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. It 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 oblique 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 our physical therapy office, the first recommendation that we usually make is to take a short break from the aggravating activity. This allows for an environment for the inflammation to settle down and the tendon to heal. While taking a break usually helps with pain, we know for our patients to get back to the activities that they enjoy, we have to address the root of the issue.

In many cases, rotator cuff tendinitis and partial thickness tears are coupled with poor mobility of the lats and the t-spine. This can be combined with weakness of the rotator cuff and the lat muscles.  In addition, if there are imbalances at the core and hip muscles, the way an active person moves can be affected which may lead to faulty shoulder mechanics. However, the only way to know what is contributing to pain and injury is to perform a complete assessment.

When pain and stiffness is found via the assessment, our approach includes manual mobilization to alleviate pain and improve mobility. Improvements can be made very quickly if the right regions are targeted. If weakness is found, we teach activation exercises to help our clients better engage muscles that are not firing well. Once pain is controlled and muscles engage better, our next step is teaching our patients to develop stability of the shoulder girdle with load.

When addressed with a through physical therapy assessment and plan of care, rotator cuff tendonitis and partial thickness tears are conditions that can resolve relatively quickly. However, any sort of repetitive activity with poor mechanics can become a more serious issue. If you feel like you may be developing rotator cuff problem, the physical therapists at Movement Solutions would be glad to provide a through assessment and give you a diagnosis for your condition. We are available for a free 15-minute phone consultation to talk about how your shoulder is affecting you and discuss your treatment options. Call us at 864-558-7346 and ask how we can help.

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