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Rotator Cuff Tendonitis

April 30, 2014

What are the causes?
The shoulder joint is a ball and socket type joint in which the top part of the arm bone (humerus) connects with the shoulder blade (scapula).  The rotator cuff is a group of four muscles that attach the humerus to the scapula.  The rotator cuff muscles help raise, rotate, and stabilize the shoulder.  The tendons of the rotator cuff pass underneath bony area on their way to attaching to the humerus.  Rotator cuff tendinitis occurs when the tendon rubs along the bone causing irritation and inflammation of the tendon.  This can be caused by:

• Poor posture caused by activities such as leaning over a desk
• Jobs that require prolonged positioning of the arm such as job duties of dental hygienists, hair stylists, and painters
• Sports such as baseball or swimming that require repetitive overhead activity
• Muscle tightness and/or weakness causing muscle imbalances surrounding the shoulder
• Bone spurs (overgrowth of bone) that narrow the space where the tendon passes

Over time the tendon may wear down and fray like a rope.  This can result in a rotator cuff tear!

What are the symptoms?
Pain is typically located in the front of your shoulder and can radiate to the side of your upper arm.  The pain commonly occurs during the following activities:

• Overhead activities such as brushing hair, reaching into a cupboard, or playing an overhead sport
• Reaching behind your back to perform activities such as washing your back or tucking in your shirt
• Laying on the involved shoulder

You may also have weakness and loss of motion making it difficult to raise your arm above your head or reach behind your back.

How can physical therapy help?
Physical therapy can help to decrease your pain and improve your shoulder function.  It is important to seek medical care early in order to prevent further damage of the rotator cuff tendon.  Early treatment can help you avoid surgery!  Physical therapy may involve the following:
• Patient education:  A physical therapist will suggest certain movements and activities to avoid or modify to allow the tendon to heal.
• Pain management: A physical therapist may use modalities such as ice, electrical stimulation, or iontophoresis to help decrease your pain.
• Range of motion: A physical therapist will teach you motion exercises and stretches to increase your shoulder mobility.  They may also perform manual therapy techniques to improve your shoulder range of motion.
• Strengthening: A physical therapist will assess the strength of your rotator cuff and scapular muscles; the therapist will then determine which exercises are best for your specific impairments.

References:
Andres BM, Murrell GA. Treatment of tendinopathy: what works, what does not, and what is on the horizon. Clin Orthop Relat Res. 2008;466(7): 1539–1554.

Senbursa G, Galtaci G, Atay A. Comparison of conservative treatment with and without manual physical therapy for patients with shoulder impingement syndrome: a prospective, randomized clincial trial. Knee Surg Sports Traumatol Arthrosc. 2007;15(7):915-921.

Impingement syndrome.  Retrieved from http://my.clevelandclinic.org/orthopaedics-rheumatology/diseases-conditions/hic-impingement-syndrome-of-the-shoulder.aspx

Physical therapist’s guide to rotator cuff tendinitis. Retrieved from http://www.moveforwardpt.com/SymptomsConditionsDetail.aspx?cid=1bd18bbc-e7ea-436d-bc9e-ffee9c4dbd87#.U151eBbF_ww

Rotator cuff problems.  Retrieved from http://www.nlm.nih.gov/medlineplus/ ency/article/000438.htm

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