What is it?
Tendinopathy is essentially inflammation and bruising in a tendon; the same way you get inflammation or bruising when you stub a toe or cut your finger. Inflammation is part of the healing process of the body and is an extremely important part of recovery from physical activity. Although, when a Rotator Cuff Tendon (or any tendon for that matter) is put under consistent high load, this inflammatory process can become repetitive and result in consistent achy Shoulder pain. This happens because the inflammation in the tendon is not recovering properly between each load session. If left untreated this can result in long term change to the state of the tendon and the strength of the Rotator Cuff muscles.
Tendinopathy very rarely happens in isolation, but generally has an underlying reason for a spike in load. This could be something as simple as a recent increase in training or something a little harder to see, such as changes in the way the shoulder is moving under load. This could be putting greater than normal load on one specific tendon in the shoulder.
How do I Identify it?
Rotator Cuff Tendinopathy typically presents with consistent build up of niggly shoulder pain. This can build up over the course of anywhere between one week to a few months depending on the severity of the inflammation. They tend to be more painful in the morning when first waking or when warming up for exercise but start to feel better when the shoulder is warm and the body is ready to go. Despite feeling good while you exercise the pain tends to come back and be quite sore once the body has cooled down and inflammation has had time to set it.
What can you do?
The process for settling sore tendons is quite simple and is very effective, however it does take a bit of time for the inflammation to completely settle.
Step 1: Relative rest – Relative is the important word here. IF you rest completely from exercise the pain will settle only to come back when you return to exercise again. It is important to REDUCE your exercise level to a point that is pain free and comfortable during and after the exercise but NOT STOP completely. For example, in climbing this might mean reducing your climbing level from v.4-5 to v.2-3.
Step 2: Load and Unload – Plan your week to have load days and rest days. Always follow a load day with a rest day.
Step 3: Specific tendon Loading – Tendons love static load to help stimulate healing, without overloading and increasing the inflammation. My favourite two exercises to help stimulate the tendon are: