Calcific Tendonitis Physical Therapy: Benefits, Tips

Calcific tendonitis results from the buildup of calcium in the shoulder, causing pain and limited range of motion. Symptoms can often be treated with physical therapy to restore the shoulder’s range of motion and improve rotator cuff strength.

This article reviews physical therapy exercises for calcific tendonitis and the general recovery timeline.

Location and Pain Sensation of Calcific Tendonitis 

Calcific tendinitis often leads to a dull ache in the shoulder that gets worse when you move your arm, limiting its range of motion. This condition also frequently causes increased shoulder pain at night, interfering with sleep.

When to Begin Rehabilitation 

It’s important to start rehabilitation for calcific tendonitis as soon as you can. If not treated, the condition may develop into a frozen shoulder, which leads to severe and painful stiffening of the shoulder joint. This can significantly limit movement and interfere with daily activities.

Shoulder Calcification Physical Therapy Exercises 

Exercises for calcific tendonitis focus on moving your shoulder through its full range of motion and strengthening your rotator cuff muscles to support and stabilize your shoulder.

You should also do exercises to strengthen the muscles that control your shoulder blades, like the middle and lower trapezius, rhomboids, and serratus anterior. This helps improve shoulder alignment and prevents shoulder impingement.

Shoulder impingement occurs when the rotator cuff tendons are pinched under the acromion, a part of the shoulder blade. It often occurs with calcific tendonitis and can worsen its symptoms.

A physical therapist will progressively increase the difficulty of your exercises as you build up strength and range of motion and will monitor your form to make sure that you are performing the exercises correctly and activating the right muscle groups. 

If your range of motion is significantly affected, your physical therapist will also stretch and mobilize your shoulder. Following your physical therapy visits, you will be provided with a home exercise program to improve your shoulder strength and range of motion at home.

Wall Slides

This exercise helps move your shoulder joint through different planes of motion.

To perform this exercise:

1. Hold a towel with both hands and press it against the wall in front of you.
2. Slide the towel up the wall as high as possible.
3. Slowly slide the towel back down to the starting position.
4. Repeat 20 times.
5. Next, keep the towel in contact with the wall and move your arm in a circular motion as if cleaning the wall.
6. Perform 20 clockwise circles and 20 counterclockwise circles.
7. Then, turn sideways, holding the towel against the wall at your side.
8. Slide the towel up the wall as high as you can to feel a good stretch.
9. Slowly slide the towel back down to the starting position.
10. Repeat 20 times.

Resisted Shoulder External Rotation

This exercise improves the strength of the rotator cuff muscles to stabilize and externally rotate your shoulder.

To perform this exercise:

1. Tie a resistance band to a railing or doorknob and stand at a 90-degree angle to it with your unaffected shoulder next to it.
2. Grab the loose end of the resistance band with the hand of your affected shoulder with your palm facing up and your elbow bent at 90 degrees.
3. While keeping your elbow hugged into your side, pull the band out to the side away from the railing without extending your elbow. Then relax.
4. Repeat for three sets of 10 repetitions.

Rows

This exercise improves the strength of muscles that control the alignment of your shoulder blades, including the rhomboids and middle trapezius.

To perform this exercise:

1. Secure a resistance band to a railing so that there are two loose ends, grabbing one end in each hand. 
2. While keeping a 90-degree bend in both elbows, pull the ends of the band back and squeeze your shoulder blades together. Your forearms should stay parallel with the floor throughout the movement. Then relax.
3. Repeat for three sets of 10 repetitions.

Theraband Shoulder Extension

This exercise improves the strength of muscles that control the alignment of your shoulder blades, including the rhomboids, middle trapezius, and lower trapezius.

To perform this exercise:

1. Secure a resistance band to a railing so that there are two loose ends, grabbing one end in each hand. 
2. Keeping your arms at your sides, pull your arms straight back while keeping your elbows fully extended as you squeeze your shoulder blades together. Then relax.
3. Repeat for three sets of 10 repetitions.

Band Pull-Aparts

This exercise improves the strength of the rotator cuff muscles to stabilize your shoulder, the posterior deltoid, and the muscles that control the alignment of your shoulder blades, including the rhomboids and middle trapezius.

To perform this exercise:

1. Grab a resistance band with two hands, keeping your palms facing up. Make sure there is at least a foot of distance between your hands.
2. Raise your arms up to shoulder height and while maintaining this position, pull your arms apart out to your sides to stretch the band. Then relax.
3. Repeat for three sets of 10 repetitions.

Ys and Ts

These exercises improve the strength of your rotator cuff muscles to stabilize your shoulders and muscles that control the alignment of your shoulder blades, including the rhomboids, middle trapezius, and lower trapezius.

To perform this exercise:

1. Lay face down.
2. Place your palms inward and point your thumbs up.
3. Lift both arms up like you are making the letter Y with your body. Then relax.
4. Then move both arms out to your sides like you are making the letter T. Then relax.
5. Alternate through the Y and T positions for 10 repetitions each.
6. Repeat for three sets of 10 repetitions.

 Tools and Exercise Aids 

Exercise equipment like light weights and resistance bands are useful to use during your rehabilitation for calcific tendonitis; increasing resistance during exercise will help your muscles get stronger.

Estimated Recovery Timeline

During your recovery, upper body and overhead movements for long periods of time will be difficult at first, which can impact your ability to work and engage in family and social activities. Jobs that have more physically demanding work duties will require a longer amount of time to recover and return to work. 

For most cases, you will need to attend physical therapy visits two to three times per week for one to two months. During and after your physical therapy sessions, you should expect to keep up with your progress by performing a home exercise program as well. 

Calcific tendonitis typically resolves over time as the calcium deposits in your rotator cuff tendons are eventually broken down by your body. This process can take up to 12-18 months.

The stages of calcific tendonitis include:

• Precalcification stage: Tendons undergo cellular changes that can make them more likely to form calcium deposits.
• Calcific stage: Calcium is excreted from tendons, forming calcium deposits. This phase is the most painful.
• Postcalcific stage: Calcium deposits are broken down and reabsorbed by the tendons, causing them to disappear.

How to Find a Physical Therapist

To find a physical therapist, you can use an internet search engine with the keywords “physical therapy” and your town to find PT practices near your location. You can also use the “find a provider” search function on the website of your health insurance company to find physical therapy providers in your area that accept your insurance. 

Physical therapists work at a variety of locations, including private practice physical therapy clinics, hospitals, and doctors’ offices.

Insurance Coverage and Costs 

The cost of your physical therapy visits will depend on your individual health insurance coverage. Most insurance companies approve a certain amount of visits at a time or per year, but these visits can often be extended if treatment is considered medically necessary.