Rotator cuff problems generally fall into three categories, which often overlap:
Impingement & Bursitis: This occurs when the tendons or the protective fluid-filled sac (bursa) get "pinched" during overhead movements. It feels like a sharp catch in the shoulder.
Tendinitis (Tendinopathy): This is inflammation or wear-and-tear of the tendons themselves, usually from repetitive use. It often presents as a dull, constant ache that worsens at night.
Rotator Cuff Tears: Tears can be partial or full-thickness. While some happen suddenly during a fall, many develop slowly over time.
A precise diagnosis is the key to a successful non-surgical plan:
Specialized Physical Exams: We use specific "stress tests" to isolate each of the four tendons, checking for weakness or pain in different positions.
X-Ray: X-ray helps evaluate for calcium deposits that can irritate the rotator cuff. It also helps rule out other problems such as arthritis, fractures, or growth plate problems.
MRI: If we suspect a significant tear, an MRI provides a detailed map of the injury, helping us determine if the tissue is healthy enough for regenerative treatments or if a surgical consult is necessary.
Current medical research shows that many rotator cuff tears and most cases of impingement respond just as well to conservative treatments as they do to surgery. Our goal is to bridge the gap between "just resting" and the operating room. Effective treatment options include:
Activity Modification: Adjust your routine or workspace to take the stress off the injured area temporarily while it heals
Physical Therapy: Tailored exercises to improve shoulder strength, mobility, and posture
Anti-Inflammatory Medications: NSAIDs can help control pain and inflammation
Manual Therapy: Techniques like massage, dry needling, or myofascial release can reduce muscle tension
Injections: Corticosteroids or platelet-rich plasma injections (PRP)
In cases where conservative measures fail, surgical intervention may be considered.