RISK FACTORS.

* Age: 30 and over
* Always using the arm in an overhead position or throwing motion, as in:
o Tennis or other racquet sports
o Swimming
o Baseball
o Jobs (eg, overhead assembly work, butchering, or using an overhead pressing machine)
* Pre-existing degeneration.

* some medications

* collagen diseases (eg Marfan’s)

* genetics (eg blood group ‘O’)

* medical conditions such as rheumatoid arthritis or diabetes mellitus.


SIGNS AND SYMPTOMS.


Symptoms develop gradually over time and pain slowly increases with use.

* Pain (a dull ache) in the shoulder and upper arm
* Pain at night, especially when sleeping on the injured side
* Pain when trying to reach for a back zipper or pocket
* Pain with overhead use of the arm
* Shoulder weakness, usually due to pain with effort
* Shoulder stiffness with some loss of motion

Regardless of the site of the tendinopathy, the history is likely to be similar, and can usually be plotted against increased loading of the tendon. Symptoms develop gradually. Many clients will admit to a recent change in training volume and/or intensity. Pain and stiffness are often worse first thing in the morning, particularly after a hard training session the previous day, and will improve once they ‘get moving’. Pain at the onset of activity that settles during performance and worsens again afterwards is typical. As the condition intensifies, clients may report pain throughout training and competition and, in the worst cases, during rest. Often functional exercises are required to elicit pain