Diagnosis: Rotator Cuff Tendinopathy
What is Rotator Cuff Tendinopathy?
Rotator cuff tendinopathy, also known as shoulder tendonitis, is where the tendons of the rotator cuff muscles around the shoulders become irritated and inflamed1.
Symptoms of Rotator Cuff Tendinopathy
Many people with Rotator cuff tendinopathy usually present with one or more of the following symptoms:
- Shoulder clicking and pain when raising arm above shoulder height1
- Swelling in the front of the shoulder2
- Pain when lying on the affected shoulder1
- Shoulder and upper arm pain (can refer down to the elbow)1
- Loss of movement and strength in the affected arm2
- Stiffness of the shoulder2
How is Rotator Cuff Tendinopathy Diagnosed?
The diagnosis of Rotator Cuff Tendinopathy can be difficult to make, as there are many structures can give rise to pain. However, providing a good history of the symptoms and the physical examination can help confirm the diagnosis2. The physiotherapist may also ask about any neck problems as it can cause pain in the shoulder similar to a tendinopathy. In the physical examination the physiotherapist can: test the strength of the muscle around the shoulder to see if there is any weakness or pain, move the shoulder joint to assess pain and rotate the shoulder in and out as well as up and down to see if this reproduces any symptoms1. In some cases, the shoulder may needed to sent for imaging to rule out other causes of the pain such as shoulder arthritis3.
What Causes Rotator Cuff Tendinopathy?
The rotator cuff is a group of four muscles around the shoulder that help rotate the shoulder inwards and outwards such as when pitching a baseball. There are two different ways that rotator cuff tendinopathy can occur2. The first is from placing excessive stress on the tendons of these muscles by overworking them2. This causes the tendon to swell causing pain. Another way is that the tendons become compressed. The rotator cuff tendons travel through a tunnel surrounded by joints called the coraco-‐acromial arch3. When the distance between the top of the arch and the tendon decreases, which can happen due to a number of reasons such as: tight muscles and reduced shoulder blade movement, the tendon becomes compressed when moving the shoulder up causing pain3.
How is Rotator Cuff Tendinopathy treated?
The treatment of rotator cuff tendinopathy is very successful, with most cases resolving well3. At first it may be very difficult to move the arm due to pain, so it is best to rest and ice the affected area, as well as reducing any movements that cause pain such as; sleeping on the affected arm and moving it above the head. Afterwards, with the physiotherapist may provide some gentle movements to the arm and set a stretching and strengthening program for the shoulder. These exercises may include stretching pulling the arm across the body, or using a resistance band to rotate the shoulder in and outwards. Prevention is the best treatment of rotator cuff tendinopathy. The physiotherapist may provide some advice on your daily activities in order to prevent a recurrence.