Tendinopathy of the rotator cuff
This is a degenerative or traumatic lesion at the rotator cuff tendons which is a frequent source of pain and functional disability, particularly after age 40.
These tendons make up the end section of the muscles surrounding the head of the humerus connected at the shoulder blade and at the other end on the upper extremity of the humerus, and allow for elevation of the arm and rotational movements.
A particularity of these tendons is that they are « sandwiched » between the head of the humerus and the acromion, which is an « excrescence » of the scapula located above the shoulder. With time, or following an accident or repetitive movements, these tendons are subject to repeated rubbing which can be worsened by bone formation below the acromion, which proceeds to chip away progressively at the tendons.
Added to the physiological thinning of the tendons caused by age, this phenomenon can lead to irritation or partial/complete rupture of the tendons as well as the development of calcification.
Three major categories of lesion can therefore be distinguished at the rotator cuff:
- The sub acromial conflict, which corresponds to a wearing down of the tendons without a complete rupture.
- Calcific tendinopathy of the shoulder, where calcus-type deposits form in the irritated rotator cuff tendons, often resulting in major pain.
- Rupture of the tendons of the rotator cuff, which represents the advanced stage of this pathology, and which can vary in degree and in gravity and in the long term can lead not only to pain, but also to the complete inability to raise the arm as well as destructive arthritis of the shoulder.