Rotator Cuff Tendinopathy

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Rotator cuff tendinopathy describes a painful, degenerative change within the cuff tendons — most often the supraspinatus — without a full-thickness tear. The tendon becomes thickened, disorganized, and painful under load. It exists on a continuum with partial-thickness tearing and, in some cases, progresses to complete rupture. Calcific tendinopathy — calcium deposits within the tendon — is a common painful variant.

Lateral shoulder and upper arm pain, especially with reaching overhead and lifting. Tenderness over the greater tuberosity. Painful arc of motion between 60–120° of abduction. X-rays may show calcium deposits. Ultrasound and MRI identify tendon thickening, intratendinous signal change, and partial tearing.

1. Barbotage (needle lavage)

   Ultrasound-guided needling and irrigation of calcium deposits in calcific tendinopathy — highly effective for the calcific variant.

2. Extracorporeal shock wave therapy (ESWT)

   Evidence-based non-invasive treatment for calcific tendinopathy and chronic rotator cuff tendinopathy.

3. PRP injection

   Intratendinous PRP for partial-thickness tears not responding to rehabilitation.

Refractory calcific tendinopathy or partial-thickness tears progressing despite 6+ months of conservative treatment may be considered for arthroscopic intervention.

External patient-education references and related OSI pages for additional background:

• Britannica — Tendinitis
• Britannica — Shoulder (anatomy)
• AAOS OrthoInfo — patient education library
• OSI glossary — orthopedic terminology in plain language