Rotator Cuff Therapy Exercises

Tendonitis of the Rotator Cuff

Tendonitis of the rotator cuff is one of the most common conditions that affect the shoulder joint.

Of all the rotator cuff shoulder symptoms that people take to their doctors, it is, for the majority, the easiest to treat. That is not to say it isn’t painful and debilitating because it is.

Unfortunately there is a small percentage of the population for whom tendonitis of the rotator cuff is not so easy to treat. In this small percentage symptoms can be not only severe but can persist for a long time.

In this section I aim to describe what is rotator cuff tendonitis and define the symptoms associated with tendonitis of the rotator cuff.

Please bear in mind that all rotator cuff symptoms will vary from person to person. What I will show is the most common symptoms and tests used to diagnose the condition.

What causes tendonitis of the rotator cuff

The generally accepted view is that tendonitis of the rotator cuff is caused by overuse. The tendons are damaged with tiny tears developing on a microscopic level. This is a natural phenomenon and generally nothing to be worried about. The problem begins when these microscopic tears have insufficient time to heal properly and then are damaged again.

This process, repeated again and again over time, is what causes the pain and swelling associated with tendonitis rotator cuff. The tendon is weakened by the production of scar tissue. The tendon is composed mainly of collagen molecules. The scar tissue prevents the structured laying down new collagen molecules. Over time this process further weakens and inflames the tendon.

Tendonitis of the Rotator Cuff

Diagnostic symptoms

The pain experienced with shoulder tendonitis can vary from a dull, throbbing ache to an almost piercing pain. Often it is reported that the pain is not in one particular spot but occurs in the general shoulder area and occasionally over the Deltoid muscle. The pain is often worse on raising the arm or if sleeping on the affected shoulder. Sometimes whilst asleep the pain can become severe. This is probably due to a muscle spasm caused as the muscles relax.

It has been noted that the symptoms are often worse for those younger patients. Although the condition typically affects those of 40 years old and above; it is not restricted to people in that age group. The younger you are the more likely the pain will be more intense but last a shorter time. This is because the younger you are the more vigorous is the body’s repair process.

A physical examination of a typical person suffering with tendonitis of the rotator cuff would show the following

  • Pain on lifting the arm - particularly between 60 and 120 degrees, this is known as the painful arc. Movement outside this arc is generally painless
  • Pain will be felt along the front of the acromion with the shoulder extended
  • Abduction of the arm held in external rotation is often painless
  • Pain can be brought on by holding the arm at 90%flexion and rotating the shoulder internally
  • There should be no pain on passively abducting the arm

These tests together performed with a thorough physical examination should be sufficient to make a diagnosis. Taken together with a full description of the onset and history of symptoms will make an accurate diagnosis likely.

Long standing injuries will present a more complex problem. Rotator cuff symptoms associated with tendonitis left untreated will result in a wasting of the muscles and tendons. This in turn will lead to greater weakness and restricted motion particularly in abduction and external rotation of the arm. It is quite likely that as the tendons weaken they may rupture or tear.


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