The rotator cuff tendons control the motion of our shoulder joint. They are four very important muscles and a very common cause of shoulder pain.
What is Rotator Cuff Tendinosis?
Tendinosis of the rotator cuff is a degenerative (genetic, age or activity related) change that occurs in our rotator cuff tendons over time. Rotator cuff tendinosis is exceptionally common. Although many people with shoulder pain will be found to suffer from tendinosis. Many, many people have tendinosis of the rotator cuff and do not even know it. Why rotator cuff tendinosis bothers some people and doesn’t bothers others is currently a question the orthopedic surgery community can not answer. Rotator cuff tendinosis is just as likely to be found in a professional body builder as it is likely to be found in a true couch potato.
What does Rotator Cuff Tendinosis Look Like?
In this photo, the white round structure on the right is the top of the humerus. The frayed tissue just to the left is the rotator cuff. This patient was suffering from rotator cuff tendinosis and a partial-thickness cuff tear.
Tendinosis represents a structural change in the tendon at a microscopic level. This results in disorientation of the tendon structure and, ultimately, partial tearing as the weakened tendon gives way. The analogy I always use is your favorite pair of blue jeans. You wear them for years and then one day you feel a breeze down by your knee — you look down and there’s a hole. No trauma, no accident… the fabric just wore out.
Therefore, rotator cuff tendinosis is not the result of a single traumatic event. It is brought on by genetics, age and repetitive activity. We are not sure why some patients with rotator cuff tendinosis have pain, and others do not.
Many patients with rotator cuff tendinosis and partial tears do not require surgery and will respond very well to a coordinated physical therapy program to strengthen the remaining cuff tissue. Ice and anti-inflammatories can work well, too.
This condition is the most common cause of shoulder pain in patients between 35 and 60 years old.