Rotator Cuff Tendinitis

Treatment of Rotator Cuff Tendinitis

Shoulder pain and weakness complaints among patients of different age groups are frequently caused by rotator cuff injuries. The rotator cuff is a set of four tendons and four small muscles in the shoulder that helps to lift and rotate the arm. Its most important function is however in control of gliding of the humeral head under acromial arch during lifting of the arm. Rotator cuff tendons can be damaged due to various reasons such as acute injury, overuse in professional activities and sports, poor shoulder position due to poor posture, etc.

The rotator cuff tendon disease, refers to injuries of two different types: tendinitis and tendinosis, which should not be confused as they have different nature and require different treatment. Rotator cuff tendinitis refers to tendon injuries accompanied by inflammation while tendonisis involves damage to a tendon at a cellular level. Tendinosis is often misdiagnosed as tendinitis. It should be noted that tendinosis is characterized by degenerative changes in the collagenous matrix, hypercellularity, hypervascularity and a lack of inflammatory cells, which are specific to tendinitis. Proper diagnostics is important for detecting the type of tendinopathy and prescribing adequate treatment.

Since tendon degeneration does not involve inflammation it does not respond to anti-inflammatory medication.

Why Does Rotator Cuff Tendinitis and Tendinosis Occur?

The acute pain in the rotator cuff appears from an abrupt motion like lifting something heavy in an unusual way, throwing something forcefully or falling down on a shoulder or an arm. The pain can appear after overloading shoulder muscles in a gym especially when using a poor technique or excessive weight. Rotator cuff tendinitis is very common for sports, mostly baseball (especially among pitchers), tennis, cricket, swimming and kayaking. On the other hand rotator cuff atrophy caused by the lack of exercise and movement in a shoulder, can lead to tendinosis because of misbalance between different muscles will cause abnormal gliding of the humeral head and wear and tear on the cuff tendons. This also refers to poor shoulder position while sitting at the desk uncomfortably or driving all day.

What Are the Symptoms?

The symptoms for the rotator cuff tendinosis would be pain in the front or side of the shoulder which spreads to the side of the arm and difficulty in lifting the arm or reaching behind the back. Usually the pain gets worse when the activity continues. Many patients can’t sleep on the shoulder because of the pain. Also a popping or cracking sensation and general weakness would be signals for visiting a doctor.

Treatment Options

One type of treatment for rotator cuff tendinosis is platelet-rich plasma (PRP) injections. Blood plasma enriched with platelets is supposed to stimulate healing of bone and soft tissue however its efficacy and safety have not been proven on a large scale due to inconsistent results in many clinical trials. The method is dependent on the quality of plasma and it is difficult to determine the dosage. Besides, the treatment often cause side effects. Recipients of PRP injections may experience increase in pain in the treated area or intense discomfort in the muscle or bone. Also there is a possibility of infection regardless of sterilization.

Physical Therapy

The conventional treatment for rotator cuff tendinosis implies a number of rehabilitation exercises for strengthening of rotator cuff. Our approach is based on Dynamic Neuromuscular Stabilization (DNS) which combines precise positioning of the shoulder blade and humerus in specific developmental positions with the sole purpose of optimizing muscle function of rotator cuff and the whole shoulder girdle. When proper movement is restored and there are no conflicts of the humeral head under the acromial arch the pain disappears as the irritant is removed. While traditional physical therapy emphasizes strengthening the rotator cuff muscles we begin with restoration of motor control and muscular synergies and then move onto strengthening the rotator cuff. The core of DNR is Dynamic Neuromuscular Stabilization, an effective system of exercise originated from the famous Prague School of Physical Rehabilitation. This European revolutionary treatment is suitable for all ages and physical conditions and proves its high effectiveness in treating neuromuscular problems. In addition to DNS exercise, ESWT is of great importance.

The Benefits of ESWT (Extracorporeal Shockwave Therapy)

The Extracorporeal shockwave therapy is a method of treatment for multiple tendonopathies that regenerates degenerated parts of the tendon by growing new micro blood vessels around it. This biological process is called neovascularization. It’s a safe and effective method that excludes risk of infection and scar tissue formation. ESWT can be performed only after ultra sound or MRI diagnostics.

The procedure eliminates pain and restores full mobility. The beneficial effects of ESWT usually appear after only 4 treatments. Some patients experience immediate pain relief.

Our Approach

Being the first to apply the DNS method in the US, New York Dynamic Neuromuscular Rehabilitation Center presents the most modern and comprehensive rehabilitation approach. The effectiveness of DNS method in treatment of rotator cuff injuries is marked by the fact that many professional tennis and baseball players use DNS shoulder pain therapy and DNS exercises for post-traumatic rehabilitation and prevention. As one of the first DNS practitioners in the US Dr. Kalika serves as injury prevention consultant for top professional tennis players. However, the application of DNS therapy does not restrict its effectiveness to sports medicine and is equally suitable for all patient groups. Successfully combining DNS with physical therapy, chiropractic methods and rehabilitation techniques and using the most advanced equipment we help people recover and prevent neuromuscular pain.

Redcord Neurac Therapy:
Suspension Training Meets Physical Therapy for Rehab, Fitness and Performance
Your body is a masterpiece of form and function, designed to move in fluid and coordinated patterns governed by your nervous system. But oftentimes, overuse, underuse or abuse of your muscular system can result in pain, injury, uncoordinated movement and poor performance. Thankfully, through proper training and rehabilitation, your miraculous body is able to heal and recoup its natural functional capacity.

Rotator Cuff Tendinitis

Treatment of Rotator Cuff Tendinitis

Shoulder pain and weakness complaints among patients of different age groups are frequently caused by rotator cuff injuries. The rotator cuff is a set of four tendons and four small muscles in the shoulder that helps to lift and rotate the arm. Its most important function is however in control of gliding of the humeral head under acromial arch during lifting of the arm. Rotator cuff tendons can be damaged due to various reasons such as acute injury, overuse in professional activities and sports, poor shoulder position due to poor posture, etc.

The rotator cuff tendon disease, refers to injuries of two different types: tendinitis and tendinosis, which should not be confused as they have different nature and require different treatment. Rotator cuff tendinitis refers to tendon injuries accompanied by inflammation while tendonisis involves damage to a tendon at a cellular level. Tendinosis is often misdiagnosed as tendinitis. It should be noted that tendinosis is characterized by degenerative changes in the collagenous matrix, hypercellularity, hypervascularity and a lack of inflammatory cells, which are specific to tendinitis. Proper diagnostics is important for detecting the type of tendinopathy and prescribing adequate treatment.

Since tendon degeneration does not involve inflammation it does not respond to anti-inflammatory medication.

Why Does Rotator Cuff Tendinitis and Tendinosis Occur?

The acute pain in the rotator cuff appears from an abrupt motion like lifting something heavy in an unusual way, throwing something forcefully or falling down on a shoulder or an arm. The pain can appear after overloading shoulder muscles in a gym especially when using a poor technique or excessive weight. Rotator cuff tendinitis is very common for sports, mostly baseball (especially among pitchers), tennis, cricket, swimming and kayaking. On the other hand rotator cuff atrophy caused by the lack of exercise and movement in a shoulder, can lead to tendinosis because of misbalance between different muscles will cause abnormal gliding of the humeral head and wear and tear on the cuff tendons. This also refers to poor shoulder position while sitting at the desk uncomfortably or driving all day.

What Are the Symptoms?

The symptoms for the rotator cuff tendinosis would be pain in the front or side of the shoulder which spreads to the side of the arm and difficulty in lifting the arm or reaching behind the back. Usually the pain gets worse when the activity continues. Many patients can’t sleep on the shoulder because of the pain. Also a popping or cracking sensation and general weakness would be signals for visiting a doctor.

Treatment Options

One type of treatment for rotator cuff tendinosis is platelet-rich plasma (PRP) injections. Blood plasma enriched with platelets is supposed to stimulate healing of bone and soft tissue however its efficacy and safety have not been proven on a large scale due to inconsistent results in many clinical trials. The method is dependent on the quality of plasma and it is difficult to determine the dosage. Besides, the treatment often cause side effects. Recipients of PRP injections may experience increase in pain in the treated area or intense discomfort in the muscle or bone. Also there is a possibility of infection regardless of sterilization.

Physical Therapy

The conventional treatment for rotator cuff tendinosis implies a number of rehabilitation exercises for strengthening of rotator cuff. Our approach is based on Dynamic Neuromuscular Stabilization (DNS) which combines precise positioning of the shoulder blade and humerus in specific developmental positions with the sole purpose of optimizing muscle function of rotator cuff and the whole shoulder girdle. When proper movement is restored and there are no conflicts of the humeral head under the acromial arch the pain disappears as the irritant is removed. While traditional physical therapy emphasizes strengthening the rotator cuff muscles we begin with restoration of motor control and muscular synergies and then move onto strengthening the rotator cuff. The core of DNR is Dynamic Neuromuscular Stabilization, an effective system of exercise originated from the famous Prague School of Physical Rehabilitation. This European revolutionary treatment is suitable for all ages and physical conditions and proves its high effectiveness in treating neuromuscular problems. In addition to DNS exercise, ESWT is of great importance.

The Benefits of ESWT (Extracorporeal Shockwave Therapy)

The Extracorporeal shockwave therapy is a method of treatment for multiple tendonopathies that regenerates degenerated parts of the tendon by growing new micro blood vessels around it. This biological process is called neovascularization. It’s a safe and effective method that excludes risk of infection and scar tissue formation. ESWT can be performed only after ultra sound or MRI diagnostics.

The procedure eliminates pain and restores full mobility. The beneficial effects of ESWT usually appear after only 4 treatments. Some patients experience immediate pain relief.

Our Approach

Being the first to apply the DNS method in the US, New York Dynamic Neuromuscular Rehabilitation Center presents the most modern and comprehensive rehabilitation approach. The effectiveness of DNS method in treatment of rotator cuff injuries is marked by the fact that many professional tennis and baseball players use DNS shoulder pain therapy and DNS exercises for post-traumatic rehabilitation and prevention. As one of the first DNS practitioners in the US Dr. Kalika serves as injury prevention consultant for top professional tennis players. However, the application of DNS therapy does not restrict its effectiveness to sports medicine and is equally suitable for all patient groups. Successfully combining DNS with physical therapy, chiropractic methods and rehabilitation techniques and using the most advanced equipment we help people recover and prevent neuromuscular pain.

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