Rotator cuff tears involve one or more of the four muscles of the rotator cuff. These muscles, along with their corresponding tendons, connect the upper arm bone with the shoulder blade. The structure of the rotator cuff helps provide the shoulder with the greatest range of motion of any joint in the body. Rotator cuff injury is also known as pitcher’s shoulder, swimmer’s shoulder and tennis shoulder, largely because it occurs most frequently in athletes practicing sports that require the arm to be moved over the head repeatedly. It is most common in people over the age of 40, but can also occur in younger patients following acute trauma, repetitive overhead work or sports activity. Symptoms include pain, weakness, stiffness, a popping sensation in the shoulder and inability to sleep on the affected shoulder.


Shoulder impingement syndrome is caused by compression of the tendons of the rotator cuff between a part of the shoulder blade and the head of the humerus. Because this compression is caused by any repetitive action that irritates the shoulder bursae or tendons, athletes such as baseball pitchers and tennis players are susceptible to this condition. The same is true of computer users with poor posture or anyone who performs activities involving reaching over the head. Poor alignment of the shoulder joint, as well as bone spurs in the area, can also cause shoulder impingement. Symptoms can include pain of the shoulder area, sharp pain when lifting the arm to the side or in front of the body and pain and generalized soreness after repeated movement or prolonged activity.


Tendonitis and bursitis both involve inflammation of the soft tissue around the muscles and bones of the shoulder. They are typically temporary conditions, but may become recurrent or chronic problems in young and old patients alike. Unlike arthritis, for which they are occasionally mistaken, tendonitis and bursitis do not cause deformity; however, they can cause significant pain and restrict motion. Tendonitis is the inflammation or irritation of tendons, the thick fibrous cords that attach muscle to bone and transmit the power generated by a muscle contraction to move the bone. Bursitis is inflammation or irritation of bursae, the small sacs located between moving structures such as bones, muscles, skin and tendons, that act as cushions to allow smooth gliding between these structures. The most common causes of tendonitis and bursitis are injury or overuse. Both conditions may also be associated with diseases such as rheumatoid arthritis, gout, psoriatic arthritis, thyroid disease and diabetes.