Rotator Cuff Tendinitis

Rotator cuff tendinitis is an inflammation of a group of muscles in the shoulder together with an inflammation of the lubrication mechanism called the BURSA. In fact, ‘bursitis’ should not be considered a diagnosis but rather a symptom of rotator cuff tendinitis.

The rotator cuff is a group of four tendons that covers the humeral head and controls arm rotation and elevation. These muscles and their tendons work together with the deltoid muscle to provide motion and strength to the shoulder for all waist-level and shoulder-level or above activities.

In the bussy metropolitan way of life we as a whole are running for our livelyhood and solace. In this battle we really want a help to keep up with our solid body and psyche. Orthopedic Department at Shreya Hospital, Ghaziabad is the best objective for keeping up with our real strength. Orthopedic Surgeon practicing here give best treatment and consultancy to all sort of your Shoulder Tendinitis whether it very well might be Rotator Sleeve Tendinitis.

Causes of Rotator Cuff Tendinitis

The shoulder has a unique arrangement of muscle and bone. The rotator cuff (which is muscle) is sandwiched between two bones much like a sock lies between the heel and the edge of a shoe. In the same way that repeated walking eventually wears out the sock, the rotator cuff muscles fray with repeated rubbing on the bone. As the muscle begins to fray, it responds to the injury by becoming inflamed and painful. With continued fraying, like a rope, it may eventually tear.

• Repetitive overhead activities such as throwing, raking, washing cars or windows and many other types of highly repetitive motions.
• It may also occur as a result of an injury.

Rotator cuff injuries are the most common cause of shoulder pain and limitation of activities in sports in all age groups. Rotator cuff tendonitis is the mildest form of rotator cuff injury.

Symptoms of Rotator cuff tendinitis

• A ‘toothache’ like pain radiating from the outer arm to several inches below the top of the shoulder.
• Pain may also occur in the front and top of the shoulder.
• It may interfere with sleeping comfortably. It may even awaken people from a sound sleep with a nagging pain in the upper arm.
• Pain while raising the arms overhead or in activities that require reaching behind the body, such as retrieving an object from the back seat of a car.
• Reaching behind the back to fasten underclothing or to pass a belt may aggravate the arm and shoulder pain.
• A clicking in the shoulder may occur when raising the arm above the head.

Diagnosis

• A thorough history and physical exam will nearly always lead to a correct diagnosis.
• X-rays will often show changes on the arm bone where the rotator cuff muscles attach.
• An MRI provides the definitive diagnosis. This test clearly shows the muscles and indicates if the muscle is inflamed, injured or torn.

Treatment of Rotator cuff tendinitis

The following steps should be taken as a conservative approach to treating rotator cuff tendinitis:

• Stop or markedly decrease the activity that required the use of the shoulder at or above shoulder level.
• Apply ice to the affected area.
• Take anti-inflammatory medication to reduce arm and shoulder pain.
• Begin an exercise program to maintain flexibility.
• Avoid carrying heavy objects with the affected arm or using shoulder-strap bags on the affected side.

In the early phases, over-the-counter anti-inflammatory medications may provide benefit. However, to allow the inflammation to resolve, it is vital to curtail any repetitive activity and it is equally important to try to keep the elbow below the shoulder level when using the arm.

Daily stretching while in a hot shower is also beneficial. If shoulder pain becomes more severe, prescription strength medication or a cortisone type injection may help.

For a young patient under the age of 30 and with a first time episode of rotator cuff tendonitis that is treated immediately with the above protocol, the average length of time for rehabilitation is two to four weeks. For those with recurrent episodes of tendonitis and some risk factors, rotator cuff tendonitis may take months to heal and in rare cases may require surgery.

Surgical Treatment

If symptoms persist, surgery to remove a spur on the acromion can increase the space available for the inflamed tendon and may prevent further fraying or complete rupture. If an MRI shows a complete muscle injury, surgical repair may be required.

Surgery for recurrent rotator cuff tendonitis (bursitis) is occasionally performed to:

• Remove a prominence or spur on the undersurface of the acromion.
• Remove chronically inflamed, thickened and fibrotic bursal tissue.
• Inspect the tendons and tidy up and sometimes repair a tear in the tendons.

These procedures are often done in combination. This can be done either through an open or an arthroscopic approach with the start of an early rehabilitation program one or two days after surgery and advancing to a more comprehensive program between two and five weeks after surgery. The initiation and progression of these exercises is dependent upon the patient’s findings at surgery, surgical procedure and rate of healing.