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What Is Rotator Cuff Tendinitis?

rotator cuff examination

Rotator cuff tendinitis is often called impingement syndrome, bursitis, or biceps tendinitis due to inflammation of the connective tissue. The rotator cuff tendons rub against the overhanging part of the shoulder blade (acromion) and become irritated. Bursitis occurs if the bursa (a small sac of fluid under the tendon) becomes swollen or painful.

Most people can treat it at home if the condition is mild; however, with more severe rotator cuff tendinitis, working with an experienced physical therapist or orthopedic specialist is best.

The Rotator Cuff

A rotator cuff is a group of four muscles and tendons surrounding the shoulder joint. These muscles and tendons form a kind of cuff around your upper arm bone (humerus) and help support the joint, enabling it to rotate. They also give your arm stability at the shoulder socket, helping to raise and rotate your arm.

Causes Of Rotator Cuff Tendinitis

Overuse of your shoulder and repeated irritation to the area over time is a common cause of rotator cuff tendinitis. Some sports activities, work tasks, and hobbies that can lead to overuse include:

  • Throwing a ball or bowling
  • Hitting a tennis ball
  • Painting overhead
  • Lifting weights overhead or heavy repetitive lifting above the shoulder level
  • Working above the head repeatedly, such as with construction work or carpentry
  • Repetitive shoulder movements
  • Calcium in the tendons or sudden shoulder injury

When you lift something over your head, you can pinch one of the tendons of the rotator cuff between the shoulder blade and the upper part of the arm bone. This pinching is called impingement and can lead to inflammation or injury.

Symptoms Related To Rotator Cuff Tendinitis

Symptoms of rotator cuff tendinitis may be mild in the beginning and gradually worsen and include:

  • Pain in the front or side of the shoulder
  • Muscle weakness
  • Difficulty sleeping on the affected side
  • Pain, swelling, or stiffness in their shoulder area
  • Limited range of motion
  • Sudden, sharp pain when lifting or reaching
  • A clicking sound with shoulder movement

Not all these symptoms occur in every case of rotator cuff tendinitis; however, if left untreated, it can lead to a wholly or partially torn tendon.

Diagnosis Of Rotator Cuff Tendinitis

Your orthopedic doctor will first give you a physical examination which includes observing your movement and strength abilities, testing range of motion, weakness, pain, and stability. Your doctor may order an X-ray first because it can be done quickly and is good at identifying fractures and other causes of shoulder pain, but not soft tissue injuries, such as tendinitis. 

If your doctor suspects a cuff tear, they will use magnetic resonance imaging (MRI) to confirm a diagnosis of rotator cuff tendinitis.

Treatment For Rotator Cuff Tendinitis

In most cases, treatment of rotator cuff tendinitis begins with physical therapy and exercise. Physical therapy will help gently stretch and strengthen your muscles and the shoulder.

It is essential to work with an experienced orthopedic surgeon or physical therapist to ensure that you do these exercises with proper technique and consistency and not overwork your shoulder. However, it is necessary to avoid activities and lifting above the shoulder while still being active.

Along with physical therapy, other standard support treatments are:

  • Ice packs. Ice or cold packs on your shoulder will help reduce pain and inflammation and should be applied two times a day for at least 20 to 30 minutes. You can also massage the ice over the area where you have pain.
  • NSAIDs. Over-the-counter medicines such as Motrin, Advil, Aleve, ibuprofen, or Nuprin may also help to reduce pain and swelling. These aspirin-like drugs may have some side effects, so only take them as directed by your doctor.
  • Steroids. A non-surgical treatment, steroids, may often treat pain and inflammation and can be injected right above the injured tendon or a pill you may take at home. While injections may offer pain relief long-term, you should only use them sparingly and when expressly indicated.

Is Surgery An Option For Rotator Cuff Tendinitis?

Generally, rotator cuff tendinitis will not need surgery, and it is considered a last resort. Acromioplasty is the most common procedure for rotator cuff tendinitis. The surgery is done using an arthroscope, a small camera inserted into the shoulder joint through a small incision.

Your orthopedic doctor may also consider surgery if:

  • You can’t move your arm normally
  • You have pain that’s severe and limits normal daily activities and sleep (such as dressing or reaching up)
  • You’ve been seeking treatment for longer than six months, but physical therapy and medicines aren’t helping you

However, the success rate for surgery isn’t 100 percent, and surgery can lead to other complications. Your doctor will discuss the risks with you and will want to know what’s important to you when considering surgery. For example, your priorities might be returning to sports or being able to lift heavy objects at work.

See An Orthopedic Specialist

If you have symptoms of rotator cuff tendinitis, call us at Thunder Basin Orthopaedics and Sports Medicine today. Our surgeons and physical therapist have extensive knowledge and expertise in treating shoulder injuries, knee pain, lower back, and joint pain.

We will help you by developing a specialized treatment plan. Start today on your path to healing and recovery. Make an appointment today!