A partial tear in the shoulder tendon is an injury affecting one of the tendons that connect muscles to the bones of the shoulder joint. In this condition, the tendon undergoes partial damage without completely tearing. This type of injury occurs due to continuous strain, repetitive movements, or direct trauma, leading to tendon weakening and an increased risk of a complete tear if not treated properly.
Difference Between Partial and Complete Tear of the Shoulder Tendon
- Partial Tear: Occurs when the tendon partially tears but remains partially attached to the bone, causing pain with movement and limited shoulder mobility.
- Complete Tear: In this case, the tendon fully tears and detaches from the bone, leading to a loss of normal shoulder movement, often requiring surgical intervention for repair.
Symptoms of a Partial Tear in the Shoulder Tendon
Symptoms vary depending on the severity of the injury and the degree of the tear.
Early Symptoms of Shoulder Tendon Tears
- Mild to moderate shoulder pain, especially when moving the arm or lifting objects.
- Difficulty moving the arm freely, with discomfort during daily activities.
- Pain when sleeping on the affected shoulder, particularly on the injured side.
- Weakness in the muscles, making simple tasks such as lifting a bag or holding objects difficult.
- A clicking or grinding sensation in the shoulder when moving it.
| Type |
Partial Tear |
Complete Tear |
| Pain |
Moderate to severe, appears with shoulder movement |
Severe and persistent, even at rest |
| Arm Strength |
Mild to moderate weakness |
Severe weakness or complete inability to move the arm |
| Shoulder Mobility |
Partially limited with some pain |
Severely restricted movement or inability to lift the arm |
| Clicking and Grinding Sensation |
May be present but relatively mild |
Usually more noticeable and severe |
| Swelling and Joint Inflammation |
Mild or not noticeable |
Usually evident with swelling around the joint |
When to See a Doctor?
- If the pain persists for more than a few weeks despite rest or painkillers.
- In case of noticeable weakness in the arm and difficulty lifting objects.
- If swelling and inflammation in the shoulder area worsen, accompanied by redness or warmth in the skin.
- Hearing a tearing sound or feeling a sudden detachment in the shoulder, which may indicate a complete tendon rupture.
- If the injury affects daily activities such as dressing or driving.
Early diagnosis and proper treatment help prevent worsening of the injury and improve recovery chances without surgery.
Causes of a Partial Tear in the Shoulder Tendon
A partial tear in the shoulder tendon can occur due to several factors. Here are the most common causes:
Sports Injuries and Falls
- Sudden, forceful movements during sports can strain and partially tear the tendons.
- Direct falls on the shoulder or sudden arm extension can cause acute stress, leading to tearing.
- Sports involving repetitive throwing, such as volleyball and handball, may gradually weaken the tendon until a partial tear occurs.
Aging and Its Effect on Tendons
People over 40 often experience tendon weakening due to gradual tissue wear.
Reduced blood flow to tendons with age decreases the body's ability to repair damage, increasing the risk of partial tears.
Calcifications and fibrosis can accumulate within tendons over time, making them more fragile and prone to tearing.
Repetitive Movements and Excessive Strain
People working in carpentry, painting, plumbing, or lifting heavy objects are at risk due to continuous shoulder use with repetitive movements.
Daily activities such as lifting heavy weights improperly or sleeping in uncomfortable positions may lead to continuous tendon strain, making them more susceptible to tearing.
Overtraining without adequate rest periods can fatigue muscles and tendons, increasing the risk of a partial tear.
How to Diagnose a Partial Tear in the Shoulder Tendon?
"margin-bottom: 25px;">Clinical Examination and Medical History
The doctor starts by evaluating the patient's symptoms and medical history, which includes:
- Discussing Symptoms: The doctor asks about the nature of the pain, its intensity, and how it affects daily activities.
- Physical Examination: The doctor examines the affected shoulder for signs of swelling, muscle weakness, or restricted movement.
- Motion and Strength Tests: The doctor asks the patient to move their arm in different directions while applying slight resistance to test tendon strength and muscle response.
- Hawkins-Kennedy and Neer Tests: These are common clinical tests used by doctors to detect inflammation or injuries in shoulder tendons.
The Role of X-rays and MRI Scans
After a clinical examination, the doctor may use imaging tests for a clearer view of the tendons:
- X-ray:
- Cannot detect tendon tears but helps rule out other causes of pain, such as arthritis or bony spurs pressing on the tendons.
- MRI (Magnetic Resonance Imaging):
- The best method for accurately diagnosing a partial tear in the shoulder tendon.
- Reveals the extent of the tear, presence of inflammation or swelling, and the condition of surrounding tissues.
- Helps distinguish between partial and complete tears, guiding the doctor in selecting the appropriate treatment.
Treatment Methods for a Partial Tear in the Shoulder Tendon
Medication to Relieve Pain and Inflammation
Medications include:
- Pain Relievers and NSAIDs (Non-Steroidal Anti-Inflammatory Drugs): Such as ibuprofen and naproxen, which help reduce pain and swelling.
- Cold and Hot Compresses: Cold compresses help reduce acute inflammation, while hot compresses improve blood flow to injured tendons.
- Cortisone Injections: Used in cases unresponsive to oral medications, providing quick inflammation relief but not a long-term solution.
- Platelet-Rich Plasma (PRP) Injections: Used in some cases to speed up tendon healing.
Physical Therapy and Rehabilitation
Physical therapy is essential for restoring strength and normal shoulder movement after an injury. It includes:
- Stretching exercises: Help improve tendon flexibility and reduce stiffness.
- Strengthening exercises for the muscles around the joint: Such as using light weights or resistance bands to strengthen the shoulder muscles.
- Manual therapy techniques: Such as therapeutic massage and electrical stimulation to relieve pain and stimulate blood flow to the injured area.
- Posture correction: A physical therapist can help correct improper postures that may put extra pressure on the shoulder tendons.
Recommended Exercises for Shoulder Strengthening
- Front shoulder stretch:
Stand upright and hold your injured arm with the other hand.
Gently pull the arm across your body for 15-30 seconds, repeating 3 times.
- Pendulum exercise:
Lean slightly forward and let the injured arm hang down.
Move it in small circles for 30 seconds.
- Resistance exercise for internal and external rotation:
Use a resistance band and attach it to a door handle.
Hold the band and slowly rotate your shoulder inward and outward to strengthen the muscles.
When is Surgical Intervention Necessary?
- Persistent pain and loss of shoulder movement after several months of non-surgical treatment.
- A large tear in the tendon that worsens over time.
- Failure of other treatments to improve shoulder function.
Types of Possible Surgical Interventions
- Arthroscopy: Used to remove damaged tissue and repair the tendon without the need for open surgery.
- Tendon repair via arthroscopy or open surgery: Torn tendons are stitched back to the bone.
- Shoulder joint replacement: In severe cases involving chronic inflammation or joint erosion.
Home Exercises for Strengthening Shoulder Tendons
Posterior Shoulder Stretch
This exercise helps improve shoulder joint flexibility and reduce stiffness, especially after injuries or surgeries.
How to Perform the Exercise:
- Stand or sit upright.
- Hold your injured arm with the other hand and gently pull it towards your body.
- Hold this position for 15-30 seconds, then relax.
- Repeat the exercise 3-5 times for each shoulder.
Tips:
- Do not overstretch to avoid excessive pain.
- Perform the exercise slowly for the best results.
Resistance Exercise for Strengthening Shoulder Tendons
Resistance exercises help strengthen the shoulder muscles and tendons, supporting the joint and reducing pressure on it.
How to Perform the Exercise:
- Use a light to medium resistance band.
- Secure one end of the band to a fixed place, such as a door handle.
- Hold the other end with your injured hand and slowly pull the band towards your body, then return to the starting position.
- Perform 10-15 repetitions for each side, with 3 sets daily.
Tips:
- Start with low resistance and gradually increase it.
- Control the movement to avoid any injury.
Tips for Safe Exercise Performance
- Warm up for 5-10 minutes before starting exercises.
- Avoid sudden movements that may worsen the injury.
- If you feel sharp pain during exercises, stop immediately and consult your doctor.
- Practice exercises regularly for better results.
Preventing Shoulder Tendon Tears
- Proper warm-up before exercise: Perform warm-up exercises such as stretching and circular shoulder movements to activate the muscles and tendons. Warm-up increases blood flow to the tendons and reduces the risk of injury.
- Using proper technique during exercises: Performing exercises incorrectly increases pressure on the shoulder joint and leads to tendon strain. It is advisable to seek guidance from a trainer or physical therapist to ensure proper movements.
- Avoid lifting excessively heavy weights: Lifting heavy weights without proper progression can cause partial or complete tendon tears. It is best to gradually increase weights while regularly practicing shoulder-strengthening exercises.
- Allowing sufficient rest periods for the shoulder: Excessive exercise without enough rest leads to tendon fatigue and increases injury risks. It is recommended to alternate between workout and rest days to allow tendon recovery.
- Using supportive braces when needed: Some athletes need supportive braces or kinesiology tapes to reduce pressure on the shoulder joint during intense exercises.
- Maintaining proper sitting posture: Prolonged sitting in incorrect positions puts excessive pressure on the shoulder tendons. It is preferable to sit upright with lower back support and keep the shoulders relaxed.
- Avoiding sudden and violent movements: Avoid moving the arm abruptly or lifting heavy objects quickly, as this can lead to tendon tears.
- Performing daily stretching exercises: Stretching exercises help improve tendon flexibility and reduce tear risks.
- Maintaining a healthy weight: Excess weight can increase pressure on joints and tendons, raising the risk of injury.
- Following a diet rich in tendon-supporting nutrients: Consuming foods rich in collagen and omega-3 fatty acids supports tendon health.
FAQs About Partial Shoulder Tendon Tear
Can a Partial Shoulder Tendon Tear Heal Without Surgery?
Yes, in most cases, a partial shoulder tendon tear can heal without surgery, especially if the tear is not severe. Recovery depends on the extent of the tear and the patient’s commitment to conservative treatment.
- Rest and reducing strenuous movements.
- Using anti-inflammatory medications to reduce pain and swelling.
- Physical therapy and strengthening exercises.
- Platelet-rich plasma (PRP) injections to aid tissue healing.
- In some cases, surgical intervention may be necessary.
How Long Does It Take to Recover from a Partial Shoulder Tendon Tear?
- Mild cases: 4 to 6 weeks.
- Moderate cases: 3 to 6 months.
- In case of surgery: 6 months or more.
Following up with a doctor and committing to physical therapy accelerates the healing process.
Can I Exercise After Recovering from a Shoulder Tendon Tear?
Yes, but under certain conditions:
- The shoulder must have fully regained strength and normal movement without pain.
- Gradual rehabilitation is recommended to prevent reinjury.
- Regularly practice shoulder-strengthening exercises.
- Consult a doctor or physical therapist before resuming intense activities.
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