What Is Rotator Cuff Tendinopathy?

The older you get, the more likely it is you’ll get rotator cuff tendinopathy (sometimes called tendinosis or tendinitis). This type of shoulder pain is more common if you’re over age 30. If not treated, it can lead to stiffness or weakness in your shoulder.  It usually responds well to conservative therapies, but if not treated it can lead to more chronic problems.

Each of your shoulders is made up by a group of muscles and tendons called a rotator cuff. This keeps your upper arm inside your shoulder socket. It also gives you the strength and motion to rotate and lift your arms.

The wear and tear on shoulders from repeated overhead activities can lead to recurrent injury and rotator cuff problems. This includes common activities like weightlifting, swimming, tennis, golf, and many physical jobs.  While historically this was called tendinitis, that term is now being reserved for more acute, inflammatory shoulder pain. Tendinopathy refers to the degenerative pain that results from wear and tear.     

People older than age 40 are most likely to have rotator cuff problems, in general. Genes may also play a part. If someone else in your family has shoulder issues, then you may be prone to get them, too.

What Are the Symptoms?

If you have rotator cuff tendinopathy, you will notice pain in the outer part of your upper arm and sometimes the front and top of your shoulder. This could be worse when you raise your hands above your head or reach behind you. It could also wake you up at night.

You also might notice swelling and tenderness in the front of your shoulder, a “clicking” in your shoulder when you raise your arms over your head, or loss of strength or range of motion

How Is a Diagnosis Made?

Many different things can cause shoulder pain. It could be a pinched nerve or arthritis. To find out for sure, you’ll need to see your doctor. They’ll ask about your symptoms and take a look at your shoulder. They’ll test your arm strength and ask you to move your arm in different ways so they can check your range of motion.It is important for your doctor to decide if there might be a complete tear in your rotator cuff because this more often requires surgery, especially in younger people.

An imaging test like an ultrasound or MRI can help, too. These will let your doctor see any swelling or tearing of your tendons.

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What’s the Treatment?

Many times, rotator cuff injuries can be treated at home if the injury was sudden. Treatments include:

  • Over-the-counter medicine. Anti-inflammatory pain relievers like aspirin, ibuprofen and naproxen can help ease your shoulder ache.
  • Rest. You’ll need to stop any physical activity that causes or adds to your shoulder pain.
  • Ice. A cold pack can help reduce swelling and pain. Use for 15 to 20 minutes every few hours.
  • Heat. Once your pain starts to go away, you can use a heating pad to lessen any stiffness in your shoulder.
  • Stretching. Your doctor can give you daily exercises to do at home to get your shoulder more flexible. Doing these in a hot shower may help.

Usually, a specific traumatic rotator cuff will heal in 2 to 4 weeks. But if it is a severe injury, or it is a chronic injury from wear, it may require months to improve. If the pain is getting in the way of your daily life or you injure yourself again, your doctor might suggest:

  • Steroids. A shot injected in your shoulder joint can help with the soreness.
  • Physical therapy. Your trainer can guide you through exercises to help you regain strength and motion in your shoulder.
  • Surgery. This is rare. Unless you’re young and had an acute, traumatic shoulder injury, surgery is a last resort for rotator cuff tears.
WebMD Medical Reference Reviewed by Sabrina Felson, MD on July 15, 2020

Sources

SOURCES:

Mayo Clinic: “Rotator Cuff Injury.”

Cleveland Clinic: “Rotator Cuff Tendinitis,” “Shoulder Tendinitis.”

OrthoInfo/American Academy of Orthopaedic Surgeons: “Shoulder Impingement/Rotator Cuff Tendinitis.”

UptoDate: “Patient Education: Rotator Cuff tendinitis  and tear (Beyod the basics.)”

Johns Hopkins Medicine: “Shoulder Tendinitis.”

Hospital for Special Surgery: “Rotator Cuff Tears, Injuries and Treatment.”

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