Shoulder pain is a common problem for many people. Your shoulders contain several joints joined together by muscles and tendons, which allow a wide range of movement in your arms. Due to those many structures, the shoulder is a part of your body that is most vulnerable to problems. The rotator cuff tendinitis is the most popular source of frequent shoulder pains in most people.
Tendinitis is an inflammation of the muscles or tendons that help rotate your shoulder joint. The inflammation builds up over time. It could result from many issues, including sleeping on one shoulder or in one position the entire night for a prolonged period. Or as a result of activities involving the lifting of one arm over the head. Fortunately for you, it is curable.
If you experience pain in one or both of your shoulders, it could be time to seek the help of an experienced physical therapist. At Suarez Physical Therapy in Las Vegas, we offer personalized physical therapy programs that meet every individual's needs.
Rotator Cuff Overview
The human shoulder comprises three bones: the humerus (bone on the upper arm), the scapula (shoulder blade), and the clavicle or collarbone. The rotator cuff is the joint that keeps your arm in the shoulder socket. Tendons and muscles cover the head of the humerus and connect it to the scapula.
Your arms are the most active parts of your body. Thus, your shoulders require many structures to support these movements. Additionally, you have a bursa, the lubricating sac that allows the rotator cuffs to glide freely with every arm movement. The bursa is usually between the acromion (bone at the top of the shoulder) and the rotator cuff.
Your shoulders are designed with the ability to allow your arms to move freely as you carry out several activities, including digging a garden, swinging a tennis racket, reaching your back, placing something on a higher shelf, and even swinging your arms along as you walk. Humans depend on these abilities to perform a wide range of tasks. In the event of pain on one or both shoulders, it could be a disabling moment and a great cause for concern.
You may experience shoulder pain due to several reasons. For instance, younger people may incur injuries in activities like sports. Older people could experience pain due to the normal wear and tear, which occurs over time, weakening the shoulder tissues and leaving them prone to injuries. The risk is usually higher on people whose hobbies and occupations include repetitive movements of the arms, like basketball or tennis players, painters, and carpenters.
Rotator cuff tendinitis is the most prevalent cause of painful shoulders among humans. It refers to the inflammation of the main tendons on your shoulder. It starts with a dull ache around the outer part of the shoulder and intensifies with continuous use of the shoulder. The pain could become unbearable, to the point of not doing anything with the affected arm. Even sleeping on the affected shoulder could become unendurable.
Fortunately, rotator cuff tendinitis is treatable without surgical intervention. Physical therapy is among the most effective treatments that could give you relief from pain and restore the use of your shoulder once again.
Causes of Rotator Cuff Tendinitis
Tendinitis affects the muscles and tendons that aid the movement of your shoulder joints. If you are diagnosed with tendonitis, it could mean that your tendons are irritated or inflamed. The irritation or inflammation is also referred to as impingement syndrome.
Tendinitis doesn’t occur overnight; it is a condition that starts small, then worsens over time. It could result from many things, including sleeping on one shoulder for a long time or taking part in strenuous activities that involve rapid and continuous movement of your arms. Rotator cuff tendinitis is common with athletes, mainly because it involves lifting their arms over their heads. That is why this condition is also referred to as:
The pitchers’ shoulder
It could be challenging to establish the real cause of tendinitis sometimes. The good news is that you can regain the full functionality of your shoulder without the pain.
Tendinitis is a common condition, not just for young athletes but for middle-aged and older adults too. Here are the main reasons you could experience pain in your shoulder:
Repeated arm movements, like those made by painters or hairstylists
Repeated overhead shoulder movements like those made by swimmers, or basketball pitchers
Weak and imbalanced muscles in your shoulder blades, or shoulder muscles
Tight tissues and muscles around your shoulder joint
Bone abnormalities around your shoulder area that might have caused pinched tendons
Poor posture, resulting in shoulder impingement syndrome—For instance, leaning over your computer for extended periods could result in rounded shoulders.
Regardless of the cause of your shoulder pain, a proper diagnosis is required, followed by treatment. It is the only way to relieve you of your pain and restore the functionality of your shoulder.
Rotator Cuff Tendinitis Symptoms
The main sign of the rotator cuff is pain. Pain could be accompanied by tenderness or swelling in the foremost part of your shoulder. You could experience stiffness and pain when lifting your limb. It could also be painful when you lower your arm from a raised position.
In the beginning, these symptoms will be mild and easy to dismiss. Thus, most patients don’t seek early treatment, which could be less costly and prevent more severe pain and disability. Some of the signs you should watch out for if you suspect tendinitis are:
Minor pain at the shoulder, with activity or when resting — When an injury or inflammation occurs, you can expect pain, even when at rest. You may not even comfortably sleep on the affected shoulder without experiencing discomfort
A constant ache that radiates from the foremost part of the affected shoulder to one side of your affected arm
A sudden ache on your shoulder when you try to reach or lift objects
Pain when serving or throwing a ball, mainly for athletes in sports like tennis
Clicking sound as you raise your arm
Pain that could cause you to lose your sleep at night
Pain starts with a much lower intensity. Therefore, you may not even think about it until it starts increasing. Most patients wait until they lose the functionality of their shoulder to seek medical help. Some of the symptoms you might experience if you delay treatment of rotator cuff include:
Loss of motion or strength on the affected shoulder and arm
More intense pain, especially at night
Difficulty performing activities that require placing your arm behind your back, like zippering or buttoning your clothes
If you experience sudden pain, your shoulder may have severe tenderness, which could be extremely painful and limit any movement.
It might be challenging to perform basic activities like reaching household items or lifting a heavy pan or platter. If you prolong treatment even further, you could start experiencing pain in other parts of your body, like the neck.
Diagnosis and Treatment
The pain, stiffness, and loss of mobility on your shoulder and arm should cause you to seek immediate medical help. When at the doctor’s office, you’ll start by explaining your symptoms to the doctor. Your physician will check your medical history to determine whether or not the signs you are experiencing are new or recurrent. He/she will also examine your shoulder to establish the real issue and offer a proper diagnosis.
During the examination, your physician will seek to find the source of the pain, tenderness, and whether there’s a deformity in the affected area. He/she will also measure the length of movement of your shoulder and arm by moving your arm in different directions, watching your reaction. Your physician will also assess your arm length and other issues you might be having on your shoulder. An examination of your neck might also be necessary to ensure that the aching does not result from a pinched nerve on your neck. It also helps to rule out other issues like arthritis.
Doctors are not able to make a conclusive diagnosis with only a physical examination. That is why your doctor might require you to undergo imaging tests to determine the actual problem and provide the right direction for treatment. For instance, your doctor may require you to undergo an X-ray test to give a clearer image of what could be happening inside your shoulder. However, x-rays don’t show in detail the soft tissues inside your body, like your rotator cuff. A plain x-ray examination may produce expected results or could reveal a bone spur. Special x-ray exams will also show a bone spur but not more explicit details of the soft tissues.
The other options for your doctor would be an ultrasound and/or an MRI. These examinations produce better and clearer images of the soft tissues and could reveal the actual problem, including inflammation of the rotator cuff tendons. They could show inflammation or fluid in the rotator cuff or bursa, which could help in providing a more detailed and practical form of treatment. MRIs and ultrasounds can also show partial tearing of your rotator cuff, which could also cause your symptoms.
Treatment for Rotator Cuff Tendinitis
Treatment for tendonitis can be both surgical and non-surgical, depending on the nature and severity of the inflammation or damage in your shoulder. However, physical therapy is a proven form of treatment, even for the severest form of tendinitis.
Your doctor could refer you to a physical therapist, or you can consult one directly. The physical therapist will also perform an evaluation first to determine the actual problem and proper mode of treatment. The physical therapist will ask you direct questions regarding your pain and other symptoms you could be experiencing to establish the real situation. He/she will also perform motion and strength tests on your shoulder and arm and determine the kinds of jobs or hobbies you engage in.
Lastly, your therapist will gently touch various parts of your shoulder to determine the exact tendon(s) that are inflamed.
Note that it is necessary to receive proper diagnosis and treatment for tendinitis. It should happen soon after the problem occurs. Over time, an untreated degenerated tendon could start to tear, resulting in more severe pain. Physical therapy could be effective in treating tendinitis. Your therapist will guide you into creating a treatment program that meets your conditions and needs. Your treatment plan could include the following:
Pain is the main symptom and probably why you sought treatment for tendonitis in the first place. It is challenging to deal with shoulder pain, especially if it intensifies as time goes on. Thus, it should be the first item in your treatment plan with your physical therapist.
Your physical therapist could help you determine and avoid any movement that triggers pain in the affected shoulder. That should allow the inflamed tissues to heal. Massage, ice, and the application of moist heat could also help manage the pain. Sometimes therapeutic modalities like iontophoresis and electrical stimulation could be necessary. They include delivering treatment through electrically charged paths.
Other than pain management, your therapist will ensure that you know the dos and don'ts of keeping your shoulder from further inflammation and injury. Thus, he/she might recommend patient education in your treatment plan.
Posture is an essential part of treatment for an injured rotator cuff. For instance, if you work on our computer the entire day, you could roll your shoulders forward, causing the tendons at the foremost part of your shoulders to become pinched. Continuous wrong posture may not help much, even when proper treatment is in place. Thus, you must practice good posture throughout the treatment program to promote quick and effective healing.
Additionally, your therapist will recommend the ideal posture for standing, sitting, and the best sleeping positions that could help alleviate your symptoms. He/she could also suggest other ways of performing various tasks that could be painful at the moment. You might have to avoid certain activities that could trigger pain on your shoulders.
Manual Treatment Techniques
Your treatment plan could also include specific manual techniques that could help with the pain and inflammation. For instance, your physical therapist might consist of gentle movements for your joints, shoulder stretches, and soft tissue massages to restore your shoulder’s mobility and functionality.
Exercises for the Range of Motion
If the inflammation on your rotator cuff has affected your shoulder’s range of motion, your treatment plan could include exercises that could restore that motion. The idea is to restore your shoulder’s ability to move correctly and allow you to perform activities you are used to. These exercises could include stretching your arm. With a good range of motion, you should be able to reach and lift objects with minimal or no pain.
Including strength exercises in your treatment plan could help restore the functionality of your shoulder. Remember that one of the things you lose with tendinitis is the strength of your shoulder, making it difficult for you to reach or lift objects.
Your therapist will identify the strength exercises that could help your situation. For instance, you could use a medicine ball, weights, resistance band, and other kinds of strength training workout to challenge your weakened muscles.
Your therapist could even recommend a home workout program that could help you continue strengthening your shoulder blade and rotator cuff at home, even after the end of your physical therapy treatment.
As you continue with your treatment program, your physical therapist might add functional training to your schedule to ensure that you can perform your daily chores with minimal issues after recovery. As you start recovering, your therapist will slowly help you go back to your past level of functionality. It could include slowly performing household chores, tasks in your workplace, and sports activities that you did before the injury.
Functional training could also include reaching and lifting or even throwing to ensure that your shoulder slowly regains its functionality.
Ensure that you have the guidance of your physical therapist throughout the treatment period to avoid rushing into an activity that could leave you with more damages.
Additionally, choose to work with a well-trained and experienced physical therapist. An experience in treating rotator cuff tendinitis gives you the advantage of experiencing quality and effective treatment with your injury.
Find an Experienced Physical Therapist Near Me
Pain in your shoulder and surrounding tissues could indicate inflammation in your rotator cuff tendons. Delay in treatment could worsen the situation, leaving you with more significant pain and loss of functionality. If you use your arms and shoulders more, you could have rotator cuff tendonitis. It is advisable to seek proper diagnosis and treatment from an experienced physical therapist. At Suarez Physical Therapy in Las Vegas, we have the right skills and experience to diagnose and design a personalized treatment program that will meet your individual needs. Call us at 702-368-6778, and let us examine your shoulder for timely and more effective treatment.