Rotator Cuff tendinopathy
Rotator cuff tendinopathy is a common condition affecting the shoulder, especially in individuals who perform repetitive overhead movements or participate in activities that place stress on the shoulder joint. It is a type of rotator cuff injury that involves inflammation, degeneration, or tearing of the tendons in the rotator cuff, a group of four muscles and their associated tendons that stabilize the shoulder. In contrast a frozen shoulder (also known as adhesive capsulitis) is a condition characterised by a dull or aching pain with limited range of motion (ROM).
Symptoms
- A dull deep shoulder ache
- Pain that disturbs sleep
- Swelling in the shoulder area
- Limitation or discomfort with overhead movement and with moving the arm behind the back
- Arm weakness
- If left untreated, rotator cuff tendinitis can worsen and lead to a partially or completely torn tendon
Common causes of rotator cuff injuries include:
- Repetitive overhead movements making rotator cuff injuries common across a diverse patient population.
- Trauma such as falls, rapid humeral deceleration with throwers, or high resistive forces applied through the shoulder.
- Individuals over the age of 60 are more prone to rotator cuff injury.
- Subacromial bone spurs can contribute to impingement, leading to an increased likelihood of rotator cuff pathology.
- Weakness or imbalance of muscles surrounding the shoulder joint.
Interventions
Treatment options include conservative treatments, physical therapy and strengthening exercises. Dry Needling and Acupuncture can be used to release tension, improve blood flow and provide pain relief in some cases of rotator cuff tendinopathy.
Medical and Surgical Modalities such as NSAIDs, Corticosteroid Injections and/or Platelet-Rich Plasma (PRP) Therapy can be recommended as part of a treatment programme.
Shockwave Therapy (ESWT)
ESWT (Extracorporeal Shockwave Therapy), also known as Radial Shockwave (RSW) therapy, is a non-invasive treatment option that has support in the literature for helping address muscle aches and pains associated with shoulder dysfunction. During treatment with ESWT, high-energy sound waves are transmitted into the tissue propagating radially and creating a therapeutic effect on the impacted areas. Xue et al (2024) in their systematic review of 16 Randomised Control Trials (1093 patients) showed that the current evidence supports the effectiveness of Shockwave Therapy for the clinical efficacy of shoulder pain and functional recovery in patients with Rotator Cuff Tendinopathy. Shockwave Therapy provides better pain relief, functional recovery, and maintenance compared with controls.
Shao et al (2023) demonstrated a five week course of Shockwave Therapy and exercise more effectively reduced early shoulder pain than rehabilitation alone and accelerated proximal supraspinatus tendon healing at the suture anchor site after Rotator Cuff repair.
High Power Laser Treatment:
This systematic review and meta-analysis (Hao et al 2024) aimed to identify, critically appraise, and summarize the effects of high-intensity laser therapy on subacromial impingement syndrome. The authors concluded that high-intensity laser therapy is an effective treatment for subacromial impingement syndrome to augment conventional rehabilitation protocol and optimize therapeutic outcomes. They added that rehabilitation professionals and policymakers should increase their awareness of high-intensity laser therapy as an emerging technology that may facilitate greater outcomes than current widespread standards.
Yilmaz et al 2022, also demonstrated the effectiveness of high intensity laser therapy on pain, range of motion, functional capacity, quality of life, and muscle strength in subacromial impingement syndrome in this 3-month follow-up, double-blinded, randomized, placebo-controlled trial.
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