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Rotator Cuff Tendonitis
Rotator cuff tendonitis is one of the most common
conditions affecting the shoulder. It is generally caused by
overuse or overload. Overuse or overdoing shoulder exercise
can happen in sports like swimming or during
throwing sports, where the repetitive motion of the arm
causes irritation to the cuff. Tensile overload is when the
shoulder experiences a sudden pull or jerk and can lead to
rotator cuff tendonitis. An example of tensile overload to
the shoulder is when a person is walking a dog and the dog
pulls hard on the leash, resulting in a sudden jerk or pull
to the shoulder. The rotator cuff muscles are four very
small, fragile muscles named supraspinatus, infraspinatus,
subscapularis and teres minor. The purpose of these four
muscles is to help the arm attach and move properly in the
shoulder socket. Of the four muscles, supraspinatus is the
most important and the most commonly injured.
What are the symptoms of rotator cuff tendonitis?
When the rotator cuff is injured, pain results from
inflammation to the muscle group. You may feel pain that is
dull, achy, throbbing or piercing. The pain often does not
focus on one spot, but occurs in the general location of the
shoulder. The pain often worsens when raising the arm
overhead or while resting in bed at night. The history and
physical examination given by a physician helps make the
diagnosis. X-rays of the shoulder are often taken, but not
always. X-rays do not show the rotator cuff muscles only the
bones of the shoulder, but may provide useful clues for
diagnosis. Most of the time, a doctor will not request a MRI
of the shoulder until certain treatments have been tried.
Treatment for rotator cuff tendonitis:
The most common treatments for rotator cuff tendonitis
include:
- Ice, anti-inflammatory medications and rest. These
basic treatments focus on reducing inflammation and pain
to the shoulder. If you have already tried these
remedies, your physician may recommend other treatments.
- Physical therapy. Physical therapy will improve your
shoulder condition generally 70 percent of the time. You
have a choice of pursuing exercises under the guidance
of a physical therapist or at home.
- Physical therapy exercises focus on strengthening
the rotator cuff and reducing inflammation and pain. One
of the benefits of physical therapy is that the shoulder
can improve after just a handful of treatments (often 6
to 8 therapy sessions).
- Injection to the rotator cuff. If busy schedules
don’t allow time for physical therapy sessions, an
injection by a physician is a useful treatment.
Injecting medication to the area is successful in
improving symptoms from rotator cuff inflammation about
70 percent of the time. The injection usually contains
about a teaspoon of a combination of two medications.
One is a medicine to numb the shoulder, like lidocaine.
The other is an antiinflammatory
- Medication, such as cortisone. The injection is
given in a small space of the shoulder called the
subacromial space, not into the shoulder socket. The
shot is generally not painful, and is often compared
with the sensation of having blood drawn from the arm.
After the shot, you should rest the arm for about 48
hours, which means not doing any heavy lifting or
repetitive motions, to avoid causing additional shoulder
pain and irritation. Check with the governing
organization for your sport first. Some organizations
may have a policy restricting or banning cortisone use.
If pain continues, stay in touch with your doctor who may
use further tests to find the cause. Other causes of pain do
not improve with these treatments, such as: a small tear to
the rotator cuff, a tear to the cartilage around the
shoulder joint, a tight bony spot that continues to cause
inflammation or excessive looseness to the shoulder. You and
your physician can make choices about diagnostic tests if
the pain in the shoulder continues.
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