The rotator cuff is a group of four muscles that surround the shoulder joint and help to keep it stable. Shoulder tendonitis is a condition caused by inflammation of the rotator cuff and/or biceps tendons. These tendons connect the rotator cuff and bicep muscles to adjacent bones.
Shoulder tendonitis can vary widely from case to case in terms of its severity. In some cases, the inflammation may be mild and may affect only part of the rotator cuff. In other cases, it can be severe enough to affect most of the tendons of the rotator cuff and biceps.
This injury is usually the result of the tendon being pinched by adjacent structures. This condition is often referred to as rotator cuff impingement syndrome. The rotator cuff tendon passes through a narrow space between the acromion process of the scapula and the head of the humerus. Any process which causes further narrowing of this space can precipitate impingement syndrome. It can occur in sports that require the arm to be used in repeated overhead activity or in abducted position e.g. weightlifting, racket sports, baseball or even certain swimming strokes. When the shoulder tendonitis arises from inflammation of a rotator cuff tendon, it is also called rotator cuff tendonitis.
Shoulder weakness, pain and tenderness, as well as an inability to hold the arm in certain positions, are the typical symptoms. A frequent complaint is night pain, often disturbing sleep, particularly when the patient lies on the affected shoulder. There may be a grinding or popping sensation during movement of the shoulder. Onset of symptoms may be acute, following an injury, or insidious, particularly in older patients, where no specific injury occurs.The injury is most commonly treated by resting and icing the shoulder and allowing the injured tendons to recover naturally.
Shoulder tendonitis may often co-exist with shoulder bursitis, and the two conditions have very similar symptoms. Rotator cuff muscle tears may also exhibit similar symptoms.
One of the most common causes of shoulder tendonitis is the pinching of a rotator cuff tendon. This can happen, for example, if it gets stuck within the shoulder blade socket. Another name for this type of injury is rotator cuff impingement, which is alluded to above.
Another common cause of this condition is overuse of the shoulder and the four muscles that control its movements. These four muscles and their tendons form a “cuff” known as the rotator cuff. The rotator cuff muscles help to secure the ball of the upper arm bone within the shoulder socket.
Overworking the rotator cuff muscles can result in the tendons that connect them to the bones of the shoulder becoming irritated. Inflammation and swelling of these tendons can then soon develop.
Activities that require movement of the arm above the shoulder can overwork the shoulder muscles if they are repetitive enough. Examples of these activities might be:
In addition to the above activities, there are a number of factors that can increase the chances of developing shoulder tendonitis:
Shoulder tendonitis symptoms may include:
These symptoms can also be experienced with other shoulder problems, like shoulder bursitis for example. Anyone experiencing these symptoms would be wise not to automatically assume they are due to shoulder tendonitis. Instead, the best course of action would be to seek medical advice as soon as possible.
If medical help is not obtained soon enough, the symptoms may gradually worsen to include:
Left untreated, shoulder tendonitis can progress to affect many activities that we take for granted in everyday life.
To understand the cause of the symptoms described above, a doctor will likely review your medical history. He or she will be interested in any instances of previous shoulder injuries and how they may be related to the current problem.
He or she will also likely perform a physical examination of the injured shoulder. The patient may be asked to hold his or her arm in various positions. The goal of the doctor will be to see which arm positions the patient has difficulty holding.
A doctor may also request an imaging study of the injured shoulder using X-ray, MRI or ultrasound technology. Ultrasound and MRI scanning are the two most useful investigations in the diagnosis of rotator cuff problems. However, current evidence suggests that ultrasound is as good as MRI in diagnosing rotator cuff injuries. An MRI study, for example, will provide detailed images of the structures (including soft tissues) in the shoulder joint. The doctor can use these images to assess the type and extent of damage inside the shoulder joint.
The most common treatment strategy recommended by doctors for shoulder tendonitis will include the following:
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