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Rotator Cuff Tendinopathy / Tendonitis, Partial or Complete Tears

What is the Rotator Cuff?


The rotator cuff is a group of four muscles and their tendons that surround the shoulder joint. These tendons help keep the ball of the upper arm bone (humerus) centered in the socket and allow you to lift, rotate, and move your arm overhead.


What are These Conditions?


  • Tendinopathy/Tendonitis: Irritation or inflammation of the rotator cuff tendons, often from overuse.

  • Partial Tear: A tendon is frayed or damaged but not completely torn.

  • Complete Tear: The tendon is fully torn away from the bone, often causing weakness and loss of function.


Symptoms

Rotator cuff problems can cause:


  • Pain in the shoulder, often worse with lifting, reaching, or overhead activities

  • Pain at night, sometimes severe enough to disturb sleep

  • Weakness or difficulty lifting or rotating the arm

  • Clicking, popping, or a catching feeling in the shoulder

  • Limited range of motion or stiffness


What Causes Rotator Cuff Problems?


  • Repetitive use from sports, work, or heavy lifting

  • Aging and wear-and-tear, which weaken tendons over time

  • Injury or trauma, such as a fall or lifting something too heavy

  • Bone spurs, which can rub against tendons and cause tearing


How are They Diagnosed?


  • Medical history and exam: checking motion, strength, and pain points

  • X-rays: may show bone spurs or arthritis

  • MRI or ultrasound: show whether tendons are inflamed, partially torn, or fully torn


How are They Treated?


Non-surgical options (first line):


  • Rest and activity modification

  • Anti-inflammatory medicines (NSAIDs)

  • Physical therapy to restore strength and flexibility

  • Cortisone (steroid) injections for pain relief

  • Orthobiologics (such as platelet-rich plasma [PRP]) in select cases to promote tendon healing


Surgical options (if symptoms persist or in larger tears):


  • Arthroscopic repair or debridement (minimally invasive reattachment or smoothing)

  • Open or mini-open repair for larger or more complex tears

  • Tendon transfers, which use nearby muscles to restore shoulder function when the rotator cuff cannot be repaired

  • Shoulder replacement in severe cases, especially when arthritis is also present


Learn more from AAOS (OrthoInfo):

https://orthoinfo.aaos.org/en/diseases--conditions/rotator-cuff-tears/

https://orthoinfo.aaos.org/en/diseases--conditions/shoulder-impingementrotator-cuff-tendinitis/

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