Too Much Calcium in my Tendon? Understanding Calcific Tendonitis

Calcific tendonitis, also known as calcific tendinopathy or calcifying tendinitis, is a condition characterized by the formation of calcium deposits within a tendon. It is most frequently seen in the rotator cuff tendons surrounding the shoulder.

Why does it happen?

Everyone heals a bit differently. For some individuals part of the healing process involves calcifying the damaged elements of tendon to fortify them and prevent extension of tears. There is research that suggests that this actually does help prevent tear extension and the development of full thickness tears. Unfortunately, there is a cost to this. At some point, the osmotic gradient allowing the deposition of calcium in the tissues is reversed and the ionic form of calcium is now being released into the subacromial space. This can often be prompted by a minor trauma to the area of the tendon that may not even be obvious to the patient. The result is an intense inflammatory reaction that mimics the symptoms associated with a rotator cuff tear.

What can be done?

Luckily, most cases of calcific tendinopathy will "burn out" as the calcium stored in the tendon is released and reabsorbed into the blood stream. Unfortunately the time that this process takes is highly variable and may take many months for large calcium deposits to reabsorb.

In cases where patient's are struggling with significant discomfort in the shoulder, we find that corticosteroid injection around the lesion can be highly effective in limiting the degree of inflammation. Also, by trephinating the lesion with a small needle during the injection process we can also facilitate the egress for calcium and hopefully shorten the duration of overall symptoms.

Typically, after resolution of the acute inflammatory symptoms people attend a physical therapy program to return their shoulder to normal biomechanical function. If the shoulder is left in its unrehabilitated state often patient will have the return of inflammation secondary to impingement of the rotator cuff and the overlying acromion.