What is rotator cuff tendinosis?

Author: Howard J. Luks, MD- Posted in: Rotator Cuff, Shoulder, Shoulder FAQ 6 Comments

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.

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Howard Luks MD, 19 Bradhurst Avenue, Hawthorne, New York 10532, United States - Phone: 914-789-2735 Email: hluks@uopc.org


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6 Responses to “What is rotator cuff tendinosis?”

  1. Reply Jalen says:

    The power of health care and social media… and a firm digital footprint.
    “A wonderful job. Super helpful information.”

  2. Reply Partial Rotator Cuff Tears --Jonathan Niese and You - Howard J. Luks, MD says:

    [...] cuff injuries are incredibly prevalent.  Common rotator cuff related problems include tendinosis, partial rotator cuff tears, full thickness tears and calcific tendonitis.  The majority of [...]

  3. Reply andrea says:

    I have RSD AKA CRPS in my right foot and ankle and I go every 3 months for a lumbar block in order to keep it in check… when the shots wear off my foot starts to hurt and and freeze up … lately my shoulder was giving me problems so I had it looked at and after my MRI was told I had tendinosis… my question is this … is the reason I am having so much pain with my tendinosis because of the RSD? I dont have the swelling and the blotchy purple looking skin but the frozen range of motion and the pain and tingly feeling are there… maybe Im just paranoid because of the last RSD episode… (it was awful) and was brought on by Achilles tendon damage. Any input would be greatly appreciated as not many doctors are familiar with this disorder

    • Reply Howard J. Luks, MD says:

      Andrea … anyone with a history of CRPS is going to worry that any new discomfort is related… Completely understandable. While CRPS can occur in other areas, it is well known that tendinosis can cause fairly significant pain. Sometimes selective injections of the shoulder under ultrasound guidance can help determine what the source of the pain is.. and treat the pain as well. The hallmark of CRPS or RSD is pain out of proportion… the color changes and skin changes actually occur fairly late in the process. Your surgeon should be able to help you determine if this pain is related to the shoulder, the rotator cuff tendinosis or perhaps CRPS.
      Good Luck1

  4. Reply Rotator cuff injuries and recovery | Physiotherapy and Recovery.... says:

    […] from tendinosis generally come on slowly over time and reach a point where you are very uncomfortable. Some […]

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