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Rotator Cuff Tendinitis vs. Tear

Rotator cuff tendinitis is inflammation of the rotator cuff tendon in the shoulder. The rotator cuff is made of up 4 muscles (supraspinatus, infraspinatus, teres minor, and subscapularis). The condition is usually one that develops over time. It can be due to faulty overhead mechanics or repetitive activity. It is a common condition that affects athletes and non-athletes alike. A rotator cuff tear is an actual tear of the tendon. In most cases, a tear is considered “partial thickness” and is treated the same way as cases of tendinitis. In less common instances, a “full thickness” tear may exist. This kind of injury could require surgery and months of rehab to overcome. Full-thickness tears are characterized by the inability to raise the arm at an angle and extreme weakness of the rotator cuff muscles.

Some movements that can be painful with rotator cuff tendinitis or partial thickness tears include reaching overhead, behind the back, carrying, and lifting. In addition, sleeping on the affected shoulder may be painful.

In order to overcome rotator cuff tendonitis or a partial thickness tear, the first common-sense recommendation is to take a short break from the activity that aggravates the shoulder. This allows for an environment for the inflammation to settle down and the tendon to heal. While taking a break usually helps with pain, in order to get back to the activities that you enjoy, you have to address the root cause of the tendonitis or tear.

If you have rotator cuff tendonitis or a tear, you may have weakness of your shoulder stabilizer muscles (e.g. rotator cuff, lower trap, and serratus anterior).  In addition, you may have stiffness in your lat muscles or upper back that limits your overhead mobility.  You may also have difficulty coordinating your muscles and have poor overhead lifting mechanics.  If you have any of these limitations, you may be placing excessive stress on your rotator cuff tendon.

The best way to know what is contributing to your tendon problem is to have a movement assessment performed.

If you have weakness, learning how to activate muscles that are not firing well is key.  Some of our "go-to" exercises include the side-lying shoulder rotation for rotator cuff activation and supine pullover for lat activation.

Once your muscles engage better, the next step is restoring movement.  The shoulder is a ball and socket joint and should move in 3-planes of movement.  Exercises that can help restore movement are scapular wall slides, half-kneeling band pulldowns, and tall kneeling t-spine rotations.

Once you have learned restored movement, developing strength will enable you to find lasting relief from rotator cuff tendonitis or a tear. The best strength-building exercises are compound movements.  These are exercises that use several muscle groups simultaneously.  They include pushing and pulling variations like pull-ups (or weighted pull-downs), rows,  military presses, push-ups.  To ensure the smaller stabilizing muscles engaging, exercises like the kettlebell armbar and Turkish Get-up may be appropriate.  If you can generate tension and maintain solid technique, all these movements can be performed safely and will enable you to have a healthy and functional shoulder.

Most of the aforementioned exercises can be found in our video library.

When addressed with a specialized physical therapy program, overcoming rotator cuff tendonitis and partial-thickness tears is possible.  However, ignoring pain and engaging in repetitive activity can result in a further decline of your shoulder health.  If you're worried about shoulder pain, the physical therapists at Movement Solutions would be glad to help you.

We invite you to request a shoulder consultation with one of our specialists.  This is an opportunity to ask questions, obtain clarity about your shoulder pain, and foster confidence that we can help you.  If you’re certain that we’re a good fit to work together, you can decide on the next step.

If you’re in pain but unsure about what you should do, call us at (864) 558-7346 and ask how we can help.

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