In part two of our series on rotator cuff tears we look at tendinosis and degeneration.
Over time, the connective tissues in our body weaken and lose their ability to heal and repair.
Sometimes, tendons become so weak they can actually pull away from the bone without the patient even knowing.
We call this process tendinosis.
What causes rotator cuff tendinosis?
Unlike a traumatic tear caused by a fall or sports injury, tendinosis is a gradual process that usually affects people aged 40 years and over; although it can occur in a younger person who uses their shoulder repetitively in their job, sport, or daily activities.
Tendinosis commonly occurs in the rotator cuff: a series of four tendons that control your shoulder’s control, rotation and stabilisation. The tendons come from four muscles
- Subscapularus muscle
- Supraspinatus muscle
- Infraspinatus muscle
- Teres minor muscle
If you suffer from rotator cuff tendinosis, you are probably experiencing shoulder pain that’s getting progressively worse, both when you’re moving as well as when you’re in bed at night.
You may find it too uncomfortable to sleep on the affected side and rolling onto it may be painful enough to wake you.
Tendinosis patients usually can’t recall a single incident that caused the onset of their pain, because the injury has happened over time.
How is tendinosis diagnosed?
Diagnosis begins with a physical examination and we may also run imaging tests such as X-rays, ultrasound scans or MRI scans. It’s important to screen for other possible causes of shoulder pain and rule out a more serious injury.
Many patients with tendinosis don’t require surgery and respond well to physiotherapy, which strengthens the remaining cuff tissue. You can also use heat, ice and anti-inflammatories to help relieve your pain.
If you’re still experiencing severe discomfort after 3-6 months, we will then review surgical options with you.
If you suspect you may be suffering from tendinosis, it’s important to see a specialist as soon as possible. In some cases, tendinosis can progress to a rotator cuff tear . Early diagnosis and treatment can prevent your symptoms getting worse and give you the best chance of recovery.
In part three in our series on rotator cuff tears Shoulder Bursitis & Rotator Cuff Tears we look at how bursitis can often cause pain very similar to a rotator cuff tear.