In spite of being built to withstand strain, intense and repetitive movements that extend over a considerable amount of time can cause damage to major tendons of the glenohumeral joint. These tendons function incessantly as they partake in all shoulder movements–the tendons are the connective tissue that permits muscle-to-bone attachment. Four out of the five intra-articular shoulder tendons (the subscapularis, supraspinatus, infraspinatus and teres minor tendons) enfold the articular surface of the humeral head, and collectively form a group of muscles that is known as the rotator cuff. In direct contact with the rotator cuff is the long head of the biceps tendon which is the fifth tendon that passes through the rotator cuff.

The inflammation of tendons is one of the most common causes of pain or weakness affecting the shoulder girdle. The most prevailing type of tendonitis is rotator cuff tendonitis, and particularly tendonitis of the supraspinatus tendon as a result of the tendon’s vulnerable anatomical position.
Nevertheless, people that put excessive strain on the joints do not always suffer from rotator cuff tendonitis. The primary factors that contribute to the development of this condition are intensity and duration of strenuous muscle activity – therefore athletes participating in sports such as tennis or baseball, as well as individuals in occupations that require overhead shoulder movements, are more susceptible to developing rotator cuff tendonitis. Moreover, rotator cuff tendonitis can also be dependent on the anatomy of the shoulder girdle: The more curved the bony process of the scapula (acromion) is, the greater the likelihood of a ‘‘restrained’’ acromion that can cause irritation of the supraspinatus tendon. In the case at hand, rotator cuff tendonitis is the result of subacromial impingement syndrome.

Initially, patients may not display severe symptoms and thus delay a visit to the orthopedist. Manifestations of rotator cuff tendonitis commence with mild pain that persists even when the patient is at rest. Pain spreads from the anterior side of the shoulder towards the lateral side of the humerus and prevents shoulder elevation and overarm throwing movements. However, in the acute stage of the condition, pain intensifies (especially at night-time) and spreads to the neck, scapula and the totality of the upper limb. Consequently, arm movements are restricted, and patients experience a burning sensation in the affected area.

Diagnosis is based on the detailed medical history taken by the doctor and the patient’s clinical examination. The orthopedist must exclude other joint diseases, for example arthritis etc. Shoulder ultrasound can determine any potential inflammation of the rotator cuff tendons, as well as reveal possible rotator cuff tears. Ultimately, an MRI scan might be deemed necessary by the orthopedist.
Treatment for rotator cuff tendonitis aims to reduce pain and restore normal function to the upper extremity. In most cases, conventional treatment is recommended which includes rest, shoulder suspension, medication, application of ice, cortisone or growth factor therapies, and physiotherapy sessions in the post-acute stage of the condition.
In cases of tendonitis of the supraspinatus tendon, symptoms normally subside after approximately one week. However, in distinct medical cases where patients suffer from severe symptoms for a significant amount of time, or experience frequent relapses, shoulder arthroscopy can be performed in order to surgically ‘‘remove’’ damaged tissue, followed by anterior acromioplasty - partial removal of the anterior-undersurface part of the acromion.

Do you need a
Second Opinion

Are you sure about the diagnosis and the treatment that has been suggested to you? Fill in the form below to request a second opinion from Dr. Konstantinos Indzoglou.

    Make an

    And we will contact you!

      Add testimonial description here. Edit and place your own text.

      John Doe


      Add testimonial description here. Edit and place your own text.

      Jane Doe


      need help?

      Lorem ipsum dolor sit amet, consectetur adi pisicing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua.