Tendinitis & Rotator Cuff Injuries of the Shoulder

Your rotator cuff tendon can become inflamed or injured, but it can heal. The rotator cuff is a powerful team of muscles and connecting tendons about the shoulder that attach your upper arm to your shoulder blade. Your rotator cuff helps you reach, throw, push and lift. Your shoulder is one of your most mobile joints, but all the moving it does makes it prone to injury.

Problems may happen over time often from repeated overhead motions or may be caused by sudden injury. The shoulder usually hurts secondary to inflammation of the rotator cuff tendons or bursa, and these become swollen or damaged. This could be caused by may things. Maybe you fell on the shoulder or strained it by doing too much reaching or lifting, maybe you threw one too may pitches or maybe you twisted your shoulder while doing an exercise.

A rotator cuff tendinitis or injury can make everyday activities painful. Does your shoulder hurt during or after movements like the ones below? Does it hurt too much to do thee things at all? Use this checklist to help assess your painful shoulder and help you determine if it needs some medical attention

Checklist Pain While Doing Pain After Doing Too Painful to Do
Reaching overhead      
Scratching your mid-back      
Throwing a ball overhead      
Combing your hair      
Raising your arm      
Sleeping on your shoulder      
Carrying a suitcase      

You may not have thought much about your shoulder until your rotator cuff started to hurt, but then you realized what a healthy rotator cuff allows you to do. With a strong rotator cuff, your shoulder is a master of motion. When your rotator cuff is damaged or inflamed, even small movements can be painful.

To better understand the rotator cuff, we will take a brief look at the anatomy of this region of the shoulder. The rotator cuff is made up of muscles and tendons that attach your upper arm to your shoulder. The acromion is a bone at the top of your shoulder blade and beneath the acromion lies the bursa, which is a lubricating sac to reduce friction in the shoulder. It helps the rotator cuff tendon to slide under the acromion. The humerus is your upper arm bone and the glenoid is your shoulder socket. The deltoid muscle covers your shoulder.


Pain told you that something was wrong with your shoulder. Now that you know that it is a rotator cuff problem, you may wonder what caused it.

Rotator cuff tendons can become damaged or inflamed (tendinitis) in many ways. These include irritation or overuse, pinching or impingement, calcium deposits (calcification) and splitting or tears. Any of these above conditions can make your shoulder weak, tender and painful. The two most common causes of shoulder pain are overuse tendinitis and impingement tendinitis.


Shoulder motions used during activities such as golfing, pitching, carrying and lifting objects may cause repetitive stress within the rotator cuff. This can lead to irritation, bruising or fraying. Any of these can then cause shoulder pain and weakness in the shoulder joint.


The acromion can pinch (impinge) and irritate the rotator cuff when the space between them narrows. This can happen when the cuff is weak, the bursa is swollen or the acromion angles down too far. Impingement tendinitis can occur with repetitive shoulder motions such as sports or jobs involving overhead reaching or lifting.


Inflammation can lead to calcium deposits within the rotator cuff, and these in turn can cause pain and a loss of shoulder strength and movement.


Severe tendinitis or injury can cause partial or complete tearing of the rotator cuff. This can result in shoulder pain, weakness and a loss of normal movement.


Your orthopedist will obtain a medical history and examine your shoulder with the use of various tests such as x-rays, arthrogram or MRI. These will help him decide on the best treatment for your shoulder. If your rotator cuff tendinitis or injury isn't severe, then non-surgical treatment or conservative treatment may be all that you need to obtain healing. These treatments can reduce swelling and relieve your pain. This may be accomplished through a short period of rest, but occasionally treatment such as oral anti-inflammatory medications or a Cortisone injection, as well as physical therapy exercises, may be needed. If the shoulder pain doesn't respond to conservative treatment, then you and your doctor may decide you need surgery.

Surgical treatment for this shoulder condition can be open surgery through a small to moderate size incision or can be accomplished through arthroscopic surgery, which is performed through very small incisions. The kind of surgery that you have depends on the type, size and location of the injury. With arthroscopic surgery, tiny instruments are inserted through incisors smaller than a buttonhole. This surgery can be used for such things as making more space for tendon movement or repairing minor tears. The acromion is shaved to create space between it and the rotator cuff, and this helps prevent irritation during shoulder movement. Also, damaged tissue and small flaps are removed from around the injured tendon. The small tears can be repaired. To repair moderate size or complete tears in your rotator cuff, open surgery is usually needed. The incision is larger than an arthroscopic surgery and healing and rehabilitation may take longer. The combining of arthroscopic surgery and open surgery is called mini-open repair. The majority of rotator cuff surgeries are performed as Same Day or Our-patient Surgery.

Call the Bone & Joint Clinic at (318) 425-8701 to schedule a consultation.