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Alternative Names Return to topSwimmer's shoulder; Pitcher's shoulder; Shoulder impingement syndrome; Tennis shoulder
Definition Return to top
Rotator cuff tendinitis is an inflammation (irritation and swelling) of the tendons of the shoulder.
Causes Return to top
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 arm to be moved over the head repeatedly as in tennis, baseball (particularly pitching), 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).
Symptoms Return to top
Exams and Tests Return to top
A physical examination may 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 show inflammation in the rotator cuff. An MRI can show a tear in the rotator cuff.
Treatment Return to top
Treatment involves resting the shoulder and avoiding activities that cause pain. Ice packs applied to the shoulder and nonsteroidal 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 allow even large tears to be repaired arthroscopically, although some large tears require open surgery to repair the torn tendon.
Outlook (Prognosis) Return to top
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.
Possible Complications Return to top
When to Contact a Medical Professional Return to top
Call for an appointment with your health care provider if persistent shoulder pain occurs. Also call if symptoms do not improve with treatment.
Prevention Return to top
Avoid repetitive overhead movements. Develop shoulder strength in opposing muscle groups.
References Return to top
Burbank KM, Stevenson JH, Czarnecki GR, Dorfman J. Chronic shoulder pain: part II. Treatment. Am Fam Physician. 2008 Feb 15;77(4):493-7. Review.
Burbank KM, Stevenson JH, Czarnecki GR, Dorfman J. Chronic shoulder pain: part I. Evaluation and diagnosis. Am Fam Physician. 2008 Feb 15;77(4):453-60. Review.Update Date: 7/29/2008 Updated by: Thomas N. Joseph, MD, Private Practice specializing in Orthopaedics, subspecialty Foot and Ankle, Camden Bone & Joint, Camden, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.