Rotator Cuff Tendonitis
(Impingement Syndrome, Shoulder Bursitis)

The shoulder joint is a ball and socket type of joint. The rotator cuff is a group of four muscles (supraspinatus, infraspinatus, teres minor, and subscapularis) which act together to hold the upper arm (humerus) in place at the shoulder joint and allow it to move in various directions. The tendons of these muscles (especially the supraspinatus) can frequently become inflamed and cause a great deal of discomfort for many people. Sports that involve repetitive overhead motion of the arm such as tennis, baseball (especially pitchers), swimming, and lifting weights are well known to cause this type of tendon inflammation (tendonitis). Other activities, such as brushing one’s hair or simply reaching overhead have also been known to cause pain when rotator cuff tendons become inflamed. Rotator cuff tendonitis or “impingement syndrome” as it is sometimes called is a very common repetitive stress condition. The “impingement” takes place when one or more of the rotator cuff tendons become irritated on the undersurface of the acromion (bony protuberance of the shoulder blade also known as the scapula) as the arm is lifted overhead. Also present between the rotator cuff tendons and the acromion is a fluid filled sac – which acts as a cushion to protect the tendons - known as a “bursa.” When this bursa becomes inflamed due to repetitive overhead motion, shoulder bursitis (another term for rotator cuff tendonitis) can occur. Along with pain with overhead motion, people may sometimes experience mild to moderate weakness of the shoulder. This condition is diagnosed by a thorough history and physical examination. Treatment usually consists of medications to control the pain and decrease inflammation as well as physical therapy to restore motion and strength to the surrounding muscles. However, if symptoms are severe enough or conservative measures do not provide adequate treatment, cortisone (steroid) injections into the area of inflammation may be required. Finally, if there has been no improvement with either medication, physical therapy, or injections and your symptoms begin interfering with sleep, and your activities of daily living, surgery may be necessary to treat this condition.