Rotator Cuff Calcific Tendinitis

What is Rotator Cuff Calcific Tendonitis?

Calcific Tendonitis

Calcific tendonitis is a condition that causes the formation of a small, usually about 1-2 centimetre size, calcium deposit within the tendons of the rotator cuff. These deposits are usually found in patients at least 30-40 years old and have a higher incidence in diabetics. The calcium deposits are not always painful, and even when painful they will often spontaneously resolve after a period of one to four weeks.

What Causes Calcific Tendonitis?

The cause of calcium deposits within the rotator cuff tendon (calcific tendonitis) is not entirely understood. Different ideas have been suggested, including blood supply and ageing of the tendon, but the evidence to support these conclusions is not clear.

One of the most compelling arguments is delayed healing.

Normally, the tendon heals via the action of collagen forming cells known as fibroblasts. After a period of weeks or months, the fibroblasts become less numerous in the region and are replaced by osteoblasts (bone forming cells). These osteoblasts stimulate the growth of bone (calcium) in the tendon.

Hence the main reason for the development of calcific tendonitis appears to be delayed healing.

How Does Calcific Tendonitis Progress?

calcific tendonitis

Calcific tendonitis usually progresses predictably, and almost always resolves eventually without surgery. The typical course is: 

Pre-Calcification Stage

You usually do not have any symptoms at this stage. At this point in time, the site where the calcification tends to develop undergo cellular changes that predispose the tissues to develop calcium deposits. 

Calcific Stage

During this stage, the calcium is excreted from cells and then coalesces into calcium deposits. When seen, the calcium looks chalky, it is not a solid piece of bone. Once the calcification has formed, a so-called resting phase begins, this is not a painful period and may last a varied length of time. After the resting phase, a resorptive phase begins--this is the most painful phase of calcific tendonitis. During this resorptive phase, the calcium deposit looks something like toothpaste.

Post-Calcific Stage

This is usually a painless stage as the calcium deposit disappears and is replaced by more normal appearing rotator cuff tendon.

Patients usually seek treatment during the painful resorptive phase of the calcific stage, but some patients have the deposits found incidentally as part of their evaluation impingement syndrome, usually on X-ray.

What is Rotator Cuff Impingement Syndrome?

Impingement (impact on bone into rotator cuff tendon or bursa) should not occur during normal shoulder function. 

When it does happen, the rotator cuff tendon becomes inflamed and swollen, a condition called rotator cuff tendonitis

Likewise, if the bursa becomes inflamed, shoulder bursitis will develop. These conditions can co-exist or be present independently.

While a traumatic injury can occur eg fall, it is repeated movement of your arm into the impingement zone overhead that most frequently causes the rotator cuff to contact the outer end of the shoulder blade (acromion).

When this repeatedly occurs, the swollen rotator cuff is trapped and pinched under the acromion. 

Rotator Cuff FAQs

  • What is the Shoulder Impingement Zone?
  • What Causes Rotator Cuff Impingement & Bursitis?
  • What is your Scapulohumeral Rhythm?
  • Rotator Cuff Calcific Tendonitis Treatment

    Rotator cuff calcific tendonitis is a common complaint that we see at PhysioWorks and it is, unfortunately, an injury that often recurs if you return to sport or work too quickly – especially if a thorough rehabilitation program is not completed. 

    Your rotator cuff is an important group of control and stability muscles that maintain “centralisation” of your shoulder joint. In other words, it keeps the shoulder ball centred over the small socket. This prevents injuries such as bursitisimpingementsubluxations and dislocations.

    We also know that your rotator cuff provides subtle glides and slides of the ball joint on the socket to allow full shoulder movement. Plus, your shoulder blade (scapular) has a vital role as the main dynamically stable base plate that attaches your arm to your chest wall.

    Did you know that your arm only has one bony joint articulation where your collarbone (clavicle) attaches to the acromion (tip of the shoulder blade)?

    The rest of your attachments are muscular, which highlights the importance of retraining and strengthening of your shoulder muscles. 

    Calcific Tendonitis Treatment

    Researchers have concluded that there are essentially 7 stages that need to be covered to effectively rehabilitate these injuries and prevent recurrence – these are:

    1. Early Injury Protection: Pain Relief & Anti-inflammatory Tips
    2. Regain Full Range of Motion
    3. Restore Scapular Control
    4. Restore Normal Neck-Scapulo-Thoracic-Shoulder Function
    5. Restore Rotator Cuff Strength
    6. Restore High Speed, Power, Proprioception & Agility
    7. Return to Sport or Work

    Calcific Tendonitis Treatment Results

    There is no specific time frame for when to progress from each stage to the next. Your injury rehabilitation status will be determined by many factors during your physiotherapist’s clinical assessment.

    You’ll find that in most cases, your physiotherapist will seamlessly progress between the rehabilitation phases as your clinical assessment and function improves.

    It is also important to note that each progression must be carefully monitored as attempting to progress too soon to the next level can lead to re-injury and frustration.

    For more specific advice about your bursitis or rotator cuff injury, please contact your PhysioWorks physiotherapist.

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    Helpful Products for Calcific Tendonitis

    Rotator Cuff Calcific Tendonitis

    Related Rotator Cuff Injuries

    General Information

    Rotator Cuff

    Adhesive Capsulitis

    Shoulder Bursitis

    Shoulder Instability

    Acromioclavicular Joint

    Bone Injuries

    Post-Operative Physiotherapy

    Muscle Conditions

    Systemic Conditions

    Referred Pain

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    FAQs about Rotator Cuff Calcific Tendonitis

  • Common Physiotherapy Treatment Techniques
  • What is Pain?
  • Physiotherapy & Exercise
  • When Should Diagnostic Tests Be Performed?
  • Massage Styles and their Benefits
  • What Causes Post-Exercise Muscular Pain?
  • Can Kinesiology Taping Reduce Your Swelling and Bruising?
  • How Much Treatment Will You Need?
  • Rotator Cuff: What is it?
  • Sports Injury? What to do? When?
  • What are the Common Massage Therapy Techniques?
  • What are the Early Warning Signs of an Injury?
  • What Can You Do To Help Arthritis?
  • What Causes Rotator Cuff Impingement & Bursitis?
  • What is a Tendinopathy?
  • What is a TENS Machine?
  • What is Chronic Pain?
  • What is Nerve Pain?
  • What is Sports Physiotherapy?
  • What is the Shoulder Impingement Zone?
  • What is your Scapulohumeral Rhythm?
  • What's the Benefit of Stretching Exercises?
  • When Can You Return to Sport?
  • Why Kinesiology Tape Helps Reduce Swelling and Bruising Quicker
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    Last updated 14-Feb-2019 10:56 AM

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