Can prior shoulder dislocation cause tendonitis?

From the Guidelines

Yes, a prior shoulder dislocation can cause tendonitis, particularly in the rotator cuff tendons, due to the trauma and subsequent inflammation caused by the dislocation. When a shoulder dislocates, it can damage the surrounding tendons, leading to inflammation and tendonitis 1. The trauma from dislocation can cause microscopic tears in the tendons, and the body's healing response includes inflammation. Additionally, after a dislocation, people often develop altered shoulder mechanics or compensatory movement patterns to avoid pain, which can place abnormal stress on the tendons and contribute to tendonitis development.

Key Points to Consider

• The instability that remains after a dislocation can also cause repeated microtrauma to the tendons during normal activities 1.
• Treatment typically includes rest, ice, anti-inflammatory medications like ibuprofen (400-600mg three times daily with food), physical therapy to strengthen the rotator cuff and scapular stabilizers, and occasionally corticosteroid injections for severe cases 1.
• Prevention of recurrent dislocations through rehabilitation exercises is crucial to avoid developing chronic tendon problems in the shoulder 1.
• Imaging studies such as ultrasonography and MRI can be helpful in diagnosing tendonitis and guiding treatment 1.

Recommendations for Management

• Relative rest of the affected area to prevent further injury 1.
• Icing to reduce pain and inflammation 1.
• Eccentric strengthening exercises to promote tendon healing and strengthen the surrounding muscles 1.
• Consideration of topical or systemic nonsteroidal anti-inflammatory drugs for acute pain relief, although these should be used with caution 1.

From the Research

Prior Shoulder Dislocation and Tendonitis

• There is no direct evidence in the provided studies to suggest that prior shoulder dislocation causes tendonitis 2, 3, 4, 5, 6.
• However, studies have shown that shoulder instability, which can be caused by prior shoulder dislocation, can lead to various shoulder problems, including rotator cuff injuries and labral tears 3, 4.
• A study on the treatment of traumatic shoulder dislocation found that labrum repair can reduce the risk of future shoulder dislocation, and that non-surgical management can also be effective in preventing recurrent shoulder dislocations 4.
• Another study found that postoperative NSAID use after arthroscopic rotator cuff repair can reduce opioid requirements and decrease patient pain levels, but does not lead to an increased risk of tendon retear 5.
• It is worth noting that the provided studies focus on the treatment and management of shoulder dislocations and instabilities, rather than the direct relationship between prior shoulder dislocation and tendonitis.

Risk Factors for Shoulder Instability

• Male sex, participation in sport, hypermobility in males, and glenoid index have been identified as risk factors for first-time shoulder instability 3.
• Male sex, age <30 years, and history of glenohumeral instability with concomitant injury have been identified as risk factors for recurrent shoulder instability 3.
• These risk factors may be relevant to understanding the relationship between prior shoulder dislocation and tendonitis, although more research is needed to establish a direct link.

Treatment and Management

• The treatment and management of shoulder dislocations and instabilities can involve a range of approaches, including surgical and non-surgical methods 2, 4, 5.
• The use of functional electrical stimulation (FES) has been shown to be effective in treating shoulder subluxation and shoulder pain in hemiplegic patients 6.
• However, the effectiveness of these treatments in preventing or managing tendonitis is not directly addressed in the provided studies.