Shoulder Pain – Rotator Cuff Tendinitis
The rotator cuff can easily suffer from tendonitis. BoulderCentre has many treatment options from therapy to injection to surgery to help you recover.
One of the most common physical complaints is shoulder pain. The rotator cuff is a frequent source of pain in the shoulder. Your shoulder is made up of several joints combined with tendons and muscles that allow a great range of motion in your arm. Because so many different structures make up the shoulder, it is vulnerable to many different problems.
Anatomy of the Shoulder:
Your shoulder is made up of three bones: your upper arm bone (humerus), your shoulder blade (scapula), and your collarbone (clavicle).
Your arm is kept in your shoulder socket by your rotator cuff. These muscles and tendons form a covering around the head of your upper arm bone and attach it to your shoulder blade.
There is a lubricating sac called a bursa between the rotator cuff and the bone on top of your shoulder (acromion). The bursa allows the rotator cuff tendons to glide freely when you move your arm.
The Rotator Cuff:
The rotator cuff is a common source of pain in the shoulder. Pain can be the result of:
- Tendinitis. The rotator cuff tendons can be irritated or damaged.
- Bursitis. The bursa can become inflamed and swell with more fluid causing pain.
- Impingement. When you raise your arm to shoulder height, the space between the acromion and rotator cuff narrows. The acromion can rub against (or “impinge” on) the tendon and the bursa, causing irritation and pain.
Rotator cuff pain is common in both young athletes and middle-aged people. Young athletes who use their arms overhead for swimming, baseball, and tennis are particularly vulnerable. Those who do repetitive lifting or overhead activities using the arm, such as paper hanging, construction, or painting are also susceptible.
Pain may also develop as the result of a minor injury. Sometimes, it occurs with no apparent cause.
Rotator cuff pain commonly causes local swelling and tenderness in the front of the shoulder. You may have pain and stiffness when you lift your arm. There may also be pain when the arm is lowered from an elevated position.
Beginning symptoms may be mild. Patients frequently do not seek treatment at an early stage. These symptoms may include:
- Minor pain that is present both with activity and at rest
- Pain radiating from the front of the shoulder to the side of the arm
- Sudden pain with lifting and reaching movements
- Athletes in overhead sports may have pain when throwing or serving a tennis ball
As the problem progresses, the symptoms increase:
- Pain at night
- Loss of strength and motion
- Difficulty doing activities that place the arm behind the back, such as buttoning or zippering
If the pain comes on suddenly, the shoulder may be severely tender. All movement may be limited and painful.
Medical History and Physical Examination
After discussing your symptoms and medical history, your doctor will examine your shoulder. He or she will check to see whether it is tender in any area or whether there is a deformity. To measure the range of motion of your shoulder, your doctor will have you move your arm in several different directions. He or she will also test your arm strength.
Your doctor will check for other problems with your shoulder joint. He or she may also examine your neck to make sure that the pain is not coming from a “pinched nerve,” and to rule out other conditions, such as arthritis.
Other tests which may help your doctor confirm your diagnosis include:
Becauses x-rays do not show the soft tissues of your shoulder like the rotator cuff, plain x-rays of a shoulder with rotator cuff pain are usually normal or may show a small bone spur. A special x-ray view, called an “outlet view,” sometimes will show a small bone spur on the front edge of the acromion.
BoulderCentre for Orthopedics can help. Call us (303) 449-2730 and ask to see one of our shoulder and upper extremity specialists.
Article courtesy of The Hand Care Society.