At younger patients tendinitis of the rotator cuff is mostly connected with an acute overloading during explosive movement, with a normal movement at the glenohumeral instability or with an injury. It results already from the description of causes that it is not possible to differ a small rupture from inflammations of the rotator cuff (even so this division is strict for most doctors), or an irrelevant reaction of the tendon on the overloading. It is obvious that the name of tendinitis of the rotator cuff is rather speculative because there is no possibility of any objective examination only from clinical picture, and it should be connected to MRI or ultrasound which are able to differ types of the affection from a certain extension.
After overloading of the tendon there is progress of pathological states with a certain strength, which have a similar clinical picture according to the level of this overloading:
Benign overloading of the tendon with possible progress of a myofascial syndrome
But we have to stress again that most frequently we were finding traumatic tenovaginitis of the long head of the biceps during ultrasound examinations at patients with the diagnosis of tendinitis of the rotator cuff. This tendon, or better to say synovial sheath, is more sensitive to damages than the rotator cuff.
Pains during the examination of an isometric contraction of muscles of the rotator cuff, and pains during the examination of an extension of an active and an passive movement1. Passive movements are less painful. Resting pains are smaller in comparison with pains called up by the movement and isometric contraction.
Light weakness of strength of the contraction of affected muscles of the rotator cuff.
Spasm of the muscle and triggering points in the affected muscle (see myofascial syndrome).
1Maximal soresness of isometric contraction can correspond to the affected muscle of the rotator cuff, but mostly it is not possible to specify exactly which muscle it is.