Shoulder is the most mobile joint of the body. In order to provide stability to the joint, four muscles come together and make the rotator cuff which wraps itself around the shoulder. It acts mainly to stabilize the shoulder while the shoulder is elevated.
What is RC tendinitis?
The structure of the muscle that attached to the bone is known as tendon and its inflammation is called tendinitis. Rotator cuff tendinitis is when the tendon gets inflamed due to overuse, faulty postures, injury, weakness, tightness, muscle imbalance, inadequate rest etc.
Why is it important to correctly diagnose RC tendinitis?
When a diagnosis is accurate and made in a timely manner, the patient will have maximum benefits and will receive the most successful treatment. No two conditions are the same; the treatment approach is highly dependent on the correct diagnosis. The shoulder is a complex joint with many structures in it that can be the origin of pain, being the detective and finding the exact culprit of the pain is what will define the effectiveness of the treatment.
What does it feel like?
- Nagging pain in the front and outside of the shoulder
- Pain radiating up the shoulder, sometimes even till the elbow
- Sleep disturbance due to pain
- Pain aggravated by elevating the arm, combing hair, reaching for back pocket, lifting heavy grocery bags
Why do I have this?
The most common cause of RC tendinitis is repetitive overhead motion. Other causes include faulty postures, muscle imbalances, previous injury, sport injuries. The best way to avoid this overuse injury is education about appropriate rest, muscle stretching and strengthening and improving posture.
Treatment options in Physiotherapy
The Physiotherapist can help in many ways of which making a correct diagnosis based on subjective history and objective evaluation is the first. Following this a full plan of care is developed based on the presented symptoms.
Education about personal risk factors, rest and activity modification is given. Pain reducing modalities like IFC, TENS, Laser, cryotherapy is used to manage pain. Once the pain is under control the therapist will work to strengthen the rotator cuff muscles and stretch the appropriate muscles to restore the muscle balance. Posture will be improved and functional retraining would be done so the patient can return to previous level of activity and further damage is prevented.
Frequently Asked Questions (FAQ):
Should I be wearing a brace in RC tendinitis?
While appropriate rest is necessary to help recover the damaged tissue, a brace would not be recommended in this case. The reason behind this is that if the shoulder is immobilised for long periods of time it becomes prone to developing arthritis or frozen shoulder. In acute phase of the condition passive, active assisted or active movements as tolerated is recommended.
Should I take a cortisone injection for the pain?
It depends. A thorough evaluation of symptoms, history and the shoulder will lead to a correct answer to this question. Physiotherapist will always aim to give you long term results in which the shoulder is strong and less prone to injury.
Should I use ice or heat for pain relief?
Initially, as this condition involves inflammation, ice would be recommended to help decrease the pain and as the pain is reduced heat may be preferred for muscle relaxation.