Rotator Cuff Tendinopathy / Injury

What Is It

The rotator cuff is made up of four muscles that keep the head of the humerus centred in the joint socket and enable shoulder rotation. Tendinopathy is an overload injury of these tendons, most often the supraspinatus, caused by repetitive overhead motion — typical in swimmers, handball players, tennis players and throwing athletes.

Signs & Symptoms

• Pain on the outer side of the shoulder, worsening when raising the arm between roughly 60° and 120°
• Pain that appears or worsens with overhead and throwing motions
• Night pain, particularly when lying on the affected side
• Gradual weakening of rotational strength and throwing power
• A grinding or catching sensation during circular arm movements

Cause & Mechanism

Develops through cumulative overload of the rotator cuff tendons, most often from a sudden increase in throwing or overhead training volume, weak scapular stabilisers, or poor shoulder movement patterns. In older athletes it may be accompanied by structural narrowing of the space the tendon passes through.

Diagnosis

Clinical tests (Neer and Hawkins tests, individual cuff muscle strength tests) indicate the affected tendon. Ultrasound is a fast and reliable method for assessing tendinopathy and any partial tear, while MRI is used when a full-thickness tear or associated labral pathology is suspected.

Treatment With Us

The foundation of treatment is a progressive rotator cuff and scapular stabiliser strengthening programme, alongside a temporary adjustment of overhead training volume. For persistent pain PRP therapy may be considered to accelerate tendon healing; surgery is considered only for a confirmed full-thickness tear unresponsive to conservative treatment.