How to Tell the Difference Between Rotator Cuff Tear and Tendonitis

Shoulder pain is often linked to problems within the rotator cuff, a group of muscles and tendons that stabilize the shoulder joint. Two common conditions that affect the rotator cuff are rotator cuff tendonitis and rotator cuff tears. While they share similar symptoms, there are key differences between the two that can help you identify which condition you might be dealing with. Understanding these differences is essential for seeking appropriate treatment and avoiding further injury.

What Is Rotator Cuff Tendonitis?

Rotator cuff tendonitis occurs when the tendons in the rotator cuff become inflamed, often due to overuse, repetitive overhead motions, or gradual wear and tear. The inflammation leads to pain, particularly when moving the shoulder, lifting objects, or reaching overhead. The pain tends to be dull and aching, and it may worsen at night or after activity. However, tendonitis typically doesn’t cause a sudden loss of strength or severe weakness in the shoulder.

What Is a Rotator Cuff Tear?

A rotator cuff tear, on the other hand, is a more serious condition where one or more of the tendons in the rotator cuff are partially or completely torn. Tears can result from acute injuries like falling on an outstretched arm or from chronic degeneration over time. A rotator cuff tear often leads to sharper, more intense pain compared to tendonitis and is usually accompanied by noticeable weakness in the shoulder. Many people with a tear struggle to lift their arm or perform overhead movements without assistance.

Key Differences Between Tendonitis and a Tear

• Onset of Symptoms: Tendonitis pain tends to develop gradually and worsens with activity. A rotator cuff tear may cause sudden, sharp pain at the time of injury.
• Severity of Pain: Tendonitis usually results in dull, aching pain, while a tear leads to sharper, more intense discomfort.
• Weakness: Tendonitis may cause discomfort but generally does not result in significant weakness. A tear often leads to difficulty lifting the arm and noticeable strength loss.
• Clicking or Popping Sensation: More commonly associated with rotator cuff tears, though it can occasionally occur with tendonitis.

Getting a Proper Diagnosis

Because the symptoms of tendonitis and a rotator cuff tear can overlap, it’s important to consult a healthcare provider for an accurate diagnosis. A physical exam, along with imaging tests like an MRI or ultrasound, can confirm whether the issue is inflammation (tendonitis) or an actual tear in the tendon.

In summary, while both conditions cause shoulder pain, rotator cuff tendonitis typically results in gradual discomfort without major weakness, whereas a rotator cuff tear is often linked to sharper pain, limited movement, and noticeable strength loss. Early diagnosis and treatment can prevent the condition from worsening and help restore shoulder function.