Rotator cuff tendinitis affects the tendons and muscles that help move the shoulder joint. Tendinitis means that these tendons are inflamed or irritated. Rotator cuff tendinitis may also be called impingement syndrome.
Tendinitis of the rotator cuff usually occurs over time. It can be the result of keeping the shoulder in one position over a period of time, sleeping on the shoulder every night, or participating in activities that require extending the arm over the head.
Athletes playing sports that require extending the arm over the head commonly develop rotator cuff tendinitis. This is why the condition may also be referred to as swimmer’s shoulder, pitcher’s shoulder, or tennis shoulder.
Sometimes rotator cuff tendinitis can occur without any known cause. Most individuals with rotator cuff tendinitis are able to regain full function of the shoulder without any pain.
Symptoms of rotator cuff tendinitis tend to worsen over time. Initial symptoms may be relieved with rest, but eventually the symptoms can become constant. Symptoms that go past the elbow usually indicate another problem.
Symptoms of rotator cuff tendinitis include:
- pain and swelling in the front of the shoulder and side of the arm
- pain triggered by raising or lowering the arm
- clicking sound when raising the arm
- pain that causes you to wake from sleep
- pain when reaching behind the back
- loss of mobility and strength in the affected arm
If you are having symptoms of rotator cuff tendinitis, your doctor will begin by examining your shoulder. He or she will check to see where you are feeling pain and tenderness. Your doctor will also test your range of motion by asking you to move your arm in certain directions.
Your doctor may also test the strength of your shoulder joint by asking you to press against his or her hand. He or she may also examine your neck to check for conditions such as a pinched nerve or arthritis that can cause symptoms similar to rotator cuff tendinitis.
Your doctor may order imaging tests to confirm the diagnosis of rotator cuff tendinitis and rule out any other causes of your symptoms. An X-ray may be ordered to see if you have a bone spur. Your doctor may order an ultrasound or magnetic resonance imaging (MRI) to check for inflammation in the rotator cuff and to check for any tearing.
Initial treatment of rotator cuff tendinitis involves managing pain and swelling to promote healing. This can be done by:
- avoiding activities that cause pain
- applying cold packs to the shoulder three to four times per day
- taking non-steroidal anti-inflammatory medications (NSAIDs) like ibuprofen and naproxen
Additional treatment may include:
Your doctor may also refer you to a physical therapist. Physical therapy will initially consist of stretching and other passive exercises to help restore range of motion and ease pain. Once the pain is under control, your physical therapist will teach you exercises to help regain strength in your arm and shoulder.
If the rotator cuff tendinitis is not being managed by more conservative treatment, your doctor may recommend a steroid injection. This is injected into the tendon to reduce inflammation, which reduces pain.
If nonsurgical treatment is not successful, your doctor may recommend surgery. Most individuals experience full recovery after having rotator cuff surgery. The most non-invasive form of shoulder surgery is accomplished via arthroscopy. This involves two or three small cuts around the shoulder, through which your doctor will insert various instruments. One of these instruments will have a camera, so your surgeon can view the damaged tissue through the small incisions.
Open shoulder surgery is usually not required for rotator cuff tendinitis. However, this method may be used if there are other problems in the shoulder, such as a large tendon tear. Any type of surgery involves recovery that consists of rest and physical therapy to restore strength and range of motion.
There are several things you can do to help reduce pain from rotator cuff tendinitis. These techniques can also help prevent rotator cuff tendinitis, or another flare-up of pain.
Shoulder self-care includes:
- using good posture while sitting
- avoiding lifting your arms repetitively over your head
- taking breaks from repetitive activities
- avoiding sleeping on the same side every night
- avoiding carrying a bag on only one shoulder
- carrying things close to your body