Rotator Cuff Tendinopathy

Description

Rotator cuff tendinopathy is a common cause of shoulder pain. Rotator cuff tendinopathy occurs when tendons of the rotator cuff become degenerative after extended periods of use and are unable to fully recover. If the tendon is unable to fully recover before the next training session or work day, the damage accumulates until the tendon degenerates substantially. This can become quite painful and in the worst case scenario your rotator cuff muscles (most commonly the supraspinatus) may tear or rupture.

Quite often these tendinopathies will be secondary to shoulder impingement and may be caused through faulty biomechanics which cause the muscles/tendons to be loaded more than they can handle. A common muscular imbalance in the shoulder as seen in swimmers or gym goers is the overdeveloped anterior chest muscles, particularly the pectorials. These overdeveloped muscles cause the shoulder to roll forward causing the posterior stabiliser muscles and the supraspinatus to work much harder placing them at high risk of developing a tendinopathy.

Rotator cuff tendinopathies frequently occur during training errors where the workload was increased quicker than the body could adapt. This is typically the case when increasing mileage ahead of an important race or meet.

Workers at risk of developing rotator cuff tendinopathies include those who do a lot of repetitive overhead lifting.

Symptoms

Symptoms include:

  • Pain with overhead activity.
  • Pain with swimming, throwing, overhead shots in racket sports.
  • Discomfort with abduction of the shoulder, especially around 90 degrees.
  • Pain with resisted shoulder movements particularly abduction (lifting your arm sideways away from your body).
  • An ache or pain in the shoulder after a gym session, tennis game or heavy day of lifting at work.
  • Stiffness in the shoulders when warming up for exercise or work.

Treatment

Treatment for rotator cuff tendinopathies include:

  • Massage to relax tightened muscles.
  • Stretches to lengthen any tightened muscles and correct any biomechanical abnormalities in the shoulder.
  • Specific strengthening techniques to ensure the tendons are sufficiently stimulated to repair.
  • Strengthening for surrounding muscles in the case of an imbalance to ensure the correct strength ratios in the shoulder are present.
  • Mobilising or manipulating surrounding joints including the spine which may be stiff resulting from the tendinopathy or be causing the altered biomechanics leading to the development of the tendinopathy.
  • Technique analysis to ensure you aren’t placing yourself at risk.