Rotator Cuff Tendinopathy and Bursitis

Understanding the Symptoms, Causes and Treatments

Understanding Rotator Cuff Tendinopathy and Bursitis

The shoulder is a complex, highly mobile joint designed to provide the highest amount of motion of any joint in the body. The rotator cuff is a collection of four muscles that surround the shoulder joint. Its primary responsibility is to promote stability of the joint. The muscles are the supraspinatus, infraspinatus, teres minor, and subscapularis. On top of the rotator cuff is the subacromial/subdeltoid bursa.

Causes of Rotator Cuff Tendinopathy and Bursitis

The rotator cuff can be acutely torn, such as with a fall or accident, but much more commonly we see slow and progressive wear over time that results in pain without a specific incident. The tendons first become thickened and irritated, but with repetitive insults, like rubbing a worn cloth over and over, small tears can develop. With more time big tears can develop until it separates from the attachment point of the humerus.

Symptoms of Rotator Cuff Tendinopathy and Bursitis

Pain in the shoulder, most often over the deltoid
Pain with overhead or outward reaching
Slight weakness in the shoulder
Pain may radiate down the arm slightly
Can be worse at night or while you are sleeping

Diagnosing Rotator Cuff Tendinopathy and Bursitis

A comprehensive history and physical examination is the most important piece to determine if the rotator cuff is involved in your shoulder pain. X-ray, MRI, and/or ultrasound are imaging modalities that allow us to see the rotator cuff and surround tissues.

Treatment Options

Change your ergonomics – set up your work station in such a way that helps you maintain proper posture
Physical therapy – To help build strength, correct your posture, and improve function
Medications– Usually NSAIDs or Tylenol short-term to help control symptoms while going through a PT program
Steroid injections- Strong anti-inflammatory medication to reduce pain and inflammation in order to facilitate therapy. Typically done with ultrasound to guide the injection
Regenerative medicine – Harnessing the body’s incredible power to heal itself, rebuild tissue, and avoid surgery.