If you have rotator cuff tendinopathy (also called tendinopathy of the shoulder), you have cellular level degeneration of the tendon collagen in the rotator cuff of the shoulder. This degeneration can lead to chronic weakness, pain, limited range of motion and inflammation.
The breakdown of collagen from tendinopathy can’t be reversed, but the progression and symptoms of your chronic tendon disease can be managed through a combination of therapies and approaches.
Before you begin tackling a treatment or pain management plan for your shoulder tendinopathy, you need a physician to diagnose the condition.
The physician will begin by checking for one or more of these rotator cuff tendinopathy symptoms:
Your physician will also take into account any risk factors for shoulder tendinopathy, such as previous shoulder injuries, sports activities, occupational risk, age, obesity, or diabetes. (If you are over 40, are significantly overweight, or participate in an overhead throwing sport like baseball or tennis, you’re at greater risk.)
After looking at symptoms and risk factors, the next step is a physical exam—including diagnostic tests—to determine the cause of your symptoms.
Exams start with the doctor checking your range of motion, pain level, and the strength or weakness of your shoulder. To check for rotator cuff tendinopathy, your physician may ask you to move your arm through a series of movements. He or she may also feel your neck to check for signs of arthritis or a slipped or pinched disk—conditions that could be responsible for the symptoms you’re experiencing.
To confirm a diagnosis of shoulder tendinopathy, however—and to isolate its cause—your physician will probably need to do some imaging tests. For example:
An exam can also diagnose or rule out other shoulder issues such as a shoulder dislocation, shoulder impingement, a SLAP lesion tear, a rotator cuff tear, tendonitis (which is similar to tendinopathy, but not chronic), frozen shoulder, or shoulder bursitis.
Most physicians will advise conservative, non-surgical treatment for tendinopathy, unless the degeneration of the tendon is severe and has resulted in a serious tendon tear requiring repair.
The purpose of non-surgical treatment is to find ways to reduce inflammation if you have it; to manage your pain; and to improve your range of motion, restoring it to normal if possible.
It bears repeating that chronic rotator cuff tendinopathy isn’t something that can be fixed or cured, per se; it’s caused by a cellular breakdown of the collagen in your tendons that’s usually due to sports-related or age-related wear and tear. However, treatments can manage your pain and other symptoms and may help to slow the degeneration (particularly if the degeneration is compounded by poor biomechanics when you’re using your shoulder joint).
The techniques available to manage tendinopathy non-surgically include:
Surgery may be recommended if your symptoms do not improve with nonsurgical therapies after a period of time (usually 3-6 months).
If you’re referred to an orthopedic surgeon, arthroscopy—minimally invasive surgery involving the insertion of a camera through a small incision point—may be necessary to get a closer look inside the rotator cuff.
Once inside the joint, the surgeon may be able to see a problem that was difficult to identify on imaging tests. Impingement, for example, may require decompression surgery to remove impediments and make more space for the tendon to smoothly glide without friction.
Often, patients who progress to the point of needing surgery for tendinopathy actually have some other issue at play, such as a rotator cuff tear. Once the tear is repaired and the rehabilitation is complete, patients can usually return to prior activities.
To learn more about your treatment options for Rotator Cuff Tendinopathy, contact Coastal Orthopedics in Corpus Christi today at (361) 994-1166.
Article written by: Rob Williams, MD