Shoulder

Rotator Cuff Tendonitis of the Shoulder

The rotator cuff is a group of muscles that forms a common tendon that helps to stabilize the shoulder so that the bigger muscles such as the deltoid and the pectoralis major can move the arm. Rotator cuff tendonitis of the shoulder is also known as bursitis, impingement syndrome, and tendonopathy. This condition involves inflammation of the subacromial bursa – a small, fluid-filled sac - which lies between the rotator cuff and the under-surface of the Acromion Bone in the shoulder.

• How it happens

  Rotator cuff tendonitis can be initiated by an injury or overuse, or there may not be an inciting event at all. Overuse may be related to an increase in the frequency or intensity of weight-lifting, particularly involving pressing movements or a recent increase in overhead activity such as painting the walls at home.

• How it feels

  Rotator cuff tendonitis causes pain around the shoulder, most commonly on the outside or lateral part of the shoulder. Pain can often be felt down the arm and even as far as the elbow or below. Less commonly, people have pain in the front or back of the shoulder itself. When the pain related to the rotator cuff is present with activities of daily living, such as getting dressed or lifting light objects, or if the pain causes difficulty with sleep, consultation with a healthcare professional is generally recommended. In some cases magnetic resonance imaging (MRI) of the rotator cuff is helpful to determine if the rotator cuff is torn or if there is another problem in the shoulder.

• How it is fixed

  If the symptoms have only been going on for a few days, this problem will often go away on its own. After several weeks or months, patients will generally require anti-inflammatory medication, physical therapy, and time away from lifting to allow the rotator cuff pain to settle down. If these measures don't work, a cortisone injection in the subacromial space will often relieve the symptoms. For other patients, in whom the above measures do not relieve the pain, surgery for the rotator cuff may be considered to achieve relief. This involves arthroscopic surgery, where the inflamed bursal tissue is removed, and more room is created for the rotator cuff tendons by using a burr to remove some of the underside of the Acromion Bone.

• Recovery/Post-Surgery

  After the pain is relieved, the patient can gradually get back to full activities including lifting and sports. The return to activity must be gradual to avoid reoccurrence. It is generally recommended that all lifters do some rotator cuff strengthening to avoid this problem. Light external rotation either performed with a cable or a dumbbell while lying on the side (also know as the L-fly) is effective. Prevention is the best cure, and by maintaining a strong rotator cuff this problem can be headed off before it begins.

Testimonials

"For the better part of the last two years I was limited to being a bystander and not an active participant in many sports and activities that I enjoy. Under the advice of a family friend and doctor I was referred to Dr. Marx at HSS. After Dr Marx had examined me as well as my MRI and x-rays he gave me two options, therapy or rotator cuff surgery. I found comfort in a surgeon who gave me the option of not having to have surgery as the first option. After realizing that my shoulder was to badly damaged I opted to have the rotator cuff surgery. Dr Marx laid out what to expect from the surgery as well as the recovery and following therapy, and never left any of my appointments until all of my questions were answered in full. Dr. Marx was also right on that six months after surgery I would be between 90 to 100% and he was right on. Thank you to Dr. Marx and your great staff for making a difficult time a whole lot easier. "

Regards,

~ Kevin A. Ridgway