Rotator Cuff Tendinitis

GENERAL INFORMATION:

What is rotator cuff tendinitis? Rotator cuff tendinitis (ten-di-NI-tis) is an inflammation (swelling) of the tendons in your shoulder joint. A tendon is a cord of tough tissue that connects your muscles to your bones. The rotator cuff is a set of muscles and tendons in the shoulder. It holds the top of the upper arm into the shoulder blade to form the shoulder joint. The rotator cuff also helps keep the bones in place even when moving your arm or shoulder. Rotator cuff tendinitis usually happens to those over 40 years of age and who repeatedly do overhead activities. With proper care and treatment, you may be able to resume your normal daily activities.

What causes rotator cuff tendinitis? Rotator cuff tendinitis may be caused by any of the following:

• Overuse: Most rotator cuff tendinitis happen with tendon wear and tear caused by too much shoulder activity. This commonly happens to athletes, such as baseball pitchers, swimmers, and tennis or racquetball players. This condition is also common in people who have to work with their arms frequently overhead.
  
  
• Impingement: Falls or incorrect throwing techniques or arm movements and weak shoulder muscles may cause the arm bone to move up and trap the tendon. This may also happen in persons who overtrain or have a sudden change in arm or shoulder activity.
  
  
• Calcium deposits: Calcium may deposit in the tendons due to decreased oxygen and poor blood supply. These deposits may cause irritation and inflammation of the tendon.

What are the signs and symptoms of rotator cuff tendinitis? The signs and symptoms usually appear when activity of the shoulders and arms increases. You may have pain and swelling in your shoulder, especially when lifting your arm over your head. The pain may be worse after sleeping on the affected shoulder. You may have weakness and limitation of movement of the shoulders and arms. Over time, the pain may become worse and may be present even at rest.

How is rotator cuff tendinitis diagnosed?

• Physical exam: Your caregiver may test your shoulder by moving your arm in different directions and raising it overhead. Your caregiver will look for limitation of shoulder movement due to pain and weakness. Both your painful and non-painful shoulder may need to be checked for any abnormal position or movement.
  
  
• Joint x-ray: This is a picture of the bones and tissues in your joints. Joints are the places in your body where two bones meet. You may be given dye as a shot into your joint before the x-ray. This dye will help your joint show up better on the x-ray. A joint x-ray with dye is called an arthrogram.
  
  
• Magnetic resonance imaging: This is also called MRI. During the MRI, pictures of your shoulder are taken. An MRI may be used to look for tendon injuries or other problems.
  
  
• Ultrasound: An ultrasound is a test that looks inside your body. Sound waves are used to show pictures of your muscles and tissues on a TV-like screen.
  
  
• Arthrogram: An arthrogram is an x-ray that is taken after dye is injected into your affected joint. This test is used to view the structures of your joint such as muscles, ligaments, tendons and cartilage. The dye helps your caregiver see the structures better. People who are allergic to iodine or shellfish (lobster, crab or shrimp) may be allergic to some dyes. Tell the caregiver if you are allergic to shellfish or have other allergies or medical conditions.

How is rotator cuff tendinitis treated? Treatment will depend on your symptoms and the length of time you have them. Your caregiver may want you to limit activity on your affected shoulder to decrease stress on the tendon. This may help prevent further damage, decrease pain, and promote tendon healing. You may also have one or more of the following:

• Medicines: Your caregiver may give you certain medicines to decrease the pain and swelling in your shoulder joint. These medicines may be given by mouth or as a shot in your shoulder.
  
  
• Surgery: You may need surgery if the pain and tightening in your shoulder does not go away despite treatment. This may also be done if pain worsens or is so severe that it affects daily activities. During surgery, your caregiver may also remove bone spurs and inflamed tissue around the shoulder.
  
  
• Rehabilitation: This is a program that helps your rotator cuff heal faster. Exercises to make the tendon stronger will be started after the tendinitis has healed. This aims to bring back your shoulder's normal range of motion and strengthen your rotator cuff. Your caregiver may use therapeutic ultrasound or massage to increase blood flow to the affected area. You may be asked to do specific exercises, such as stretching and strengthening of your shoulder muscles. Your caregiver may help you make some changes in your activities to help decrease the stresses placed on tendons.

Where can I find more information? Contact the following for more information:

• American Academy of Family Physicians
  PO Box 11210
  Shawnee Mission, KS 66207-1210
  Phone: 1-913-906-6000
  Web Address: http://www.aafp.org
  

• American Academy of Orthopaedic Surgeons
  6300 North River Road
  Rosemont, IL 600184262
  Phone: 1-847-8237186
  Web Address: http://www.aaos.org/
  

• American Physical Therapy Association
  1111 North Fairfax Street
  Alexandria, VA 22314
  Phone: 1-800-999-2782
  Web Address: http://www.apta.org
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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