What is Rotator Cuff Tendinitis?

The rotator cuff muscles are a group of 4 muscles that attach the humerus (upper-arm bone) to the scapula (shoulder blade). The rotator cuff muscles help raise, rotate, and stabilize the upper arm. A tendon is a bundle of fibers that connect the muscles to the bone. Rotator cuff tendinitis occurs when the tendon connected to the rotator cuff muscles becomes inflamed and irritated. It can be caused by:

• Poor posture, such as rounded shoulders caused by leaning over a computer for long periods of time.

• Repetitive arm movements, such as those performed by a hair stylist or painter.

• Overhead shoulder motions, such as those performed by baseball pitchers or swimmers.

• Tight muscles and tissues around the shoulder joint.

• Weakness and muscle imbalances in the shoulder blade and shoulder muscles.

• Bony abnormalities of the shoulder region that cause the tendons to become pinched (shoulder impingement syndrome).

 

How Does it Feel?

Rotator cuff tendinitis is characterized by shoulder pain that can occur gradually over time or start quite suddenly. The pain occurs in the shoulder region and sometimes radiates into the upper arm. It does not usually radiate past the elbow region. You may be symptom free at rest or experience a mild, dull ache; however, pain can be moderate to severe with certain shoulder movements. Reaching behind the body to perform a motion, as in fastening a seat belt, can be very painful. So can overhead activities, such as throwing, swimming, reaching into a cupboard, or combing your hair. The pain can worsen at night, especially when rolling over or attempting to sleep on the painful side. You may notice weakness when lifting and reaching for household items. Holding a heavy platter or taking a pan off the stove may become difficult.

 

How Can a Physical Therapist Help?

It is important to get proper treatment for tendinitis as soon as it occurs. A degenerated tendon that is not treated can begin to tear causing a more serious condition. Physical therapy can be very successful in treating rotator cuff tendinitis, tendinosis, and shoulder impingement syndrome. You will work with your physical therapist to devise a treatment plan that is specific to your condition and goals. Your individual treatment program may include:

 

• Pain management. Your physical therapist will help you identify and avoid painful movements to allow the inflamed tendon to heal. Ice, ice massage, or moist heat maybe used for pain management. Therapeutic modalities, such as iontophoresis (medication delivered through an electrically charged patch) and ultrasound may be applied.

• Manual therapy. Your physical therapist may use manual techniques, such as gentle joint movements, soft-tissue massage, and shoulder stretches to get your shoulder moving again in harmony with your scapula.

• Range-of-motion exercises. You will learn exercises and stretches to help your shoulder and shoulder blade move properly, so you can return to reaching and lifting without pain.

• Strengthening exercises. Your physical therapist will determine which strengthening exercises are right for you, depending on your specific condition. You may use weights, medicine balls, resistance bands, and other types of resistance training to challenge your weaker muscles. You will receive a home-exercise program to continue rotator cuff and scapular strengthening, long after you have completed your formal physical therapy.

• Patient education. Posture education is an important part of rehabilitation. For example, when your shoulders roll forward as you lean over a computer, the tendons in the front of the shoulder can become pinched. Your physical therapist may suggest adjustments to your workstation and work habits.

• Functional training. As your symptoms improve, your physical therapist will help you return to your previous level of function that may include household chores, job duties and sports- related activities. Functional training can include working on lifting a glass into a cupboard or throwing a ball using proper shoulder mechanics. You and your physical therapist will decide what your goals are, and get you back to your prior level of functioning as soon as possible.  (Reference: www.moveforwardpt.com)