resting position. A very sharp pain that will gradually disable you from working out completely, and will hinder your professional development as well.

After this, people realize that something is indeed not very kosher, and only now they go to the doctor, or just google their symptoms finding out they have brain cancer.

What will the doctors suggest?

  • physiotherapy with electric impulses
  • physiotherapy with a laser
  • surgery

I cannot emphasize enough: do not undergo surgery! It is extremely risky, and it will take months to heal…if it will heal. I’ve been working in medical fields for a while, so I am definitely not against medical science, but there is a much easier way, and I will show you how to forget this menace completely.

What can cause rotator cuff tendinitis?

In order to understand the healing process you need to get familiar with what causes rotator cuff tendinitis. People sit in front of the computer, their shoulders constantly engage in repetitive movements. Or people doing manual labour, especially that requires a lot of overhead manipulation or rotations as in an office for example. And then they go home, where is no rest for these tendons either, since they use their home computer, and they get even used during the workout!

Repetitive movements

Repetitive movements occur mostly at work, etc. In case of rotator cuff tendinitis usually with work on computer, too many rotations, like switching between the keyboard and the mouse, etc., or even just a bad posture and poor ergonomics, like not having your upper arm in a completely vertical position. In case of manual labour, when you do a lot of overhead activities.

Overtraining

Yes, you can easily overtrain your tendons with bad exercises or with poor execution, but most commonly: with very frequent application of both. Once your rotator cuff gets injured, and your workout is not 100%-ly rotator cuff friendly, then you will just aggravate the issue more and more.

Strains and sprains

It’s not a coincidence that usually the fitness-related tendinitis is also called repetitive strain injury. Many people think that they can maximize their exercise movement range by over-stretching the muscle, and while it also hurts the muscle itself yielding no benefit at all, it can be fatal for your tendons. This is why it is extremely important to execute every exercise properly, thus you can avoid any repetitive strain injury, and hear about them only from your uneducated friends.

The remedy

The most important part is prevention…yeah, it’s a cliche, but still. These methods work, and I have developed and tested them on myself. In my case, the pain did never go away, and regardless of how long I kept my tendons rested, no improvement occurred. That is why it is crucial to engage your tendons in activity, because only if you use them, only then they start to synthesise collagen again, and only then it will heal, and only then the pain will go away.

How to prevent it?

  • get an adjustable desk, so you can have your upper arms completely 90 degrees from the ground
  • keep your upper arms beside your body
  • relax your shoulders
  • do mild stretches and take breaks
  • warm up with inward and outward rotations when training chest or shoulders
  • include more dumbbell exercises instead of barbells when pushing
  • no excessive shoulder exercises
  • quit smoking
  • cut down omega-6 fatty acids (sunflower oil, grape seed oil), use healthier oils
  • sleep enough (seriously, it’s the most important dietary supplement ever)

You may not even realize, but your cool-looking desk can literally make you disabled. Ergonomic tools are one of your most important investments. The shoulders’ position should always be aligned with your body, otherwise it gets unnatural pressure, which is not ideal even without symptoms of tendinitis, but with them it should be completely avoided. Some people keep their shoulders constantly flexed without even noticing. This may lead to long-term damages, so just pay attention, and then your subconscious will quickly adopt the healthy state. Breaks are always welcomed, especially if you rotate your shoulders a lot or keep them lifted, just make some movements with them, stretch a little (not too much!). When pushing with barbells your shoulders can be under a lot of pressure, because barbells may force them into an unnatural position. Dumbbells help amazingly to alleviate the pressure, thus allowing you to train without pain and to prevent injuries. Your shoulders get used in many pushing exercises too, so no need to keep a separate shoulder day. Train and eat smart and well, and you will get those cannon balls anyway. They are involved not only in upper body exercises, but they are actively engaging even in squats, etc. Also, when people directly train them, they tend to overstretch them for the bigger movement range: don’t do that! Smoking decreases blood flow and increases inflammatory activities. I mean, it’s unhealthy on default, but when it’s with a little exaggeration about life and death, then it’s the perfect opportunity to get rid of an addiction, thus building a stronger personality as well. Omega 6 fatty acids increase inflammatory activities in your body. There is nothing wrong with using sunflower oil once in a while, or using grape seed oil (for example for steaks due to its higher smoke point), but in general, try to use them as less as possible, and look for more balanced fatty acid profiles, like olive oil. Check the Ingredients page for more info, you won’t regret it. I cannot emphasise enough the importance of sleep. You may get by by sleeping less, but you will eventually pay the price for it. 8h is good, seriously, just do it. And don’t tell me you don’t want it, lol!

How to treat it?

Phase 1.

  • keep your shoulders beside your body during work
  • relax your shoulders (some people unconsciously keep them flexed)
  • take breaks, very mild stretches only
  • very moderate painful exercises
  • take a vacation at work if needed
  • icing and anti-inflammatory creams and medication ONLY at the beginning, as long as it is still swollen

When you reach the 1st healing phase there are two things to keep in mind: leaving your tendons to rest and then taking care of the inflammation. Inflammation is a natural process that is designed to provide the much needed blood flow for the injured tendon, however, the swollen tendon tissue may damage your nerve tissue, and that damage could be irreversible. Stretching is not recommended, only very mild ones, because your tendon is very sensitive and vulnerable right now. This is why it may be crucial to take some days off from work, because this phase is about nothing else but healing. I mean it’s better to do it now than due to a surgery, no? You can easily battle inflammation with icing and anti-inflammatory creams. I would not quite recommend anti-inflammatory tablets, but if the problem is way too severe, couple of days of tablets won’t do any harm. Keep in mind that while anti-inflammatory treatments reduce inflammation, they also inhibit healing, since they interfere with collagen synthesis, thus with rebuilding the damaged tendon tissue itself.

Phase 2.

  • increase the circulation (massage, putting warm things on it, sauna, etc.)
  • gradually start to engage them in exercises gently (avoid exercises that cause pain)

And this is why the 2nd phase of healing is about actual healing. The 1st phase was your Stalingrad to stop the nazi inflammation, and now is your turn to march all the way to Berlin! Now is the time to rebuild your war-torn tendons. At first, increase the circulation by every way possible. Massage your shoulders (especially from behind), put something warm on them, go to sauna, etc. Sauna is an excellent way for “this type of cardio”. You have to realize that increased collagen synthesis that is desperately required for your recovery will be stimulated by stimulating the given tendon itself, hence you will have to engage it in activities again. If workout is too much for them, you can use rubber bands with inward and outward rotations. 1-1 when your elbow is hanging on your body’s side, and 1-1 when your elbow is aligned with your shoulder. It’s like a weird dance in an East-German disco!

And that’s it, if you pass these steps, you can gradually return back to the normal, and can be stronger/faster/etc. more than ever! Happy healing!

What about light therapy?

Light therapy won’t do any harm, but it is mostly intended to kill malignant microorganisms on a healing scar, it’s not some healing magic beam. Basically a flashlight could do the job better, since it provides more warmth.

How about visiting a chiropractor?

Dude, I love Harry Potter too, but magic doesn’t exist, and giving tons of money to charlatans is a transgression against civilization.