What is Rotator Cuff Tendinopathy?

The rotator cuff is the name given to a group of four muscles which form a vital part of the shoulder joint. The rotator cuff muscles run from the shoulder blade to the top of the arm bone. Their main function is to move and support the shoulder joint. Without the rotator cuff muscles, it will be virtually impossible to move the shoulder in any direction or lift it up. The rotator cuff muscles are joined to the arm bone by tendons. If for any reason, there is swelling and inflammation of any of these tendons then it is termed as Rotator Cuff Tendinopathy. This usually causes pain, tenderness, and restricted range of motion of shoulder with palpable swelling. Physical therapy is perhaps the best way of treating Rotator Cuff Tendinopathy.

Overuse is perhaps the main factor responsible for causing Rotator Cuff Tendinopathy, although it can also be caused due to an injury or trauma to the shoulder as a result of a fall or being pushed while playing contact sports like football and rugby.

Supraspinatus muscle is the part of the rotator cuff muscle that is most commonly affected. The main function of this muscle is to assist the other muscles of the group in moving the shoulder sideways. The supraspinatus muscle actually passes through a very small space between the top of the arm bone and the shoulder which makes it susceptible to wear and tear and subsequent injuries.

With repetitive use of the shoulder, the tendons can rub against the bones causing inflammation and irritation of the tendons resulting in Rotator Cuff Tendinopathy.

The primary presenting feature of Rotator Cuff Tendinopathy is pain in the top of the arm. The onset of pain is gradual and is usually felt when lifting the arm overhead. During the initial phase of the injury, the pain will be felt with exercise and activity and will ease off at rest but as the condition progresses the pain will be felt at rest as well. There will also be associated tightness and stiffness with pain as a result of Rotator Cuff Tendinopathy.

With progression of the condition, the severity and intensity of the pain worsens resulting in reduced ability to use the arm and almost complete inability to lift the arm off to the side or up above the head. Some of the other symptoms of this condition are numbness and tingling along the shoulder area as a result of Rotator Cuff Tendinopathy.

The diagnosis of Rotator Cuff Tendinopathy is generally based on the symptoms with which the patient presents. The physician will first begin by taking a detailed history as to whether the patient has had a fall in the recent past landing on the shoulder or has been partaking in contact sports which may have resulted in an injury to the shoulder.

Once through with the history taking, the physician will then perform a detailed physical examination of the affected shoulder starting with assessing range of motion of the shoulder and the ability of the patient to lift the arm above the level of the head. The inability of the patient to do so will point towards rotator cuff pathology.

The physician will then order radiological studies in the form of x-rays and advanced imaging in the form of CT and MRI scans of the shoulder. This will clearly show inflammation of the tendons which will confirm the diagnosis of Rotator Cuff Tendinopathy.

The frontline treatment for Rotator Cuff Tendinopathy is applying ice and resting the shoulder. The patient will be asked to rest the shoulder for a few days and avoid any aggravating activities which may potentially irritate the tendon more and make the condition worse.

The patient will be recommended to ice the area with ice wraps or ice packs 15 to 20 minutes two to three times a day till the time the symptoms resolve. In some cases, the affected shoulder may be put in a sling to prevent any mobilization which may worsen the condition.

Once the inflammation is somewhat resolved and the pain caused due to Rotator Cuff Tendinopathy is under control the patient will then be referred to a physical therapist who will formulate an exercise regimen best suited for the patient.

Physical therapy for Rotator Cuff Tendinopathy may include exercise for stretching, strengthening, range of motion. During the physical therapy sessions it will also be determined why the tendonitis developed and ways to prevent future recurrences of Rotator Cuff Tendinopathy.

If an individual has incurred an injury to the shoulder and suspects that he or she may have Rotator Cuff Tendinopathy then it is best to go to a physician right away for treatment as ignoring this condition may cause further damage to the tendon to the point that it may need surgical correction.

Some of the don’ts for Rotator Cuff Tendinopathy are:

• Never try and raise the affected arm overhead.
• Try and avoid any aggravating activity which may worsen the condition.
• Try and avoid participating in any kind of contact sports as it may worsen the condition.

Once through with physical therapy, always return back to normal routine when the treating physician and the physical therapist gives the go ahead to return back to sporting and normal activities post treatment for a Rotator Cuff Tendinopathy.