 In the shoulder, the tendons sort of tear off the bone as opposed to tearing where the muscle meets the tendon. As you get more mature, these tendons start to slowly degenerate. This causes them to hurt with too much stress. We're not sure why that happens, but we know that if tendons see too much stress over a short period of time, a lot of times it's not really inflammation as we know it. It's really considered something that's more of an osis, so we call it painful tendinosis, which doesn't really matter very much, but it does in terms of what sort of things you use to try to make it get better.