Calcific Tendinopathy - When crystals, toothpaste, and bone grow inside your tendons!

Calcific Tendinopathy is one of the more unusual conditions we see, and occurs when hydroxyapatite and calcium phosphate (chalk like substances that are similar to bone) start developing into crystal like deposits within the tendons of the body. Any tendon throughout the body can be affected, with the rotator cuff muscles of the shoulder being one of the most common sites (80% of all rotator cuff cases in the supraspinatus tendon). The exact cause is still unknown, but females, people with diabetes, thyroid issues, and metabolic disorders tend to get it more.

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What does Calcific Tendinopathy feel like?

Calcific Tendinopathy usually has 3 stages, where each stage feels a bit different.

• Stage 1. The Pre-calcific stage: where the cells inside the tendon starts to transform allowing the calcium deposits to form. Pain is not usually felt at this point.
• Stage 2. The Calcific stage: where the calcium is deposited into the tendon and starts to build in size like crystals. This is normally when symptoms begin and people start to notice some shoulder pain. At the end of this stage where the body starts to reabsorb these calcium deposits, people tend to feel the most amount of pain.
• Stage 3. The Post-calcific Stage: where the tendon tissue remodels as the calcium is removed. This can last several months and finishes with complete healing of the tendon. Most people's pain will slowly go away throughout this stage.

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How is Calcific Tendinopathy treated?

For 90% of people, the calcium deposits disappear on their own but this may take from 12 to 18 months. For those who do experience pain that interferes with their daily life, this can be treated with anti-inflammatory medications, cortisone injections, physiotherapy, shockwave therapy, and as a last resort, surgery to remove the calcifications (which comes out like toothpaste!).

At Milsons Point Health, we work together with GP's and Shoulder Surgeons to provide the physiotherapy and shockwave options for people in the Milsons Point, Kirribilli, and North Sydney areas with painful calcific tendinopathy. Physiotherapy sessions involve determining which stage the condition is in, and putting together an exercise program to manage the pain, decrease inflammation, regain the shoulder movements, and strengthen the shoulder muscles.

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