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 most commonly causes a dull ache in the shoulder that worsens with movement of the arm and limits the range of motion of the shoulder. The condition also often causes increased shoulder pain at night that interferes with sleep.

When to Begin Rehabilitation 

Rehabilitation for calcific tendonitis should begin as soon as possible. If left untreated, the condition can progress to a frozen shoulder, causing severe, painful stiffening of the shoulder joint capsule that significantly restricts movement and interferes with daily activities.

Shoulder Calcification Physical Therapy Exercises 

Exercises for calcific tendonitis include moving your shoulder through its full range of motion and increasing the strength of your rotator cuff muscles that support and stabilize your shoulder. 

Also perform strengthening exercises for the muscles that control your shoulder blades, such as the middle and lower trapezius, rhomboids, and serratus anterior, to improve the alignment of your shoulder. Strengthening these muscles will also prevent shoulder impingement, the pinching of the rotator cuff tendons under the forward projecting portion of the shoulder blade called the acromion, which often occurs with and worsens symptoms of calcific tendonitis.

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 out in front of you.
2. Slide the towel up the wall as high as you can.
3. Slowly slide the towel back down to the starting position.
4. Repeat for 20 repetitions.
5. Next, keep the towel in contact with the wall in front of you as you move your arm in a circular motion as if you are cleaning the wall.
6. Perform 20 circles to the right (clockwise) and 20 circles to the left (counterclockwise).
7. Then turn toward the side so that you are holding the towel against the wall out to your side.
8. Slide the towel up the wall as high as you can up to the side to feel a good stretch.
9. Slowly slide the towel back down to the starting position.
10. Repeat for 20 repetitions.

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.

Summary

Calcific tendonitis is a painful condition of the shoulder that develops from calcium deposits in the rotator cuff tendons, causing pain, stiffness, and decreased range of motion. While calcific tendonitis tends to resolve over time, physical therapy exercises can help improve your symptoms by increasing your shoulder mobility and strength of muscles that control your shoulder blade and shoulder joint alignment, to decrease compression of the rotator cuff tendons.  

A Word From Verywell

Calcific tendonitis can be a painful condition that limits your ability to perform everyday activities. If you feel that your pain, stiffness, and limited shoulder range of motion is interfering with your daily tasks, scheduling an evaluation with a physical therapist can help provide you with treatment and exercises to help alleviate your symptoms. If symptoms still do not improve with physical therapy, a cortisone injection or surgery may be recommended next.