Rotator cuff tendinitis

Rotator cuff tendinitis is a common cause of shoulder pain and impingement in professional and amateur athletes. In this condition, your main shoulder muscles, rotator cuff becomes inflamed and swollen.

The rotator cuff consists of four muscles, the subscapularis, supraspinatus, infraspinatus and teres minor muscles. All these muscles are responsible for stabilizing your shoulder during movement. If one of these muscles are injured or inflamed, then the other muscles will have to work harder to compensate for the weakness of the damage muscle.

Rotator cuff tendinitis mainly occurs in sports or work that involves repetitive movement of the shoulders or excessive load due to altered shoulder mechanics. In particular, freestyle and butterfly swimmers are particularly liable to rotator cuff injuries because they develop excessive strength of the internal rotators of the shoulder, resulting in excessive movement of the shoulder joint.

Predisposing Factors

• Anatomical abnormalities
• Poor scapular control (shoulder blade)
• Excessive Load of rotator cuff muscles
• Shoulder Instability
• Abnormal Biomechanics

Since the rotator cuffs are situated right next to the subacromial bursa, the swelling of the rotator cuff tendons would decrease the space in the shoulder joint itself. As a result, there will be less room for the bursa to move freely and cause the bursa to be inflamed.

Clinical Features

• Pain with overhead activities such as throwing, swimming, pulling shirt over the head and hanging
• up the clothes.
• Pain in the the shoulder joint
• Wakes up at night time if he/she lies on the injured shoulder
• Problem with moving their shoulder past 90 degrees.
• Ultrasound or MRI scan of the shoulder should show the appearance of rotator cuff tendinitis.
• Winging of the shoulder blade due to the altered muscle imbalance.

Treatment

It is important to consider treatment as two components.

The first component is aimed at treating the tendinitis itself. This is done by:

• Avoiding aggravating activities such as lifting heavy objects, repetitive shoulder movements and
• any overhead shoulder movement.
• Reduce overall inflammation of the tendon, by using NSAID (Non-Steroidal Anti-Inflammatory
• Drugs) in use with electrotherapeutic modalities such as interferential therapy, ultrasound, magnetic
• field therapy and laser.
• Local soft tissue therapy – usually performed by a massage therapist or physical therapist.
• If the above intervention have no effect, then a corticosteroid injection into the shoulder joint is
• often helpful and may reduce the athlete's symptoms effectively to allow the commencement of the
• rehabilitation program.