In most cases, calcific tendonitis can be treated using non-surgical techniques, including NAT
If you’re experiencing stiffness and shoulder pain and it’s making it hard for you to sleep at night, you could have Calcific Tendonitis.
With this condition, 1- 2 centimeter deposits of calcium form in the tendons of the rotator cuff. As the calcium accumulates, the area becomes very tender and it is difficult to lift your arm without experiencing pain and stiffness.
The pain is typically felt around the rotator cuff muscles (usually supraspinatus) and is often misdiagnosed as frozen shoulder syndrome.
The good news is that in most cases, calcific tendonitis can be treated using non-surgical means.
Calcific Tendonitis often develops as a result of overhead activities like playing tennis or house painting.
When muscles and tendons rub against one another over and over again, it can cause inflammation.
Calcium then develops as part of the body’s attempt to repair this damage. Poor posture is another common cause and there is a growing school of thought that some metabolic diseases of the parathyroid glands in the neck may generate extra calcium.
Very often the cause is simply a cyclical process that occurs over time, leading to a build up of calcium.
During the day, regular arm movements may shut off some of the blood flow to the supraspinatus muscle. Then, when you are resting or sleeping at night blood flows back into the area to compensate.
This cyclical pattern may cause calcific tendonitis to develop over time.
Stages of Calcific Tendonitis
Calcific tendonitis exists in two different forms. With Degenerative Calcification, calcium accumulates in weak, run-down tendons that develop as we get older. Reactive Calcification, on the other hand, progresses through a series of stages:
In the Pre-Calcification Stage, you don’t experience any symptoms. At this point, the tissue in the area where the calcium will develop goes through cellular changes.
In the Calcific Stage, calcium comes out of the cells and forms into deposits. At this point, the calcium looks like chalk.
There is a Resting Phase, where you will experience no pain. During the Resorptive Phase, the pain returns and can become quite excruciating. At this point, the calcium is the consistency of toothpaste.
Finally, in the Post-Calcific Stage, the calcium disappears and is replaced by the normal rotator cuff. At this point, the pain goes away.
Although there are a number of stages, it is not always a long process. In some cases, the condition is resolved in about 4 weeks.
Calcific tendonitis is seen most often in people between the ages of 30-50, and more often in women than in men. People who have diabetes are more susceptible to developing the condition.
Location of calcium deposits
Calcium is most frequently deposited in the rotator cuff of the shoulder. The following are the most common areas where we find calcium deposits (Stefani 2009):
Supraspinatus muscle - 80%
Infraspinatus muscle - 15%
Subscapularis muscle - 5%
Aggressive treatment is not recommended in the acute phase (which usually lasts 3-5 days) as it can stir-up the already active condition.
There are however, gentle hands-on techniques that experienced therapists can use to help reduce the acute symptoms.
Once the acute phase has settled down it doesn’t mean the calcium has gone away and in fact many people are left with some shoulder stiffness as the calcium will stay in the shoulder tendons until it is removed or is slowly reabsorbed.
This stiffness can in many cases be rapidly and effectively treated with NAT.
Silent calcium deposits that are also common. These calcium deposits can be re-activated with overhead or vigorous activities such as swimming or tennis.
It is not uncommon to have silent phases of 1-2 years between the acute episodes. Your manual therapist or NAT practitioner will advise you on what you can do to prevent further episodes and reduce severity as soon as the twinges appear.
About NAT Courses
As a manual therapist or exercise professional, there is only one way to expand your business - education!
Learning more skills increases the services that you offer and provides more opportunity for specialization.
Every NAT course is designed to build on what you already know, to empower you to treat more clients and grow your practice, with a minimal investment in time and money.
About Niel Asher Education
Niel Asher Education is a leading provider of distance learning and continued education courses.
Established in the United Kingdom in 1999, we provide course and distance learning material for therapists and other healthcare professionals in over 40 countries.
Our courses are accredited by over 90 professional associations and national accreditation institutions including the National Academy of Sports Medicine (NASM) and National Certification Board for Therapeutic Massage and Bodywork (NCBTMB). Full details of all international course accreditations can be found on our website.
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NAMTPT AWARD 2017
We are honored to have received the 2017 "Excellence in Education" Award from the National Association of Myofascial Trigger Point Therapists.
Since 1999 Niel Asher Education has won numerous awards for education and in particular for education and services provided in the field of trigger point therapy.
Award Winning Instructors
Niel Asher Healthcare course instructors have won a host of prestigious awards including 2 lifetime achievement honorees - Stuart Hinds, Lifetime Achievement Honoree, AAMT, 2015, and Dr. Jonathan Kuttner, MD, Lifetime Achievement Honoree, NAMTPT, 2014.
If you are a qualified/licensed manual therapist or exercise/fitness professional you can expand your credentials with NAT certification.
In addition to national accreditation for continued education, each course that we offer includes "NAT Learning Credits". By taking and completing courses you can accumulate NAT credits to qualify for NAT certification.
There are currently 3 levels of NAT certification. Certifying NAT is a valuable way to show your clients that you take continued education seriously, and to promote your skills and qualifications.
NAT courses are accredited for continuing education by over 30 professional associations in North America, United Kingdom, Australia, and European Union countries. These include The National Academy of Sports Medicine, Physical Therapy Board of California, AAFA, National Certification Board for Manual Therapists and Bodyworkers, Sports Therapy Institute, and Myotherapy Australia.
Niel Asher Technique
Since 1999 the Niel Asher Technique for treating trigger points has been adopted by over 100,000 therapists worldwide, and has been applied to the treatment of a number of common musculoskeletal injuries.
The Niel Asher Technique for treating frozen shoulder was first introduced and published in 1997 and has been widely adopted by therapists and exercise professionals working within elite sports and athletics.
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This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell.
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