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An Overview of Tendonitis of the Rotator Cuff

written by: AngelicaMD • edited by: Tania Cowling • updated: 5/5/2011

Shoulder pain is common and is usually caused by inflammation of the tendon (also called the rotator cuff) that connects its muscles to the bone. Learn more about the causes, symptoms and treatment of tendonitis of the rotator cuff.

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    What is Rotator Cuff Tendonitis?

    Tendonitis (or tendinitis) of the rotator cuff is the inflammation, irritation and swelling that afflicts the shoulder, resulting in pain and limitation of motion.

    The upper arm bone is attached to the shoulder bone and kept securely in place by the rotator cuff, anatomically the tendon of the shoulder muscles. This is a ball and socket type of joint with a wide range of motion. Being such, the shoulder joint may be subject to a lot of activities and stress, resulting in the damage of the tendon by wear and tear. This is due to the rotator cuff tendon rubbing against the bone repetitively, leading to irritation and swelling of the tendon. This causes pain, which in turn alarms the body to limit its mobility.

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    The Causes of Rotator Cuff Tendonitis

    Normal wear and tear damage occurs especially in people over 30 years old. Activities that require repetitive lifting the arm over the head like combing can gradually cause thinning of the rotator cuff tendon.

    Overstretching and friction on the rotator cuff due to overuse or repetitive motions in activities such as swimming, sports involving throwing (like baseball), tennis and house painting can cause rotator cuff injury and inflammation to the shoulder.

    A sudden pull or jerk on the shoulder causes unguarded injury by tearing (rotator cuff tears) or overstretching of the tendon and this can lead to tendonitis.

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    Symptoms

    The most prominent symptoms are pain and limitation of movement of the shoulder, especially when trying to lift the arm over the head as in combing the hair. The pain may be dull, achy or throbbing and it is felt all over the shoulder, especially on the side and front. The shoulder may be weak and can hardly lift the arm. The pain may also be felt while resting or lying on the affected side.

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    Diagnosis and Treatment

    Physical examination will reveal pain, weakness and limitation of motion in the affected shoulder. Bony spurs may be seen on x-ray images of the shoulder. MRI will show inflammation or a tear in the shoulder tendon.

    Treatment for tendonitis of the rotator cuff consists initially of resting the shoulder and avoiding activities that cause the pain. However, the shoulder should not be completely immobilized with a brace or splint to avoid leading to a frozen shoulder. Other modes of treatment include:

    • Application of ice to reduce the inflammation on the joint - this can be used alternately with heat therapy.
    • The use of nonsteroidal anti-inflammatory drugs (NSAIDs) to help reduce inflammation and pain
    • Physiotherapy, or physical therapy – consists of gentle exercises to mobilize the joint and strengthen the muscles; usually leads to improvement of the condition within a few weeks
    • Steroid injections – can be given on the affected shoulder if oral medications and physical therapy do not work immediately to relieve severe pain
    • Arthroscopic surgery – may be done to remove bone spurs and repair the torn or damaged tendon

    Prognosis or outcome of treatment is usually good, especially if the injury to the rotator cuff is minor or has not been there for a long time. Patients usually recover full function of their shoulder after adequate treatment.

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    References

    Gatorade Sports Science Institute, “Rotator Cuff Tendonitis”, http://www.amssm.org/MemberFiles/RotatorCuff.pdf

    WebMD, “Rotator Cuff Disorders”, http://www.webmd.com/a-to-z-guides/rotator-cuff-disorders-topic-overview