Rotator Cuff Tendinitis
We assess and treat rotator cuff tendinitis with an emphasis on accurate diagnosis, targeted physiotherapy, and measured use of injections. If needed, we consider keyhole (arthroscopic) surgery to restore pain-free function for work, sport and sleep.
What Is Rotator Cuff Tendinitis?
The rotator cuff is a group of four muscles and tendons that stabilise the shoulder and control lifting and rotation. When these tendons are overloaded or pinched under the acromion (the bony roof of the shoulder), they become inflamed and painful—this is rotator cuff tendinitis (also called shoulder tendinitis or part of the impingement spectrum).
Common Symptoms
- Pain at the front or outer shoulder, worse with overhead reach
- Night pain—especially lying on the affected side
- Sharp pain with lifting, throwing, or reaching behind the back
- Weakness or fatigue with repetitive use
- Clicking, catching, or a sense of “pinching”
- Reduced range of motion and stiffness over time
Causes & Risk Factors
- Repetitive overhead activity: swimming, tennis, gym work, painting, trade labour
- Posture & biomechanics: rounded shoulders, poor scapular control
- Rotator cuff weakness or imbalance
- Age-related tendon changes reducing tendon resilience
- Acromial shape or bone spurs narrowing the subacromial space
- Previous injury: dislocation, fracture, or postsurgical stiffness
Diagnosis
We identify the pain source and exclude a tear to guide the right treatment.
- History & examination: impingement signs, strength and range testing
- X-rays: acromial shape, AC joint changes, calcific deposits, arthritis
- Ultrasound or MRI: tendon inflammation or partial/full-thickness tears, bursitis
Non-Operative Treatment
Physiotherapy
- Restore pain-free range (capsular and pec minor stretching)
- Strengthen rotator cuff and scapular stabilisers
- Motor control & posture re-training for overhead tasks
Adjuncts
- Short course anti-inflammatories (if suitable)
- Subacromial injections—corticosteroid or PRP for persistent inflammation
- Activity modification and ergonomic/work technique changes
Most people improve with a structured 6–12 week program.
Surgical Options
Arthroscopic Subacromial Decompression
Keyhole surgery to remove inflamed bursa and smooth bony spurs, creating more space for the tendons to glide. Often a day procedure considered after high-quality physiotherapy and injections have plateaued.
Rotator Cuff Repair (if a Tear Is Present)
For confirmed partial or full-thickness tears that fail non-operative care, we may perform an arthroscopic repair during the same sitting.
Recovery & Rehabilitation
Days 1–7
- Sling for comfort if needed; hand, wrist, elbow movement
- Ice, elevation, gentle pendulum exercises
Weeks 1–6
- Guided mobility; isometric cuff work
- Scapular control and posture drills
Weeks 6–12
- Progressive strengthening and functional tasks
- Gradual return to overhead work and sport
3–6 Months
- Most patients return to full duties, gym, swimming, and racquet sports as tolerated
Results, Risks & Prevention
- Outcomes: The majority improve with physiotherapy; surgery helps when non-operative care has plateaued.
- Risks: Infection, stiffness, persistent pain, rare nerve irritation. We minimise risk with sterile protocols and early motion.
- Prevention: Maintain shoulder and scapular strength, optimise posture, periodise overhead training, address technique early.
Frequently Asked Questions
Is rotator cuff tendinitis the same as impingement?
They are closely related. Tendinitis often occurs because the tendons are impinged (pinched) under the acromion. Management principles overlap.
How do I know if I have a tear?
Persistent weakness or traumatic onset raises suspicion. Ultrasound/MRI can confirm if there is a partial or full-thickness tear.
Will I definitely need surgery?
No. Most people recover with a structured 6–12 week physiotherapy program and activity changes. Surgery is considered only if symptoms persist.
Next Steps
If shoulder pain is limiting sleep, work or sport, we can help. We’ll confirm the diagnosis, start the right physiotherapy, and discuss injections or arthroscopy if needed.