Impingement Syndrome/Rotator Cuff Tendonitis Treatment

Overview

Shoulder impingement occurs when there is not enough space for the rotator cuff tendons to move freely beneath the acromion. This can happen when bone spurs develop with age or when repeated overhead use causes swelling of the rotator cuff muscles and tendons.

This swelling—commonly referred to as rotator cuff inflammation—results in rotator cuff tendonitis, a condition where the tendons become irritated over time due to overuse. Tendonitis involves inflammation of a tendon, the fibrous tissue that connects muscle to bone. In rotator cuff tendonitis, the tendons are inflamed but not torn, distinguishing it from more severe rotator cuff injuries.

What causes Impingement Syndrome/Rotator Cuff Tendonitis?

Shoulder impingement and rotator cuff tendonitis typically develop due to a combination of structural and functional factors.

Primary Causes Include:

• Age-related bone spurs
• Over time, bone spurs can form on the acromion, narrowing the space where the rotator cuff tendons pass and increasing friction.
• Overuse and repetitive overhead motion
• Activities that involve repeated lifting or reaching overhead—such as throwing or swimming—can lead to tendon irritation and inflammation.
• Rotator cuff weakness
• Weak rotator cuff muscles allow the humerus (upper arm bone) to shift upward, further reducing space and worsening impingement.

1. How the Injury Occurs:

• Repeated overhead arm movements
• Gradual tendon irritation rather than a sudden injury
• Poor shoulder mechanics or posture

2. Common Everyday Causes:

• Reaching overhead for extended periods
• Lifting heavy objects improperly
• Prolonged desk work with poor posture

Sports Commonly Associated with Rotator Cuff Tendonitis:

• Baseball – repetitive throwing places stress on the shoulder
• Swimming – continuous overhead strokes irritate the tendons
• Tennis – serving and overhead shots strain the rotator cuff
• Volleyball – frequent spiking and serving
• Golf – repetitive swinging motions affect shoulder mechanics

Symptoms

Symptoms often begin gradually and worsen over time. Common signs include:

• Shoulder pain when lifting the arm or performing overhead movements
• Pain on the outer portion of the shoulder
• Discomfort that worsens when sleeping on the affected side
• Shoulder stiffness and reduced flexibility

If Left Untreated, Symptoms May Progress to:

• Loss of shoulder mobility, making daily tasks difficult
• Loss of strength in the affected arm
• Tendon tearing or rupture, which may require rotator cuff surgery.

Non-operative treatment

The goal of shoulder impingement treatment is to increase the space for the rotator cuff tendons. It is also essential to reduce swelling in the area. One of the most important actions you can take to heal rotator cuff tendonitis is avoiding activities that cause tendon overuse and inflammation. You may also try non-operative treatments to alleviate pain and rotator cuff inflammation associated with rotator cuff tendonitis, such as:

• Resting the affected shoulder and arm
• Applying ice to the affected shoulder
• Anti-inflammatory medication, such as ibuprofen, to reduce swelling
• Physical therapy is used to strengthen the muscles of the shoulder (more specifically, the scapula muscles) and increase the space for the rotator cuff under the acromion.
• Injections for pain relief and to reduce inflammation, such as corticosteroid injections (administered to you by an orthopedic specialist)

You can also try these exercises at home to stretch and strengthen the muscles surrounding the shoulder:

Rotator Cuff Tendinitis

Surgical Treatment

The primary goals of non-surgical rotator cuff injury treatment are to reduce inflammation, relieve pain, and restore shoulder mechanics.

Common Non-Surgical Treatments Include:

• Rest and activity modification to avoid tendon overuse
• Ice application to reduce swelling
• Anti-inflammatory medications such as ibuprofen
• Physical therapy, focusing on strengthening scapular and rotator cuff muscles to increase space under the acromion
• Corticosteroid injections to reduce inflammation and pain

Home exercises may also help stretch and strengthen the shoulder muscles and support recovery.

Rotator Cuff Tendinitis