Tendinitis in the shoulder can lead to a tear called a rotator cuff tear. A rotator cuff tear can occur suddenly or gradually from many tiny tears from overuse and aging. The gradual kind of injury can be caused by chronic wear and tear with the breakdown of the tendon.
Some athletes who have a lot of throwing movement in their sport or heavy weight lifting are more prone to rotator cuff tears including pitchers in baseball, swimmers and tennis players, golfers, basketball players, tennis players, runners and even people who bowl.
Some occupations, hobbies and sports involve repeating the same motions over and over, and this can damage a tendon: typing, clicking a mouse, clenching a steering wheel or using power tools, gardening, shoveling, raking and painting. Sudden tears are more likely when there has already been wear and tear on the tendon. Abrupt stress causes one of the tendons to pull away from the bone or tear in the middle of the tendon. You can also tear a rotator cuff by falling on your shoulder or using your arm to break a fall and lifting heavy weights.
The incidence of tendon injury increases with age, and it's especially common after age 40. Some medical conditions can increase the risk, including arthritis, gout and thyroid disorders.
- Pain, usually with overhead activities
- Catching, locking, popping, or grinding sound when you use the tendon
- Occasional night pain or pain with daily activities
- A sense of instability in the shoulder
- Decreased range of motion
- Loss of strength
Because the rim of the shoulder socket is soft tissue, x-rays will not show damage to it. The doctor may order a computed tomography (CT) scan or magnetic resonance imaging (MRI) scan. In both instances, a contrast medium may be injected to help detect tears. Ultimately, however, the diagnosis will be made with arthroscopic surgery.
Sudden, severe trauma can damage the tendons instantly, and may require arthroscopic surgery, a minimally invasive procedure using a camera to repair the tear.