Calcific tendinopathy is a condition of the tendon where calcium deposits are formed by the body. It is one of the most painful shoulder conditions.
Calcific tendonitis goes through 3 stages and can take a long time to develop.
- The first is the pre-calcification stage where the tendinous tissue undergoes metaplasia into fibrocartilage. This is thought to be brought on by repetitive strain and damage to the rotator cuff.
- The second stage is the calcific stage where the calcium deposit is formed.
- The third stage is reabsorption where the calcium becomes more of a toothpaste consistency and the body starts to reabsorb it and remodel the tissue.
It is thought to be caused by:
- Repetitive trauma to the tendons, particularly the supraspinatus tendon although in can also occur the infraspinatus, teres minor and subscapularis.
It is more common as people age with the incidence peaking in people in their 5th decade.
Common symptoms include:
- Severe pain which can radiate from the neck down the arm.
- During the acute phase it can be aggravated by all shoulder movements.
- In more chronic cases the pain is more likely to be at night.
- The pain is often quite difficult to localise and can cover a wide area about the shoulder.
You can have calcific tendinopathy for years without having any symptoms, so it is hard to tell what stage you are in without an investigation.
Conservative treatment such as physio can be successful in up to 90% of patients.
- Although physiotherapy cannot remove the calcium deposits, specific mobilisation techniques can be used to restore movement to the shoulder and the effected surrounding joints, thereby relieving the pressure on the shoulder.
- Strengthening exercises are started when appropriate to restore strength to the shoulder to help it maintain the correct position in all movements.
- Shoulder biomechanic retraining. If you have calcific tendinopathy you will have developed faulty patterns of movements in the shoulder, these have to be corrected if you are to make any progress.
- Postural education.
- Massage to relieve tight muscles.
Once the pain has been corrected it is important to continue with the exercises to ensure the shoulder maintains its full movement and the stabilisers maintain their strength so you no longer have any impingement and your shoulder problems do not return.