Pulled Shoulder Tendon

Dealing with a pulled shoulder tendon can be excruciating, disrupting daily routines, and hindering mobility. The sharp, persistent pain accompanied by discomfort can significantly impact one’s quality of life. However, there’s a glimmer of hope for relief without the necessity for surgery, with various non-invasive treatment options offering promising outcomes.

What Is A Pulled Shoulder Tendon?

A pulled shoulder tendon, often referred to as a shoulder tendon strain or tear, occurs when the tendons connecting the muscles to the bones in the shoulder are overstretched or torn. This typically transpires due to sudden, forceful movements or repetitive strain, such as lifting heavy objects, sudden impacts, or engaging in activities with repetitive overhead motions. 

The affected tendons are usually those of the rotator cuff, a group of muscles and tendons that stabilize the shoulder joint and facilitate its movements.

When a shoulder tendon is pulled, the individual may experience sharp pain, stiffness, and limited range of motion in the shoulder. The pain can range from mild discomfort to severe agony, depending on the extent of the injury. In some cases, there may be swelling or bruising around the shoulder joint, indicating inflammation and tissue damage. 

This condition can significantly impair everyday activities and may require prompt medical attention to alleviate symptoms and prevent further complications.

Risk Factors

Several factors can increase the likelihood of experiencing a pulled shoulder tendon:

• Age: As individuals age, the tendons in the shoulder can weaken and become more prone to injury. Age-related changes, such as decreased elasticity and blood flow, can compromise the tendon’s ability to withstand stress, making older adults more susceptible to tendon strains or tears.
• Overexertion: Engaging in activities that require repetitive or excessive use of the shoulder muscles without adequate rest or conditioning can strain the tendons, leading to injury. Overexertion commonly occurs in occupations or sports that involve frequent overhead motions, lifting heavy objects, or repetitive arm movements.
• Smoking: Smoking has been linked to impaired healing and decreased blood flow to tissues, including tendons. This can compromise the tendons’ ability to repair themselves after injury and increase the risk of developing tendon problems, such as strains or tears. Smokers may therefore be more susceptible to experiencing pulled shoulder tendons compared to non-smokers.

Symptoms Of A Pulled Shoulder Tendon

When a shoulder tendon is pulled, the accompanying symptoms can significantly disrupt daily life, causing discomfort and hindering mobility. Understanding these signs is crucial for timely diagnosis and appropriate management. Here’s a breakdown of possible symptoms and their impact:

Pain

Pain is often the most prominent symptom of a pulled shoulder tendon. It can range from a dull ache to sharp, stabbing sensations, depending on the severity of the injury. This pain may intensify with certain movements or activities, making it challenging to perform routine tasks such as reaching overhead or lifting objects.

Tenderness/Swelling

Tenderness and swelling around the affected area are common indicators of tendon damage. The shoulder may feel tender to the touch, and there may be visible swelling or inflammation. This can limit shoulder mobility and exacerbate discomfort, especially during physical activity or when pressure is applied to the area.

Inability To Bear Weight

Individuals with a pulled shoulder tendon may experience difficulty bearing weight on the affected arm. This can make activities like lifting, pushing, or carrying objects extremely challenging and may necessitate modifications to daily routines to avoid exacerbating the injury.

Bulge Or Deformation

In severe cases, a noticeable bulge or deformation may be present in the shoulder area where the tendon is injured. This abnormal protrusion can be visually apparent and may indicate a more significant tear or rupture of the tendon, requiring prompt medical attention.

Snapping/Popping While Moving The Shoulder

Some individuals may hear or feel a snapping or popping sensation in the shoulder when moving it. This could indicate instability or friction within the joint, potentially resulting from a torn or strained tendon. Such sensations may cause apprehension and discomfort, limiting the range of motion in the shoulder.

Weakness

Muscle weakness in the shoulder and arm is another common symptom of a pulled tendon. The affected muscles may feel noticeably weaker, making it challenging to perform tasks that require strength or endurance. Weakness can further exacerbate functional limitations and increase the risk of compensatory movements that may worsen the injury.

Stiffness

Stiffness in the shoulder joint is often experienced alongside tendon injuries. The shoulder may feel tight and restricted in movement, particularly during initial attempts to mobilize the joint after periods of rest. This stiffness can contribute to pain and functional limitations, affecting activities like reaching, lifting, and overhead movements.

Inability To Keep the Arm Elevated

Individuals with a pulled shoulder tendon may find it difficult to keep their arm elevated or to maintain certain positions for extended periods. This can impact daily activities such as dressing, grooming, or reaching for objects on high shelves, leading to frustration and reduced independence.

Common Causes

Understanding the common causes of pulled tendons in the shoulder is essential for prevention and treatment. Various factors, ranging from sudden injuries to repetitive strain, can contribute to this painful condition. Here’s an overview of the primary culprits:

Injuries

Acute injuries, such as falls, sports-related impacts, or accidents, can lead to pulled tendons in the shoulder. These events may cause the tendons to stretch beyond their normal capacity or tear outright, resulting in immediate pain and functional impairment. 

Traumatic incidents like these can occur during activities like contact sports, heavy lifting, or sudden movements that place excessive stress on the shoulder joint.

Overuse

Repetitive use or overexertion of the shoulder muscles and tendons can gradually wear them down, increasing the risk of strains or tears. Activities that involve frequent overhead motions, such as painting, swimming, or throwing, can place repetitive stress on the shoulder tendons, leading to inflammation and micro-tears over time. 

Poor technique, inadequate rest periods, and insufficient conditioning can further exacerbate the risk of overuse injuries, making individuals more susceptible to developing pulled tendons in the shoulder.

Common Treatments

When it comes to treating a pulled shoulder tendon, various options are available to alleviate pain, promote healing, and restore shoulder function. From non-surgical approaches to advanced medical interventions, the goal is to address inflammation, reduce discomfort, and strengthen the affected area. Here’s an overview of the different types of treatments:

Non-Surgical Treatments

The following are some non-surgical treatments that may help relieve the symptoms of a pulled shoulder tendon:

• RICE (rest, ice, compression, elevation): This classic approach involves resting the shoulder to allow the tendon to heal, applying ice packs to reduce inflammation and pain, using compression wraps and elevating the arm to support the joint and minimize swelling. 
• Physical therapy: A structured exercise program supervised by a physical therapist can help improve shoulder strength, flexibility, and range of motion. Targeted exercises and stretches can alleviate pain, prevent stiffness, and promote tissue healing.
• Pain relievers: Over-the-counter or prescription pain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen, can help manage pain and reduce inflammation associated with a pulled shoulder tendon.
  • Downside of NSAIDs – while these medications are designed for short term use, many patients use more longer term which can be detrimental to your body’s healing. You can explore more about it here.

Advanced Medical Treatments

Here are some advanced medical treatments for a pulled shoulder tendon:

• Steroid injections: Corticosteroid injections may be administered directly into the shoulder joint to reduce inflammation and alleviate pain. These injections can provide temporary relief, allowing individuals to participate more comfortably in physical therapy and other rehabilitation exercises.

While these injections have the ability to reduce inflammation, at what cost?

• Traditional steroids are toxic to mesenchymal stem cells.
• Oral steroids markedly increase the risk of a serious bone disease—osteonecrosis.
• Steroid shots hurt tendon cells and make tendinitis symptoms worse.
• Repeated steroid shots break down cartilage.
• Steroids mess with the cortisol pituitary axis—your stress management hormones.
• Steroid epidurals increase the risk of fractures in older women.
• Steroids kill cartilage cells from arthritic joints.

• Arthroscopic surgery: In cases where conservative treatments fail to provide sufficient relief, arthroscopic surgery may be considered. This minimally invasive procedure involves inserting a small camera and surgical instruments into the shoulder joint to repair or remove damaged tissue, such as torn tendons or debris.
• Open surgery: In more severe cases or when other treatments are ineffective, open surgery may be necessary to repair or reconstruct the damaged tendon. This involves making a larger incision to access the shoulder joint and perform the necessary repairs, such as tendon reattachment or reconstruction.

What if you fail conservative measures but are adamant to avoid surgery and do not want steroid injections?

Orthobiologics such as Platelet Rich Plasma (PRP) and Bone Marrow Concentrate (BMC) procedures can potentially help avoid surgery

On Partially Torn Tendons Of Your Rotator Cuff: 

A study looked at outcomes comparing PRP with rotator cuff repair surgery, which found that PRP was just as good as surgery plus improved much faster, with less overall pain and same function.

“Both surgical repair and platelet-rich plasma injection into the tear site are equally effective in the treatment of high-grade intrasubstance partial-thickness rotator cuff tears, while platelet-rich plasma provides significantly shorter recovery time”

On Fully Torn Tendons: 

In 2020 we published our randomized control trial looking at this for patients who wanted to avoid a big surgery. We compared outcomes to 3 months of physical therapy and all conservative options then treated 50+ patients over the last 8+ years and followed them over time.  

What we found was that 89% of patients improved significantly and these patients also had MRI evidence of tendon healing and improvement!

We have been treating tendon tears for almost 20 years and giving patients good viable alternatives to traditional medicine with orthobiologics!

When Should You See a Doctor?

It’s important to seek medical attention if symptoms of a pulled shoulder tendon persist or worsen despite self-care measures. Here are some indications that it may be time to see a doctor:

• Persistent pain: If the pain in your shoulder persists for more than a few days, especially if it interferes with daily activities or worsens over time, it’s advisable to consult a healthcare professional.
• Limited mobility: Difficulty moving your shoulder or performing routine tasks due to pain, stiffness, or weakness may indicate a more serious underlying issue that requires medical evaluation.
• Swelling or bruising: Visible swelling, bruising, or a noticeable deformity in the shoulder area could signify a significant tendon injury or other structural damage that warrants medical attention.
• Inability to bear weight: If you’re unable to bear weight on your arm or if the pain significantly impairs your ability to lift or carry objects, it’s essential to seek medical advice.
• Recurrent symptoms: If you’ve experienced recurrent episodes of shoulder pain or instability, it’s important to identify and address any underlying factors contributing to these issues to prevent further injury.

How It Is Diagnosed

Diagnosing a pulled shoulder tendon typically involves a thorough evaluation of the patient’s symptoms, a physical examination, and diagnostic imaging tests to confirm the diagnosis and assess the extent of the injury. Here’s an overview of the diagnostic procedures commonly used by doctors and specialists:

What’s being checked: During the evaluation, the healthcare provider will assess areas of discomfort and pain in the shoulder, as well as evaluate the patient’s range of motion and strength. They will inquire about the onset and duration of symptoms, as well as any contributing factors or previous injuries.

Specific procedures used: 

• X-rays: X-rays are often the first imaging tests performed to rule out other conditions such as fractures or dislocations. While X-rays cannot directly visualize soft tissues like tendons, they can help identify bone abnormalities or alignment issues that may contribute to shoulder pain. 
• MRI (magnetic resonance imaging): MRI is a more detailed imaging technique that can provide visualization of soft tissues, including tendons, muscles, and ligaments. It can help identify tendon tears, inflammation, or other abnormalities within the shoulder joint. MRI is particularly useful for diagnosing complex or recurrent shoulder injuries and determining the extent of tendon damage.

Related Conditions

When experiencing shoulder pain, it’s essential to consider various conditions that may present similar symptoms or occur alongside a pulled shoulder tendon. Here’s a brief overview of some conditions that share symptoms or occur in conjunction with tendon injuries:

• Rotator cuff tear: A rotator cuff tear occurs when there’s a partial or complete rupture of the rotator cuff tendons. Like a pulled shoulder tendon, it can cause pain and there might be weakness in the arm. It also limits the range of motion in the shoulder. However, a rotator cuff tear may involve specific movements or positions that exacerbate symptoms, such as lifting the arm or reaching overhead.
• Pinched nerve: A pinched nerve in the shoulder, often due to compression or irritation of the nerves that run through the shoulder joint, can cause similar symptoms to a pulled tendon, including pain, numbness, tingling, and weakness. Pinched nerves may result from conditions such as cervical radiculopathy (nerve compression in the neck) or shoulder impingement syndrome.
• Shoulder arthritis: Shoulder arthritis, particularly osteoarthritis or rheumatoid arthritis, can lead to chronic joint inflammation, stiffness, and pain that may mimic symptoms of a pulled tendon. However, arthritis pain often worsens with movement and may be accompanied by swelling and decreased range of motion in the shoulder joint.
• Tendonitis: Tendonitis, or inflammation of the tendons, can cause localized pain, tenderness, and swelling in the shoulder area. While similar in presentation to a pulled tendon, tendonitis typically involves repetitive stress or overuse of the shoulder muscles, leading to inflammation rather than a tear of the tendon fibers.
• Bursitis: Bursitis occurs when the small fluid-filled sacs (bursae) that cushion the joints become inflamed. It can cause pain, swelling, and tenderness in the shoulder, often exacerbated by movement or pressure. Bursitis may coexist with tendon injuries or develop independently, sharing common symptoms with a pulled shoulder tendon.
• Impingement: Shoulder impingement syndrome occurs when the rotator cuff tendons or bursa become compressed or pinched between the bones of the shoulder joint. This can cause pain, weakness, and limited mobility, especially when lifting the arm or performing overhead activities. Impingement may accompany or contribute to symptoms of a pulled shoulder tendon.

How to Prevent a Pulled Shoulder Tendon

Preventing a pulled shoulder tendon involves adopting proactive strategies to reduce the risk of injury and promote shoulder health. Here are some preventive measures to consider:

• Give your shoulder a break: Incorporate rest periods into your routine, especially after engaging in activities that place stress on the shoulder muscles and tendons. Avoid overexertion and listen to your body’s signals of fatigue or discomfort.
• Stop activities that aggravate pain: If certain activities or movements exacerbate shoulder pain, refrain from performing them to prevent further strain or injury. Pay attention to ergonomics and body mechanics to minimize repetitive stress on the shoulder joint.
• Modify everyday activities: Adjust your posture and technique when performing tasks that require shoulder movement, such as lifting, reaching, or carrying objects. Use proper lifting techniques, such as bending your knees and keeping your back straight, to reduce strain on the shoulders.
• Make adjustments to prevent recurring injuries: Gradually increase the intensity and duration of physical activities to allow the shoulder muscles and tendons to adapt and strengthen over time. Incorporate cross-training and varied exercises to avoid overuse injuries and maintain overall shoulder mobility and stability. 
  
  Implement a comprehensive warm-up and stretching routine before engaging in physical activity to prepare the shoulder muscles and reduce the risk of injury. Consider wearing supportive braces or using assistive devices during activities that place excessive stress on the shoulders, such as sports or heavy lifting.

Can A Pulled Shoulder Tendon Heal On Its Own? 

In many cases, a pulled shoulder tendon can heal on its own with minimal to no medical intervention, particularly if the injury is mild to moderate and not associated with severe symptoms or complications. 

The body’s natural healing processes, coupled with conservative self-care measures, can often facilitate recovery over time. Here are some factors to consider regarding the potential for self-healing:

• Mild to moderate injuries: Minor tendon strains or partial tears may resolve with rest, ice, and over-the-counter pain medication to manage symptoms. Giving the injured shoulder adequate time to rest and heal can allow the damaged tendon fibers to repair themselves gradually.
• Natural healing processes: The body has innate mechanisms for repairing damaged tissues, including tendons. With proper care and time, the injured tendon can undergo a process of remodeling and strengthening as it heals. This process may take several weeks to months, depending on the severity of the injury and individual healing capacity.
• Conservative self-care measures: Self-care strategies such as rest, ice therapy, compression, and elevation (RICE), along with avoiding activities that aggravate the injury, can help alleviate pain and inflammation while supporting the healing process. 

Physical therapy exercises may also be beneficial in restoring shoulder mobility and strength as the tendon heals.

• Monitoring symptoms: While most cases of pulled shoulder tendons can heal on their own with conservative management, it’s essential to monitor symptoms closely. If pain persists or worsens over time, or if there are signs of significant weakness, instability, or limited range of motion, it may indicate a more severe injury requiring medical evaluation.
• Seeking medical advice: If symptoms persist despite self-care measures or if there are concerns about the severity of the injury, it’s advisable to consult a healthcare professional for evaluation and guidance. 
  
  A doctor or physical therapist can provide personalized recommendations based on the specific nature of the injury and the individual’s overall health and lifestyle.

Get Your Shoulder Tendons Checked by a Professional

At the Centeno-Schultz Clinic, diagnosing and treating pulled shoulder tendons involves a comprehensive and patient-centered approach aimed at addressing the underlying causes of pain and dysfunction. 

With a team of experienced medical professionals specializing in orthopedic and regenerative medicine, the clinic offers advanced diagnostic techniques and innovative treatment options to provide patients with personalized care and optimal outcomes.

Shoulder injuries deserve to be treated with utmost care. Consult with us today!

Click Here

Empty Spacer

Christopher J. Centeno, MD

Christopher J. Centeno, M.D. is an international expert and specialist in Interventional Orthopedics and the clinical use of bone marrow concentrate in orthopedics. He is board-certified in physical medicine and rehabilitation with a subspecialty of pain medicine through The American Board of Physical Medicine and Rehabilitation. Dr. Centeno is one of the few physicians in the world with extensive experience in the culture expansion of and clinical use of adult bone marrow concentrate to treat orthopedic injuries. His clinic incorporates a variety of revolutionary pain management techniques to bring its broad patient base relief and results. Dr. Centeno treats patients from all over the US who…

Read more

John Schultz, MD

John R. Schultz M.D. is a national expert and specialist in Interventional Orthopedics and the clinical use of bone marrow concentrate for orthopedic injuries. He is board certified in Anesthesiology and Pain Medicine and underwent fellowship training in both. Dr. Schultz has extensive experience with same day as well as culture expanded bone marrow concentrate and sees patients at the CSC Broomfield, Colorado Clinic, as well the Regenexx Clinic in Grand Cayman. Dr. Schultz emphasis is on the evaluation and treatment of thoracic and cervical disc, facet, nerve, and ligament injuries including the non-surgical treatment of Craniocervical instability (CCI). Dr. Schultz trained at George Washington School of…

Read more

John Pitts, M.D.

Dr. Pitts is originally from Chicago, IL but is a medical graduate of Vanderbilt School of Medicine in Nashville, TN. After Vanderbilt, he completed a residency in Physical Medicine and Rehabilitation (PM&R) at Emory University in Atlanta, GA. The focus of PM&R is the restoration of function and quality of life. In residency, he gained much experience in musculoskeletal medicine, rehabilitation, spine, and sports medicine along with some regenerative medicine. He also gained significant experience in fluoroscopically guided spinal procedures and peripheral injections. However, Dr. Pitts wanted to broaden his skills and treatment options beyond the current typical standards of care.

Read more

Jason Markle, D.O.

Post-residency, Dr. Markle was selected to the Interventional Orthopedic Fellowship program at the Centeno-Schultz Clinic. During his fellowship, he gained significant experience in the new field of Interventional Orthopedics and regenerative medicine, honing his skills in advanced injection techniques into the spine and joints treating patients with autologous, bone marrow concentrate and platelet solutions. Dr. Markle then accepted a full-time attending physician position at the Centeno-Schultz Clinic, where he both treats patients and trains Interventional Orthopedics fellows. Dr. Markle is an active member of the Interventional Orthopedic Foundation and serves as a course instructor, where he trains physicians from around the world.

Read more

Brandon T. Money, D.O., M.S.

Dr. Money is an Indiana native who now proudly calls Colorado home. He attended medical school at Kansas City University and then returned to Indiana to complete a Physical Medicine and Rehabilitation residency program at Indiana University, where he was trained on non-surgical methods to improve health and function as well as rehabilitative care following trauma, stroke, spinal cord injury, brain injury, etc. Dr. Money has been following the ideology behind Centeno-Schultz Clinic and Regenexx since he was in medical school, as he believed there had to be a better way to care for patients than the status quo. The human body has incredible healing capabilities…

Read more

Other Resources for Pulled Shoulder Tendon