It has been a while since I blogged. I guess 4th yr at Osteopathy school and general busyness at work get in the way - after a 12hr day (for example Mondays comprise of school clinic in the morning 8.40am-12.40pm, then my own Moorgate clinic 2.15-8.15pm, and home at 9pm), the last thing I want to do is sit down at a computer and reflect on the day. But then if I don't, it never happens. So today (a Monday), it is 10.30pm, and I am writing this up now before I wake up tomorrow and am busy all over again.
Calficic Tendonitis. What's that? Well, I had heard about it, but last week. I actually had it, so I'm pretty well placed to tell you all about it. At this stage, all you need to know is, it's PAINFUL!
For some people, calcium deposits will build up in a tendon - often Supraspinatus, sometimes Biceps Brachii, I've even heard (now that I have looked into it) of it occurring in an anterior thigh muscle (Rectus Femoris). For me, it happened in Long Head of Biceps (LHB) - I had felt it coming on for a couple of weeks - a strain on my biceps tendon, getting progressively stronger, I tried self-massage, foam rolling, IAM tool, nothing really helped... then on Friday last week after a typical but not too intensive day at work, my right shoulder really started to hurt. I wondered what I had done, I couldn't pin it down to anything in particular. On Saturday morning, when I work up, I couldn't move my arm without intense pain kicking in. Particularly in Internal Rotation and Adbuction (taking your arm out to the side), but also in flexion, extension and lateral rotation. I was puzzled - this wasn't the usual type of impingement. Getting dressed was intensely hard work, as I couldn't lift my arm above my head. I couldn't lift it at all. I was a little bit worried, as obviously I need my arms for my work.
It was a school weekend; I let a couple of my school friends work on some of the soft tissues of my shoulder to see if it would help, it certainly didn't make things worse, but it didn't have too much of an effect. I know in my line of work, sometimes you just have to let something really acute run its cause, and then jump into treatment when it eases off and allows intervention. I decided to adopt this approach - wait and see. I iced it for about an hour on Saturday evening. I woke up on Sunday morning at 5am with acute pain throbbing from the biceps tendon. Still couldn't move my arm in any range of movement all throughout Sunday. I booked an appointment with an Osteopath I work with on the Tuesday.
Monday I felt things start to ease off a little - I began to get a little bit more movement with a little less pain, back into my arm. I actually had to work on Monday afternoon/evening, and fortunately, it didn't impact my work too much at all (I did tell my patients that I might be limited by my shoulder pain, but it wasn't really an issue). When I got home, I noticed a lump on the biceps tendon, which most certainly wasn't there before.
On Tuesday, the bump on the biceps tendon had all but disappeared, as had about half of the pain and I was back to about 50% full range of movement in the shoulder. The osteopath I see is super experienced and instantly diagnosed it as calcific tendonitis or bursitis. Bursitis as I have never had this before and it could have been a one off, but i think it was probably the tendonitis form as I felt it build up in the Long Head of Biceps and the fact there was a lump there, which had disappeared.
On Wednesday, I had full range of movement back in the shoulder, and just a mild residual supraspinatus impingement.
With something like Calficic Tendonitis, for whatever reason, the body lays down calcium in a tendon and this is generally asymptomatic (you don't feel it). At some stage, the calcium will be released (and re-absorbed by the body) - this is the stage that hurts. It goes on to cause acute local inflammation - everything around it will swell up within the shoulder, giving what appears like Adhesive Capsulitis aka frozen shoulder aka a shoulder joint that cannot move because of intense pain. Fortunately, this stage ends once the calcium deposits have been reabsorbed by the body. I am lucky in that this only lasted a few days. Some people have shoulder problems that can last for a long time and require surgical intervention to resolve. Calcific Tendonitis is likely to occur again, but at least I am now prepared for it.
And as someone who deals with a lot of patients with shoulder problems, I can honestly say I have a renewed insight into shoulder pain and dysfunction and how it effectively disables you. It made it very painful and hard to get dressed, have a shower, I had to transfer all weight bearing activities to my left arm, couldn't park my scooter on it's stand, had to sleep upright with pillows, and so on. I was also guarding my arm and shoulder a lot, something I am always telling my patients off for, but I realise now it's a completely subconscious thing, you can't help it. Insight like this is invaluable. At Osteopathy school, I'm encouraged to reflect on all my experience and see what I learned, and this was most certainly a fascinating learning experience!