From the Guidelines
Rotator cuff tendonitis is primarily caused by a combination of repetitive overhead activities, age-related degeneration, and traumatic injuries, which irritate or damage the tendons connecting the shoulder muscles to the upper arm bone. This condition commonly develops from overuse during sports like swimming, baseball, and tennis, or occupations requiring frequent lifting or overhead work, as noted in 1 and 1. Age-related degeneration also plays a significant role, as tendons naturally lose strength and flexibility over time, making them more susceptible to inflammation and tears, particularly after age 40, as mentioned in 1.
Some key factors that contribute to the development of rotator cuff tendonitis include:
- Repetitive overhead activities and movements
- Age-related degeneration
- Traumatic injuries such as falls or direct blows to the shoulder
- Poor posture, muscle imbalances around the shoulder, and improper lifting techniques
- Anatomical factors including bone spurs under the acromion, which can create impingement and lead to tendonitis, as discussed in 1 and 1.
It's worth noting that the term "tendonitis" might be misleading, as most cases are actually degenerative conditions rather than inflammatory ones, as pointed out in 1. However, the underlying causes and risk factors remain the same, and understanding these is crucial for preventing and managing rotator cuff tendonitis. The most recent and highest quality evidence, as seen in 1 and 1, suggests that a combination of these factors contributes to the development of rotator cuff tendonitis, and addressing these factors is essential for effective prevention and treatment.
From the Research
Rotator Cuff Tendonitis Etiology
The causes of rotator cuff tendonitis are multifaceted and can be attributed to various factors. Some of the key factors include:
- Trauma: Rotator cuff tendon tears can occur due to trauma, which can lead to tendonitis 2
- Natural degeneration: The rotator cuff tendons can degenerate over time, leading to tendonitis 2
- Repetitive stress: The tendon-bone interface of the rotator cuff experiences immense stress, making it prone to failure and tendonitis 2
- Intrinsic protective mechanisms: The rotator cuff has intrinsic protective mechanisms, such as the rotator crescent or coronal-transverse force, which can help redistribute stress and prevent tendonitis 2
Pathogenesis and Biomechanics
The pathogenesis and biomechanics of rotator cuff tendonitis involve the interplay of various factors, including:
- Location, size, and type of rotator cuff tendon tears: These factors can influence the development of tendonitis and the effectiveness of treatment 2
- Intrinsic healing: The rotator cuff tendons have an intrinsic healing process, which can be flawed and lead to reinjury 2
- Biomechanical remodeling: The rotator cuff tendons require biomechanical remodeling to prevent reinjury and promote successful healing 2
Treatment and Management
The treatment and management of rotator cuff tendonitis involve various injection therapies, including:
- Corticosteroid injection: Can provide short-term pain relief and functional improvement, but may not be effective in the long term 3, 4
- Platelet-rich plasma (PRP) injection: Can provide superior short-term pain relief and functional improvement compared to corticosteroid injection, but may not have a sustained benefit in the long term 3, 4, 5
- Prolotherapy: Can provide long-term pain reduction and functional improvement, but may have limited evidence to support its effectiveness 4