Rotator cuff tendinitis is a very common cause of shoulder pain. It refers to inflammation in the small muscles in your shoulder (your 'rotator cuff'), and is usually the product of a mechanical strain, like doing some strenuous exercise, or carrying some heavy loads. It'll settle down pretty quickly with the right treatment, but ignoring it and trying to force yourself to work through the pain is a sure way to prolong your recovery.

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AGE IS NOT YOUR

FRIEND HERE

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As you get older, rotator cuff tendinitis issues become more common. It's easier to strain the small muscles and tendons in your rotator cuff, and it also takes a little longer for your body to recover.

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The statement above certainly doesn't sound nice, but take heart. This isn't meant to discourage you. Rather, it should serve as a reminder that you need to take more caution when doing something strenuous or lifting something heavy. You should also place more importance on doing your 'maintenance work' to keep your rotator cuff healthy, and prioritise setting aside some time in the week for these home therapy exercises.

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HOW DID I GET THIS?

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Rotator cuff tendinitis usually starts because of a mechanical strain, when you've overused your shoulder, or tried to carry something too heavy, or if you carry a weight for a very prolonged period (such as when you carry your child around for a few hours).

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You can also get it from a minor injury to your shoulder, such as when you accidentally twist your shoulder and sprain it.

WHAT CAN I DO?

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A rotator cuff injury is a usually strain or overuse injury. The best strategy in treating this is PREVENTION. 

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Always warm up fully before doing exercise, even if you're not working your upper body on that day. Do some shoulder circles and stretches to loosen your shoulder up and activate your shoulder muscles before exerting yourself.

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Put in the work and set some time aside for your rotator cuff exercises at least 2 to 3 days in the week. Doing these simple strengthening regularly will help you keep your rotator cuff strong and healthy, and minimise your risk of an injury.

 

A lot of people have difficulty setting aside even 10 minutes just for their therapy exercises, so you should try to incorporate it into your daily routine. I suggest exercising three days a week, and adding shoulder exercises in to be done at the end of your exercise routine, every time you exercise, without fail.

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If you did have an injury and some pain in your shoulder, you need to first make sure that it isn't something too serious.

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If you had it because of a fall or something hitting your shoulder, you should get it checked by a doctor to see if you need an x-ray. You need to make sure that you haven't broken something, or dislocated your shoulder, since those are conditions that need urgent medical attention.

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If the pain isn't too bad and you didn't injure your shoulder, you can try a few things to settle the pain down. Try icing the painful part of your shoulder soon after the onset of pain, to reduce the inflammation in the area. 

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As we've talked about above, rest is a very important part of your recovery process.

 

Avoid any heavy lifting and strenuous physical activity for a half a week to a week. If your pain hasn't gone away completely after a week, you can consider resting it for a further 1 to 2 weeks if you felt the pain was initially improving with the period of rest.

 

However, if the pain hadn't changed very much even after this period of rest, it'd be best to have a doctor look at your shoulder and check it.

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You can take an anti-inflammatory medication to settle your pain down. These are called 'NSAIDs', and refer to a medical term for this class of medications. These medications will help settle your pain down pretty quickly since they reduce the swelling and inflammation in the affected area, allowing for recovery and resolution of your pain. 

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However, while these medications are very useful, they are not suitable for everyone. If you have an allergy to such medications, or have heart, gastric or kidney problems, you should not be taking them. You can check with your doctor to see if these anti-inflammatory medications are are suitable for you.

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Physiotherapy is an invaluable tool in helping you recover. In the initial few days following the onset of pain, you should first rest your shoulder and refrain from physical activity, but after 3 to 4 days of rest, you should get going with your shoulder stretches to maintain your shoulder mobility.

 

A week or two after your pain has resolved, you can start doing some gentle strengthening exercises. These will help slowly build up your rotator cuff, and minimise the chance of you straining your rotator cuff again.

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INVESTIGATIONS

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It's difficult to differentiate a rotator cuff tendinitis from a rotator cuff tear, especially when the tendinitis is severe enough to limit the power in your affected shoulder. Your doctor may be able to tell in the clinic by testing some of your shoulder movements and power, but a more reliable method is to have some sort of imaging done for your shoulder. 

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A rotator cuff tendinitis should recover within a few weeks, with rest and some anti-inflammatory medications. If it's persisting beyond 1-2 months even though you've taken time off from any physical strenuous activity and carrying heavy loads, it may be best to consider some physiotherapy, and even medical imaging tests.

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Your doctor may refer you on to see an Orthopaedic Surgeon, who may want to do an ultrasound or an MRI scan. These scans will reliably show if there is any rotator cuff injury (like a tendon tear), or if there is just inflammation in the muscles, and how bad it is. Both scans are useful, but while an ultrasound scan is a lot cheaper, it may not always be as accurate as an MRI scan.

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WRAP IT UP!

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Shoulder pain is a common issue, especially as you age. Remember a few basic things to safeguard your shoulder joint health
(i) always warm up before doing physical training
(ii) do regular rotator cuff strengthening exercises to keep your shoulder strong and healthy
(iii) remember that physiotherapy isn't a quick fix - it will help, but it'll take weeks to months to see a significant difference
(iv) see a doctor if your pain isn't going away after a week or two