Rotator Cuff Tendinopathy

What Is Rotator Cuff Tendinopathy?

Rotator cuff tendinopathy is when a tendon in your shoulder has tiny tears in it or is inflamed and hurts. It’s usually caused by overuse or general wear and tear. Sometimes called tendinosis or tendinitis, this type of shoulder pain is more common in people over age 30. If it’s not treated, it can lead to stiffness or weakness in your shoulder and other long-term 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 used for more sharp, inflammatory shoulder pain.

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.

Symptoms of Rotator Cuff Tendinopathy

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
  • Loss of strength or range of motion
  • Joint stiffness

Rotator Cuff Tendinopathy Causes

As you get older, tendons and ligaments lose strength and take longer to recover. Rotator cuff tendinopathy is more likely to happen in these situations:

  • Repeatedly using your arms, especially in movements above your head
  • Not giving your rotator cuff muscles enough time to rest after overuse
  • Slumping forward
  • Having stiffness in your shoulder socket joint from an injury

Having bone spurs (smooth growths off the edge of bones) that rub up against the tendons of your rotator cuff

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Rotator Cuff Tendinopathy Diagnosis

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 should:

  • Ask about your symptoms.
  • Ask about your medical history and any recent falls or injuries.
  • Do a physical exam and take a close look at your shoulder.
  • 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.)
  • Possibly recommend an imaging test like an ultrasound or MRI to see if there’s any swelling or tearing of your tendons.

Rotator Cuff Tendinopathy 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 Neha Pathak, MD on September 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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