Soft tissue lesions of the shoulder

Chronic wear and tear and overuse of a shoulder can lead to various lesions (injuries) of the soft tissue of the shoulder (muscles, tendons, capsules, etc.).


Chronic wear and tear and overuse of a shoulder can lead to various lesions (injuries) of the soft tissue of the shoulder (muscles, tendons, capsules, etc.). Typical symptoms include exertion-related pain, combined with restricted mobility. Sufferers should take it easy, but shouldn't immobilise the shoulder.


Main symptoms

  • Shoulder pain
    • Movement-related
    • Spontaneous pain and pain at rest
    • Pressure pain, pain when lying on the sore side

Other symptoms

  • Restriction of movement, including stiffening (“frozen shoulder”)
  • Weakness, impossible to stretch arm horizontally
  • Swollen and overheated joint
  • For torn biceps tendon: bulging muscle in the centre of the upper arm

Causes and treatment


  • Chronic wear and tear of the soft tissue of the shoulder (muscles, tendons, etc.)
    • Regular (over)use of the shoulder, jerking movements
    • Age-related processes
    • Creeping process
    • Seldom caused purely by an accident (e.g. accompanying injury to shoulder luxation)
  • Recurrent infection of joint capsule
  • Chronically thickened, inflamed bursa
  • Bone spurs
  • Calcification of tendons and joint capsules (“calcific tendonitis”)
  • Squeezing and compression of the muscle and tendon sheath (impingement syndrome)
  • Weakening, fraying and finally tearing of muscle fibres or tendons (rotator cuff)
  • Arthrosis in the shoulder joint

Further treatment by your doctor / in hospital

Possible tests
  • Examination of shoulder muscles and surrounding structures
  • Testing of mobility and neurological functions
  • Imaging procedures
    • Ultrasound (first choice)
    • X-ray
    • MRI (magnetic resonance imaging)
Possible therapies
  • Medication, injections into and around the joint
  • Physical therapy
    • Movement exercises
    • Also electrotherapy, shock wave therapy
  • Alternative methods (e.g. acupuncture)
  • Operation (if other options are unsuccessful)
    • Minimally invasive procedures are often an option (“keyhole surgery”)
    • Follow-up treatment lasts weeks to months

What can I do myself?

  • Try out each of the different measures individually
  • Treat gently (but don’t immobilise!)
  • Avoid sports and activities that require reaching overhead
  • Cooling
  • Heat treatment (not while inflamed)
  • Maybe fango treatment (mineral mud) or baths

When to see a doctor?

  • Pain and restricted movement in shoulder
  • Swollen and reddened shoulder
  • Suspicion of injury to a muscle or tendon
  • Acute loss of strength or signs of paralysis in the arm


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Exclusion of liability

CSS offers no guarantee for the accuracy and completeness of the information. The information published is no substitute for professional advice from a doctor or pharmacist.