 Rotator-cuff tendinitis or alternative names -
Swimmer's shoulder; Pitcher's shoulder; Shoulder impingement syndrome; a.k.a. Tennis shoulder.
Tearing and inflammation of the tendons of the shoulder
muscles can occur in sports which require the arm to
be moved over the head repeatedly as in tennis, pitching,
swimming, and lifting weights.
Most often the shoulder will heal itself if a break is taken from the
physical activities that caused the problem and shoulder-pain.
Intermittent ice pack applications applied to the shoulder and
non-steroidal anti-inflammatory drugs can also help reduce inflammation and shoulder pain.
Rotator cuff tendinitis is an inflammation (irritation
and swelling) of the tendons of the shoulder.
Causes, incidence, and risk factors
The shoulder joint is a ball and socket type joint
where the top part of the arm bone (humerus) forms a
joint with the shoulder blade (scapula). The rotator
cuff holds the head of the humerus into the scapula.
Inflammation of the tendons of the shoulder muscles
can occur in sports requiring the arms to be moved over
the head repeatedly as in baseball, (particularly
pitching), tennis, swimming, and lifting weights over the head.
Chronic inflammation or injury can cause the tendons
of the rotator cuff to tear.
The risk factors are being over age 40 and participation
in sports or exercise that involves repetitive arm motion
over the head (such as baseball and fast swimming).
Symptoms
- Pain associated with arm movement
- Pain in the shoulder at night, especially when
lying on the affected shoulder
- Weakness with raising the arm above the head, or
pain with overhead activities (brushing hair, reaching
for objects on shelves, etc.)
Signs and tests
A physical examination will reveal tenderness over
the shoulder. Pain may occur when the shoulder is raised
overhead. There is usually weakness of the shoulder
when it is placed in certain positions.
X-rays may show a bone spur, while MRI may demonstrate
inflammation in the rotator cuff. If a tear in the rotator
cuff is present, this can usually be identified on MRI imaging.
Treatment for Rotator cuff tendinitis
The injured shoulder should be rested from the activities
that caused the problem and from activities that cause
pain. Ice packs applied to the shoulder and non-steroidal
anti-inflammatory drugs will help reduce inflammation
and pain.
Physical therapy to strengthen the muscles of the rotator
cuff should be started. If the pain persists or if therapy
is not possible because of severe pain, a steroid injection
may reduce pain and inflammation enough to allow effective
therapy.
If the rotator cuff has sustained a complete tear,
or if the symptoms persist despite conservative therapy,
surgery may be necessary. Arthroscopic surgery can remove
bone spurs and inflamed tissue around the shoulder.
Small tears can be treated with arthroscopic surgery.
Newer techniques can permit large tears to be repaired
arthroscopically and minimally-invasive, although some
large tears require more major open surgery to repair the torn tendon.
Patient Expectations (prognosis)
Most people recover full function after a combination
of medications, physical therapy and steroid injections.
For patients with tendinitis and a bone spur, arthroscopic
surgery is usually successful in restoring them to their
pre-injury level of activity.
People with tears of their rotator cuff tend to do
well, although their outcome is strongly dependent upon
the size and duration of the tear, as well as their
age and pre-injury level of function.
Complications of the Surgery
- bursitis
- complete rotator cuff tear
- failure of treatment to improve symptoms
Calling your health care provider
Call for an appointment with your health care provider
if persistent ongoing shoulder pain occurs. Also call if symptoms
do not improve with
drug store prescriptions and medical treatment.
Prevention
Avoid repetitive overhead movements. Develop shoulder
strength in opposing muscle groups.
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