Recent news making the rounds has several Tiger players being sidelined with varying degrees of shoulder tendinitis, including pitchers Fernando Rodney, Clay Rapada, Jeff Gerbe, and outfielder Matt Joyce. With a rash of players experiencing similar – though likely different – problems, let's take a look at some of the details.
Basics: Generally speaking, tendinitis is inflammation of or around a tendon. Tendons are extremely strong components of the body, connecting muscle to bone, and allowing free movement of joints. Because they are required to withstand such rigorous forces, tendons typically have tremendous resiliency, but they can become inflamed as a result of overuse (i.e., repetitive motion injuries), disease, or traumatic injuries. Tendinitis is most common at the point the tendon reaches the bone, but a similar problem can also occur with inflammation of the lubricating sheath that surrounds the tendon at the point of attachment to the muscle; this is called tenosynovitis. It is virtually impossible to differentiate between the two injuries, as both have virtually identical symptoms and treatment. The amount of pain experienced as a result of the injury will vary with the severity of the issue, but it can be very significant, and can worsen without proper treatment.
Treatment: First and foremost among treatment options is adequate rest. Without proper healing time, further damage to the tendons can occur, including tears in the tendon or the development of chronic (long term or recurring) tendinitis. During this period of rest, it is common for trainers or physical therapists to prescribe icing, compression, and elevation, to aid the process. In addition, some strengthening work can be employed to maintain strength in the muscles surrounding the weakened tendon, while still allowing for proper rest. In severe or chronic cases that do not respond to these initial treatments, surgery can be required.
Timetable: In cases of mild tendinitis, rehab/recovery times can be as short as two weeks. In extreme cases where the problem is chronic or persists despite rest and rehab, full recovery can take in excess of six weeks.
Future Concerns: While tendinitis most frequently refers to the actual inflammation of the tendons, it can also refer to inflammation of the rotator cuff. Any problems with the rotator cuff are evil words for baseball players, and should be viewed with extreme caution. Coming back too soon from something like shoulder tendinitis can not only open the door to chronic problems, but also to compensations for a weakened component of the shoulder, potentially leading to more severe problems within the joint. Mild shoulder tendinitis in and of itself should not be cause for significant concern, but routine bouts with it or increasing severity of the injury should send up red flags going forward.