ROTATOR CUFF CONDITIONS
Rotator Cuff Tendinitis
vs. Rotator Cuff Tear
Shoulder pain does not always mean the rotator cuff is torn. Many patients with shoulder pain have inflammation of the rotator cuff rather than a tear, while others have both conditions at the same time. Determining the correct diagnosis is the first step toward choosing the right treatment.
Inflamed Tendon
Damaged Tendon Fibers
History + Examination + Imaging
Depends On The Cause
What Is Rotator Cuff Tendinitis?
Rotator cuff tendinitis refers to inflammation and irritation of the rotator cuff tendons. It often develops from repetitive overhead activity, increased activity levels, or age-related tendon degeneration.
Unlike a rotator cuff tear, the tendon remains structurally intact, although it may become thickened, painful, and weakened by inflammation.
What Is A Rotator Cuff Tear?
A rotator cuff tear occurs when the tendon fibers become partially or completely disrupted. Tears may develop gradually over time or occur suddenly after an injury.
Partial-thickness tears involve only part of the tendon, while full-thickness tears extend completely through the tendon.
Dr. Streit's Clinical Perspective
One of the most important parts of an office visit is determining whether the pain is coming from inflammation alone, a structural tendon tear, or another shoulder problem entirely. Those conditions often require different treatment strategies.
Symptoms Compared
Rotator Cuff Tendinitis
- Pain with overhead activity
- Pain after exercise
- Night pain may occur
- Usually maintains strength
- Often gradual onset
- Pain is the primary complaint
Rotator Cuff Tear
- Pain with overhead activity
- Weakness becomes more noticeable
- Difficulty lifting the arm
- Loss of endurance
- May follow an injury
- Progressive loss of function
Can The Symptoms Overlap?
Absolutely.
Many patients with rotator cuff tears also have tendon inflammation. Likewise, patients with tendinitis may experience pain that feels very similar to a tear. That is why the physical examination remains one of the most important parts of the evaluation.
How Is The Diagnosis Made?
History
Understanding when the pain started and how it behaves.
Physical Examination
Evaluating motion, strength, shoulder mechanics, and specific rotator cuff tests.
X-rays
Evaluating arthritis, bone spurs, fractures, and other causes of pain.
MRI
Used when the diagnosis remains uncertain or a structural tear is suspected.
What I Tell My Patients
"The MRI is only one piece of the puzzle. I combine your history, physical examination, X-rays, and imaging to determine what is actually causing your shoulder pain."
Treatment Options
Physical Therapy
Often the first treatment for both tendinitis and many rotator cuff tears.
Anti-inflammatory Treatment
Medication, activity modification, and selected corticosteroid injections may reduce pain.
Surgery
Considered when structural tendon damage and persistent symptoms make repair the best option.
When Should You See A Shoulder Specialist?
- Shoulder pain lasting more than several weeks
- Persistent night pain
- Weakness lifting the arm
- Pain after a fall or injury
- Loss of shoulder function
- Failure of physical therapy or other conservative treatment
Related Resources
Not Sure What's Causing Your Shoulder Pain?
A careful shoulder evaluation can determine whether your pain is caused by rotator cuff tendinitis, a rotator cuff tear, or another shoulder condition so that treatment is directed at the actual problem.
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