Understanding Rotator Cuff Tendinitis: A Quick Guide

Introduction:

In this post, we will explore the intricate pathology of rotator cuff tendinitis, providing you with an understanding of the internal changes that occur within the shoulder joint. By gaining insights into the pathology, you'll be better equipped to develop effective treatment plans and support clients experiencing this condition. Let's dive in!

Pathology of Rotator Cuff Tendinitis:

Rotator cuff tendinitis, also known as shoulder impingement syndrome, involves inflammation and irritation of the tendons within the rotator cuff and the surrounding structures.

While there is an overlap between the two conditions, rotator cuff tendonitis can be considered a specific type of shoulder impingement syndrome. In shoulder impingement syndrome, impingement of the tendons and bursa can lead to various conditions, including rotator cuff tendonitis.

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Let's examine the intra-articular pathology associated with this condition:

• Tendon Degeneration: Rotator cuff tendinitis often arises due to degenerative changes within the tendons. Over time, the tendons may undergo microtrauma, resulting in collagen breakdown, thinning of the tendon fibres, and loss of tensile strength. These degenerative changes can make the tendons more susceptible to inflammation and injury

• Tendon Inflammation: In response to repetitive stress or impingement, the tendons of the rotator cuff can become inflamed. Inflammation is the body's natural defence mechanism, but chronic or persistent inflammation can contribute to pain, swelling, and further damage within the joint. In rotator cuff tendinitis, the inflammatory response primarily affects the tendon tissues.

• Impingement and Compression: Mechanical impingement refers to the pinching or compression of the tendons between the acromion process of the scapula (shoulder blade) and the head of the humerus (upper arm bone). This impingement can occur during certain arm movements or due to structural abnormalities, such as bone spurs or a downward-sloping acromion. The compression of the tendons within the joint space can lead to further irritation, inflammation, and restricted movement.

• Bursal Involvement: In addition to the tendons, the subacromial bursa, a small fluid-filled sac that acts as a cushion between tendons and bones, can also become inflamed in rotator cuff tendinitis. The bursa may thicken and produce excessive fluid as a response to ongoing inflammation, contributing to shoulder pain and discomfort.

Conclusion:

By understanding the intra-articular pathology associated with rotator cuff tendinitis, remedial massage therapists can provide targeted treatments to address the underlying causes and symptoms of this condition. A comprehensive approach may involve techniques to reduce inflammation, promote healing, alleviate pain, and restore optimal joint function.

References:

• Neer CS 2nd. Impingement lesions. Clin Orthop Relat Res. 1983;(173):70-77.

• Uhthoff HK, et al. Rotator cuff tears: why do we repair them? J Bone Joint Surg Br. 2003;85(4): 503-511.

• Cook JL, et al. Tendinopathy: is there a role for massage? Sports Med. 2012;42(7): 545-555.