Calcific supraspinatus tendinitis

In calcific supraspinatus tendinitis, deposits of calcium hydroxyapatite form within the tendon, often in an otherwise intact rotator cuff. These deposits are most commonly located in the supraspinatus tendon as it passes through the subacromial space, and as they enlarge or change consistency they can mechanically irritate the surrounding tissues, producing symptoms similar to subacromial pain or rotator cuff tendinopathy.

The condition is often described in phases: an initial calcific phase in which deposits form and may cause little or no pain, a resorptive phase in which the body actively breaks down the calcium and triggers a marked inflammatory response, and a later repair phase in which the tendon remodels. During the resorptive phase, pain can be severe, especially at night and with movement, and shoulder range of motion may be significantly limited. Diagnosis is based on the pattern of symptoms, physical examination and imaging such as X-ray or ultrasound, which typically show a calcific density near the supraspinatus insertion.

Calcific supraspinatus tendinitis is usually managed conservatively at first, and physiotherapy plays a key role in pain control and functional recovery. During very painful phases, the focus is on finding comfortable rest positions, modifying aggravating tasks and maintaining gentle, tolerable movement so that the shoulder does not stiffen. As symptoms ease, the programme progresses to range-of-motion exercises, scapular control and graded strengthening of the rotator cuff, matched to the tendon’s current load tolerance.

Rehabilitation typically starts with low-load, simple exercises and gradually advances to more dynamic and functional activities that reflect work or sport-specific demands. Your physiotherapist may work alongside your doctor if additional options such as medication, shockwave therapy or image-guided procedures are being considered, where appropriate for your situation. The overall aim is to improve the shoulder’s load capacity step by step, reduce painful flare-ups and support a safe return to your usual daily and leisure activities.