One of the most flexible and mobile joints in the human body, the shoulder has an extensive range of motion.
It’s involved in a tremendous variety of actions performed by the arms and hands, such as adduction, abduction, flexion, extension, internal and external rotation, and circumduction. Think reaching for and operating a computer mouse; washing your hair; lifting the trash bag from the trash can; swinging a golf club; doing push-ups; or opening a car door.
Because of the burden and responsibility carried by the shoulder, along with its flexibility and anatomy, it’s susceptible to pain, a multitude of injuries, and shoulder instability.
Common Causes of Shoulder Pain
Shoulder pain, a common complaint, can range from unnoticeable and dull to functional limitations and extreme discomfort, affecting people of different ages, occupations, and activity levels (basketball, tennis, working out, etc.).
Some common causes of shoulder pain include overuse and repetitive movements, frozen shoulder, joint instability and weakness, impingement, arthritis, shoulder dislocation, and rotator cuff injuries – namely rotator cuff tendinosis.
A Closer Look: Rotator Cuff Tendinosis
Affecting tens of thousands, tendinosis of the rotator cuff is very common and refers to the chronic degeneration of the tendons, minus inflammation.
Due to the constant everyday use of the rotator cuff (stabilizing the shoulder), in addition to other risk factors, such as age, genetics, activities, poor posture, and overuse, the rotator cuff tendons age prematurely.
This results in poor blood flow within the tendon’s blood vessels, micro and full tears, and an imbalance between tendon repair and tendon breakdown. Further, degeneration accelerates over time, while the healing response decelerates.
Signs, Symptoms, & Diagnosis of Tendinosis
Although rotator cuff tendinosis does not always cause pain, if it is present, it’s often explained as a dull, nagging pain that worsens with specific activities or at night.
If untreated, symptoms will likely become progressively worse, with some experiencing radiating pain into the back, neck, and upper arm due to fatigue of the shoulder. Others may experience an increased level of pain when performing everyday tasks, such as getting dressed, brushing your hair, or driving. This is indicative of a more complex issue, one that may warrant a visit to a physician or a sports medicine clinic.
At either location, the purpose is to receive a clear diagnosis.
In some cases, a patient’s medical history, a physical exam, and strength test may be all that’s needed to get a firm diagnosis. X-rays and MRIs are also used to assess and make a diagnosis of cuff tendinosis.
Tendinosis Treatment & Surgery
The ultimate goal of treatment for rotator cuff tendinosis is to result in the resolution of pain and restoration of shoulder function. In an attempt to achieve such results, non-operative treatments are initially tried, oftentimes for 3-6 months.
Non-operative treatments are inclusive of the following:
- rest and activity moderation
- cold therapy
- NSAIDS (Advil, Alleve, ibuprofen)
- home exercise and stretching programs
- physical therapy
- cortisone injections
If improvements in function and comfort fail to be realized after 6 months, surgery may be warranted per further discussions and guidance from a trusted professional.